Datasets:

ophycare

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icliniq-dataset-1

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Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I 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.