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 have a painful armpit lump. Please suggest. ### Response: It is an infection. Take tablet Cefixime 200 mg twice daily for five days, Mupirocin ointment daily for five days. Take antiseptic soap for bathing. Tablet Aceclofenac and Serratiopeptidase once daily if there is pain. Review after five days. Infection will subside, if lump remains it need to be removed surgically. Send a photo after five days. Bacterial infection. Fasting blood sugar.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Before two days, I had sex with a sex worker for the first time. I used a condom for the sex. But my condom got broken. I did not see it for a few minutes. Now I am afraid of any sexual problem that can come in the future like HIV. I am totally upset, and I lost my hope. Please advice what should I do? ### Response: Hi. Yes, there is a chance of HIV transmission with unprotected sex. But the risk is just one in 300. In other terms, it is only 0.3 %. The risk could be less if there were no mucosal lesions for you and your sexual partner. Regarding other infections, the risk is there. But most of them are treatable. I will request you to see a Dermatologist for investigation and treatment. For most diseases, it takes time to get confirmed by blood reports. You need to go for tests after three months of a sexual encounter to make sure that you are not infected. It is not a time to get panic. Try to see your doctor without any delay.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have weight loss, cholesterol problem, and low vitamin D level. Please do check my attached blood reports and let me know if I have any other problem. ### Response: Hi. I have gone through your reports (attachment removed to protect patient identity). Based on your query, my opinion is as follows: Alcohol might be a cause for the liver related changes. Nothing major to worry for now. You will have to repeat the tests especially lipid profile and liver functions tests after 6 months to look for any changes. Avoiding alcohol should help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a cluster of small red dots on side of the knee. It looks like a hickey. It is smooth, painless, and itch-free. It has been on the knee for about two months. I have attached images for your reference. What medicines should I take? ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have GERD and was recently diagnosed with equivocal H. pylori after symptoms of wet mouth (not to the point of drooling), mild intermittent nausea (no gag or vomit) and minor upper abdomen discomfort. I completed the triple treatment (two antibiotics, Omeprazole) three weeks ago. The upper abdomen discomfort is gone. I still have mild intermittent nausea and loose stools and pretty consistent wet mouth (though still no drooling or spitting). Can this be GERD related? H. pylori possibly not eradicated? Or something entirely different such as C. diff, SIBO, etc? I have a follow up with my primary next week but cannot get in to see a GI for another month. ### Response: Hello. Nothing to worry. The loose stools may be secondary to antibiotics which you had. You can have some probiotics if it is persistent. Hope you have modified your diet and daily activities to reduce GERD (gastroesophageal reflux disease). Judicious use of Omeprazole or Rantac (Ranitidine) can help you in case of recurrent GERD. Hope your queries have been cleared

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have been dealing with a sinus odor problem for years. I am a fair online researcher and I have been shocked by how unique my problem seems to be. The odor varies in strength and seems to disappear and return over time. I have seen numerous ENT specialists over the years and with the exception of one, they seem to be totally baffled by what is going on. This is an odor that at times, it can be so strong that people can detect it when I walk into a room. Using Mupirocin in my nostrils and I am also doing the upside down nasal rinse with saline solution and peroxide. I thought they were helping but I am starting to have my doubts. I was addicted to nasal spray for many years and I am worried that I did some damage to my sinus cavity. Please advise. ### Response: Hi. You may have atrophic rhinitis due to long use of intranasal sprays. Do you have any hard crest inside your nose? What about your smell sensation? Please send me your CT scan

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am super scared. I am 30 years old and have been in the hospital for nephrotic syndrome which was discovered to be membranous nephropathy. They tested my blood for many conditions which could be a secondary cause including hepatitis and autoimmune and nothing came up. Now, they are searching my body for malignancies. I am terrified that an MRI showed a growth on my pancreas. I have no symptoms of pancreatic cancer. No jaundice and no pain. However, a paternal great grandmother died of pancreatic cancer in her 60s.Please look over these notes from my chart. Worse case scenario, if the biopsy finds a malignancy, in your opinion is this something that can be operated on? Does it appear to have been caught early? I am terrified. I am an only child for my mother and I do not want to leave my mom. ### Response: Hi. As far as pancreatic mass is concerned, there are high chances for your mass to be benign lesions. So there is nothing to worry. Follow proper instructions for nephrotic syn

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 23 years old, and I took an I-pill after having unprotected sex within 48 hours. I took the pill a month back; it was five days after I had completed my periods for that month. After taking the pill on the fifth day, I had the flow similar to my periods for five days. But I am worried that I have not got my periods this month yet and am still waiting for periods till date. Please tell me what is happening with my menstrual cycle. I am worried and need your help. ### Response: Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So, relax and do not worry. So, you can be double sure that there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. However, if you have a doubt then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact cause

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My 71-year-old father was admitted to the hospital for palpitation occurrence and fast heart beating at 143 beats per minute. He was feeling dizziness in the morning. He was given injections to reduce the heart rate and has taken Holter monitoring for one day. He had previously undergone two stent placements for blocks. According to his Holter reading, the doctor said his heart pauses for two seconds sometime in 24 hours. He has both bradycardia and tachycardia. They suggested him a biventricular pacemaker implantation that is a St. Jude medical pacemaker. He is allergic to Penicillin. During his discharge, he was prescribed the following medicines: Prolomet XL 25 mg two times a day, Xarelto once a day, Glycomet-GP 1 one and a half tablets a day, Ecosprin AV 150/10 capsules one a day, and Pantocid one a day. He takes his medicines regularly but once in 10 days, the palpitation occurs for about 10 to 15 minutes ranging 20 and sometimes 105 and then it stops. Palpitation does not come every day. The doctor says there is no need to worry. My concern is why does the palpitation occur even after the pacemaker implantation. Is there any way to stop the palpitation? Is it a serious issue. Please help me. ### Response: I have gone through the report that you have provided. In this case, the pacemaker avoids his bradycardia episodes only.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My fiance had her periods (period started) five days before, we had oral sex on the fourth day, and I had precum. When I tried to enter her vagina, she said it is paining, and we stopped. I have not ejaculated. Is there any chance of pregnancy? She had her period regularly after 28 days. If chances are there for pregnancy, please suggest pills to avoid it. When to take and can she take pills in the evening? ### Response: Hello. If her cycles are regular, then you had sexual activity in a safe period, and there is no risk of pregnancy. No need to get worried. Also, the sexual activity you had does not result in pregnancy. So you can stay relaxed and there is no need to take any pills to avoid pregnancy. Use condoms during sex to remain safe, and emergency pills are alternative but should be used in accidental or emergencies only.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I was diagnosed with dengue towards the end of last month. I was hospitalized for five days. I went through a lot during that period and since coming out of the hospital, I have developed this phobia that I might have dengue again because my area is dengue prone with lots of mosquitoes. Whenever a mosquito bites me, I get filled with this fear that I might have dengue again.When I went to my doctor with this fear, he told me dengue does not happen twice in the same season, it can happen again in the next season, but it cannot happen again this season.I want to ask if this is true? If it is true, then what is the logic behind that? Can you please explain? I am immensely afraid of the disease. ### Response: The fact that dengue cannot happen in the same season is true to some extent but not absolutely. Let me explain. Dengue is a viral infection caused by the bite of infected ades aegypti mosquito. Every mosquito bite will not lead to dengue fever as for infection to happen. First, the mosquito should be infected by the dengue virus (DEV). By infection of the mosquito I mean, the mosquito just serves as a vector or carrier for virus transfer to humans. Also, every mosquito carrying the dengue virus would not lead to dengue fever, shock, etc. Some people just have subclinical, asymptomatic infections too. There are actually four types of dengue viruses numbered from 1 to 4. Infection with one type, followed by recovery confers immunity to that type of infection. Our body produces antibodies against the virus and protects us from further infection, with time these antibodies fade away. So immunity in DEV is present but is short-lived. It can be said that the infection cannot occur in the same season, but if an infection with another type say (DEV type 1 followed by DEV type 2) occurs, the body does not have antibodies which are protective against type 2, as the body was previously infected by DEV type 1. This type of infection is more dangerous. However, in a season only one type of DEV infection occurs usually. I hope this helps.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a body pain in the back left of my body, and I have pain on the backside of the head. Nowadays, I am waking up automatically during midnight, and I have a feeling of having reduced breathing. I am an asthma patient. I am using Budamate 200 inhaler. Is this due to my asthma problem or any other? ### Response: Hi. I can understand your concern and your symptoms could be related to a tension-type headache. You can have a wrong posture. Waking up in midnight can happen due to asthma or a panic attack. For this reason, it is essential to do a pulmonary function test and a cervical spine X-ray study.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I was diagnosed with ED after a penile Doppler study and observed with low blood flow. We both have been checked and confirmed with no issues with HSG (tube test, semen analysis, etc.). As we want to have a baby, and all the reports are normal, (only problem is ED, not able to perform intercourse), the doctor has suggested self-insemination at home. He has given a catheter, a container for collecting sperm and syringes to perform the self insemination. He suggested to add equivalent amount of ringer lactate solution with the sperm collected in the container. Then, take the mixture in a syringe and flow into the vagina through a catheter. We just want to have a second opinion to know whether it works out and mainly want to know why we need to add ringer lactate solution along with the sperm. What is the importance of adding ringer lactate? Is it mandatory to add this solution or can we do without the solution? Your inputs will help us to know the process in a better way. ### Response: Ringer lactate is not mandatory. Sometimes, it helps with the sperm speed, but you can do without it. Your erection problem may be due to stress or anxiety or due to any medicine or nutritional supplement if you are taking any. Penile Doppler often gives erroneous results. Usually, it is not performed properly with visual erotica. You need to do blood tests: Depending on the reports, the treatment is decided

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Kid age 9 months. weight not sure. Since Yesterday, she is having loose motion problem. Today also she is having frequent loose motion. ORS solution and paracetamol syrup given, but got little bit control again started. ### Response: - It is very good that you are already giving ORS solution which needs to be given frequently. Loose stools can last for some days before getting better. It will help to clear the body of germs & toxins. I need to ask you a few more questions to guide you in the right direction - How many times /day does she have loose stools ? - is there any blood in stool ? - is she is any pain ? does she cry while having stools ? - is there any vomiting ? - is there any fever ? if there is no fever , there is no need to give paracetamol.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 31 year old male. My microalbumin is 10.3, urine creatinine 313, eGFR 113, microalbumin-creatinine ratio is 3.4 and HbA1c is 6.8. Should microalbumin be 0? Most sites say 20 and below is normal, but 10 is pretty high to me. I had levels done, which showed a microalbumin of less than 3. I worked for 6 hours before the test. I was moving patients around in an operating room, moving beds, etc. Then, I had a big lunch with bacon, sausage and eggs and had my testing done 30 minutes later. I am so worried for this. ### Response: Hi. We are here to help you.To help you better, I need to understand your case a bit more in detail. First of all, you have not mentioned the unit of your urine creatinine.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am starting to get a boil kind of thing on my lips. Picture attached. How can I stop it? I hope it is not herpes. ### Response: I am sorry the picture is slightly blurred (attachment removed to protect patient identity). I am not able to make out if the lesion is a bump or blister or a pustule. It is very important for me to have a clear view of the lesion. Can you please attach clear pictures that focus more on the lesion? This can be: Can you please answer these questions as well so that it helps me narrow down to the most precise diagnosis. Revert with more information to a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I appeared to have an allergic reaction to something, nearly two weeks ago. I was given antihistamines and a seven-day course of steroids (Prednisolone 40 mg). The allergy seems to subside, but it keeps coming back. I cannot be sure about the cause of this allergy. The surrounding skin around my eyes is itchy and red, from today morning. I have attached a photo of the initial flare-up. Please help. ### Response: Hi. I have seen the attached photo (attachment removed to protect patient identity). This is called as acute urticaria with angioedema. It is basically an allergic reaction, which can be due to change in diet or new medications or idiopathic (sometimes the cause cannot be known). Since there is swelling on the lips and eyes, you should visit an emergency room. You will need another course of oral steroid or injectable dose. Continue with the oral antihistamines. And oral steroid should be tapered from 40 mg to lower doses and then stopped. If stopped suddenly at 40 mg, then there can be chances of recurrence. Self-medication is not advised in this condition. Look out for symptoms like difficulty in swallowing or breathing. If they develop, visit a doctor as soon as possible. Do not wait

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am on Metoprolol for CHF. I have got a usual heart rate of 60 to 65 BPM, but tonight my HR is at 90 to 95 BPM. May I take extra Metoprolol to control my HR. ### Response: At first, sit for 5 to 10 minutes comfortably, calm yourself, and recheck your pulse rate. It is not immediately life-threatening to have a heart rate in the range of 90 to 95 with no symptoms. However, if you take an extra dose of Metoprolol, BP may go down as well. So, if your BP is on the higher side and pulse rate continues to stay in that range, then you can have it. But since it is not an emergency, it is better to wait and get yourself checked and then hike up the dose. I hope this helps you and get back if you have any doubts.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have burning sensation while urinating and a frequent urge to urinate. Can it be due to sexual contact? I am a 22 year old male. ### Response: Hi. These symptoms are classical of urinary tract infection, cystitis, prostatitis or urethritis. Yes, they can be acquired by sexual contact. Please get a urine culture and sensitivity done along with ultrasound abdomen, because stones in lower ureter can cause these symptoms. You can start on a good antibiotic like Levofloxacin 500 mg once daily in the morning till you get culture report. Revert back after the tests to a urologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a severe toothache that prevents me from sleeping and eating, and there is a big hole in my teeth. I am currently using Tylenol. ### Response: Hi. It clearly indicates that the tooth is visibly decayed and gone deeper to involve the nerves and blood vessels of that particular tooth. Ideally, there will be sensitivity if the first two layers of the tooth are affected (enamel and dentin). If the third layer (pulp) is involved and further the bugs percolate inside the length of the teeth, then the symptoms you feel would be there. Now the situation looks like you must visit a nearby dentist for either root canal treatment or extraction depending on your preference. The steps involved would be an x-ray first to check the shape of the roots of the tooth (two or three roots if it is a molar tooth). You sound like an emergency, please visit the hospital or ring the dental practices who attend patients with an emergency during the COVID-19 times. Also, adding that pain killers will not help you come out of this for not more than three hours. I highly recommend you to visit the dentist closely.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Since last 7 to 8 months I am having an eye infection, like a stye. It is getting frequent almost after every 3 to 4 weeks. I recollect having collided with somebody about one and half years back, hurt on my right eye with somebody\s elbow and had a swollen eye, very painful and under the eye, it is red and swollen. After about 4 to 5 days, it started healing, and gradually I forgot about it. Now with this frequent infection in the same eye after every 3 to 4 weeks which lasts 3 to 5 days, sometimes pus and little blood come out and sometimes it heals without any pus coming out. This time it started with an itch and has gradually swollen and is very itchy and painful and red and swollen inside and outside the eye. ### Response: This is unrelated to that trauma with the elbow. This is suggestive of lid infection. Once this episode is over then we need to evaluate your lids and lashes carefully as sometimes meibomitis or blepharitis cause recurrent lid infection.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My wife and I have the same blood group. Presently, my wife is pregnant. What is the problem for the baby\s physical body due to this? ### Response: Hello. The same blood group does not lead to any problem. The same blood group people can marry and can produce a normal child. So, as far as same blood group is concerned, do not worry about that.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a red area that is itching on the penis head for a week. It looks like balanitis according to the pictures I searched. I also have pain after urinating. I have tried with Nystatin cream, but I have more itching than before. I cannot go to the ER, but the quickest appointment with the specialist can be scheduled in a week. Please help. ### Response: I understand your concern. Please send a picture of the affected area to help you better. I need to see to suggest the appropriate diagnosis and treatment.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am experiencing lower back pain, and it hurts whenever I stand up. I am also suffering from abdominal pain. I do not know if my period is the one that caused it. ### Response: Sometimes these symptoms can be due to periods in young females, so your gynecologist should be able to give you an insight into this. As far as lower back pain is concerned, if it has been present for a long time even in the absence of your periods time, then it could be due to a spinal issue. If you have localized back pain with no other symptoms like radiating leg pain, neurological symptoms like numbness, weakness, paresthesias, etc., then you can start with following recommendations for an initial period of two to three weeks. 1. To maintain a proper posture of your back while working and sleeping. 2. If pain is more, then you can take a short course of anti-inflammatory medication like tab Ibuprofen or Paracetamol or one which suits you. 3. Physical therapy initially under the supervision of a trained physiotherapist and then to continue at home. 4. Adequate calcium and vitamin d intake if levels are low in the body. 5. Ice packs can be applied if your pain is acute, then hot fomentation can be done at home. 6. Analgesic spray for a local application can be used and is readily available. 7. Avoid lifting heavyweight and acute forward bending in mornings etc. We will observe you for the next two to three weeks how you respond to this conservative management protocol. If you are not feeling better, then we will have to get some investigations like, dynamic x-rays of lower back and few blood tests for evaluation. Do not hesitate to contact me if you need any further assistance.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 70 years old, male with history of migraine for 40 years. The last few years for stress, I have taken 60 mg Cymbalta twice daily. My headaches sometimes give me the aura and sometimes slight dizziness for 10 to 15 seconds with headache to follow. Over the years I have tried all kinds of medicines like Paxel, Topamax, etc. Maxalt and this sort of medicine have not worked. My headaches were pretty well controlled with Cymbalta and Gabapentin twice per day. I went off the Gabapentin three years ago and only experienced 3 to 4 migraines per year. My headaches have a history of pain 3/4 on 10 but long duration 7 to 30 days. A few years ago a headache specialist prescribed Prednisone pac which generally works. I have had two migraines this month, this one started with mild dizziness for 10 seconds followed with headache. I started with three Prednisone for four days and restarted the Pac beginning with 6 tablets day one, five tablets day two, four tablets day three, etc. Also had Toradol shot three days ago. Headache is mildly better but not gone. Any ideas to abort? ### Response: Hi. First of all, one needs to confirm that it is indeed migraine. I would recommend the following: 1. Do MRI brain. 2. If MRI is normal, ask the neurologist to consider starting Valproate 500 mg once a day. If the migraine is resistant to all medicines, occipital nerve stimulation can be considered.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have read several studies on the effect of autophagy on aterial fibrilation. I cannot understand most of the conclusions and need some help with this. I basically follow a regime where I eat every other day and fast at least 24 to 30 hours at a time. As I believe, autophagy is activated and can have a positive or negative effect on the heart, in particular, the atrium and remoddeling of electrics.Can you please tell me if you think what I am doing could possible cause afib or remoddeling of my heart? I have no current issues, low cholesterol and BP, no family history and have a structually normal heart. However due to my years of excess I have this fear of getting afib. I am male, 35 years old, mixed ethnicity. ### Response: Firstly, there is no good evidence for or against this rigorous fasting. Studies atleast have shown no significant increase in atrial fibrillation with such fasting. Practically, we do not have good evidence for it. Now if we consider theoretically, then yes fasting may stimulate autophagy and may have a beneficial effects on heart/ atrial fibrillation. It does improve your lipid profile and risk of myocardial ischemia which is a risk factor for atrial fibrillation. It may also reduce obesity/ bodily inflammation, which is again a risk factor for atrial fibrillation. So, there is no evidence to suggest that it induces afib or remodeling, but such rigorous fasting is not recommended based on current evidence. We are also not sure whether you are meeting the daily requirement of essential nutrients. You can share some studies with me so that I can clarify on them. So, fasting for few days say for 1-5 days a month is acceptable.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 52 year old male. I have been using hair dye since last 25 years. Two years back, I had hair dye reaction on the scalp. Yesterday morning, I had dye reaction again. The entire skin of scalp came out like snake\s skin. After that rashes have come on the knee, elbow, and on the feet. What do I do? ### Response: Hello. As per the details given, it seems that you have hair dye allergy. Most of the hair dye products contain a chemical called PPD (para-phenylenediamine) which is responsible for allergic reactions. In such cases, I advise my patients to strictly avoid application of hair dye. You may use herbal henna for dyeing hair. Antihistamines like Levocetirizine also help. You need clinical examination. So, you should visit your doctor so that he can examine you and give you prescription accordingly. You can share my opinion with him. Stay healthy.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I went to the dentist for a teeth-cleaning on Wednesday. On Thursday, I noticed that the floor of my mouth on the bottom right side felt sore. When I looked with a light, I noticed a couple of cuts that were kind of like paper cuts. They bleed when I brush. The pain can be managed somewhat with teeth pain relief gel.I do not recall these being there before my cleaning. Or if they were, they certainly did not cause any pain. Could they be caused by the cleaning?What do you recommend for healing, pain management, and preventing wound infection? ### Response: Hi. You mentioned about the bleeding of the gums after scaling. Usually, you can see bleeding gums and cut-like appearance near the border of the gingiva due to one of the following reasons. White appearance on the floor of the mouth suggests ulcers

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Before eight months, I had boils on both sides of my face. Now, they left dark black marks. They are very stubborn and extremely hard to fade. They are gradually disappearing, but it is too slow. Please help. ### Response: Post Inflammatory hyperpigmentation is tough to treat. The essential thing is protecting skin from UV (ultraviolet) rays, so sunscreen with SPF 50 (sun protection factor) is must in the morning hours, apply it for every four hours when you go out to beach or park for a longer duration. I would suggest you use a topical cream called Demelan (Kojic acid, Glycolic acid, and Arbutin). It will help to reduce the pigmentation and lightens the pigment. Use this cream twice a day. Other options are a series of glycolic acid chemical peel and microdermabrasion which will help to exfoliate the skin, and it lightens the pigment

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Twelve days ago I had protected sex with a girl I did not know after a night out. I showered that night maybe an hour afterward and used a perfume smelling body wash or shampoo. Whether it was in my head or actual, the next day I noticed an itchiness or rather a need to readjust my penis which persisted on and off for about a week with no other symptoms, visual or pain or burning. A week after the incident, the itch progressed to something between an itch and an occasional burn on the underside of the head of my penis where the ridge of the glans meets, but in total very mild, and I did not think much of it at the time. In the weeks prior and the week subsequent I was traveling with a lot of daily exercises and occasionally limited ability to shower or use shampoo. Eight days after the night out I noticed a small patch of red bumps that looked somewhat rash like in the same small area. To be specific, they do not look like pimples nor are they very raised and do not look to contain any liquid or if they do a minuscule and clear amount. The weird thing is that when these first came about, the itching also stopped, and I have no other symptoms such as discharge, burning while urinating, or other health issues. In days 10 to 12, I have had no such symptoms as well but the ridge of my glans penis around the front side of the head now appears to have symptoms similar to what balanitis may look like from other research, with a slightly swollen and red penis head and a rashy or bumpy looking appearance to the edges of the head. The itching has stopped, and from online research I figured it may be something like jock itch, a male yeast infection or another fungal situation so I began using an antifungal cream yesterday. The original red bumps on the back of the head have faded somewhat and have not blistered or scabbed or popped or shed any skin which I have been vigilant about from reading online. I am wondering if you can shed any light on my situation as I am worried just like any person experiencing STD scares. ### Response: I have gone through your case in detail. Well, you need not worry about any STD or fungal infection or jock itch or even about herpes as your lesions are not active right now. There is only mild redness which could be remnant of balanitis or friction. At the moment no signs of any sexually transmitted disease. All you have to do is to maintain a good hygiene. Avoid sweating and friction as much as you can. Wash it daily. Apply antifungal cream for a week so that it smoothe out your lesion in addition to antifungal effect

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 25 year old boy and my face is very oily during summer while in winters it is quite dry. In summers, a lot of oil pops out with white heads on my face. Even a short-term sun exposure tans my skin. I am also suffering from the problem of dark spots. Kindly suggest a face wash, sunscreen lotion, overnight cream or whatever it takes. ### Response: La shield sunscreen can be used in the morning as it is non-comedogenic. Please upload an image of your face, so that depending on the skin type, pigmentation, and acne, medications can be suggested.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a bent penis that causes pain and dissatisfaction. Please suggest me a solution. ### Response: Hi. A downward bent of the penis is an absolutely normal variation and is present in 15% - 30% of men. It will be a problem only when it is extremely bent and difficult to penetrate. Pain in the penis can be because of anxiety. If it has been since a long time, then there are chances of it being a cause of urethritis or some scarring in the musculature of penis known as Peyronie\s disease. You do not have to worry unless erection is normal. I would suggest you consult a urologist for physical evaluation to check whether the bent in the penis is a normal physiological variation or not. Stay calm and do not get tensed.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My wife just started on Pradaxa (blood thinner) a week back. She has an antiphospholipid antibody, but she has not had any clot before. We started seeing a couple of small bruises today in her hand without any injury. I want to know if we need to stop it. We consulted a doctor in the next couple of days but needed a second opinion on it. What would be the effect if we stop taking Pradaxa? What is the other alternative? Does she need to be on the blood thinner, even though she has not developed any clot yet? She was allergic to aspirin, so she could not take that.Lab test report says that her antiphospholipid antibodies were high and as per the hematologist, she is at high risk for a clot. ### Response: Now coming to your question, Pradaxa (Dabigatran), as you know, is a blood thinner, and it will predispose her to have bruises, which are mostly harmless. What you need to look for is a huge hematoma (collection of blood beneath the skin), blood in stools, and urine. If you have discussed with your doctor to continue the Pradaxa for prophylaxis of DVT (deep vein thrombosis) and PE (pulmonary embolism), then do not discontinue it, although, as I mentioned earlier it is controversial.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a tooth that is gone all the way down. So I think the pulp is exposed but I have no pain whatsoever. Is it only a matter of time before it gets infected or not? If I have no pain, it is dead right? ### Response: According to your history, the pulp is exposed and decayed by now. It means sensations are lost and that is why you are not feeling pain in it. But it does not mean your tooth cannot get an infection now. It can get infected because of the food stuck in it can cause infection in gums around broken tooth and root. That may be very painful. Therefore, I will advise you to visit your dentist and get it extracted or treated according to your clinical condition.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: The findings during chromosome breakage study for Fanconi anemia are not in favor of chromosomal breakage syndrome. Is the patient totally free from the Fanconi anemia? ### Response: In Fanconi anemia, there is a presence of birth defects along with severed degree anemia. If such a finding is present, then further work out has to be done for that. I have checked your report (attachment removed to protect patient identity). It is not showing any chromosomal abnormality. So, no chromosomal abnormality present as per reports

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I would like to get a consultation regarding my father. His blood report showed hemoglobin (optical/impedance) 12.4 g%, platelet count (optical/impedance) 93 10^3/cubic mm, WBC count (optical/impedance) 3.6 10^3/cubic mm, packed cell volume (calculated) 36%, serum vitamin B 12 472 ng/L. Please let me know the treatment for this. ### Response: Hi. Based on your query, my opinion is as follows. Folic acid deficiency. Folic acid and vitamin B 12 supplements. Revert back after three months to a hematologist online.-

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My periods are usually 29 days apart. I had a period on the 5th this month. I was supposed to have the next period on the 2nd of next month. But, I started bleeding on 22nd itself. Could I be pregnant or has my cycle just changed? ### Response: Hi. In your regular 29 days cycle, your bleeding has started on the 17th day. This shows that you had an early menses this time. This condition is called polymenorrhea (menstruation occurring in intervals of 21 days or lesser than that). There could be various reasons for early menses including stress, sudden changes in lifestyle and eating habits. If the suspicion of pregnancy exists on your part, then do a urine hCG test (human chorionic gonadotropin) and revert with reports.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My ear has been blocked for the past three days. There are mild pain and discomfort. This could have been caused because of the earbud. I used Ciplox ear drops and have tried Crocin pain relief, but it does not help. Ear feels extremely uncomfortable, and hearing is muffled. Please suggest some anti-inflammatory antibiotics as I am unable to visit a doctor because of the COVID-19 situation. ### Response: Hello. It does not necessarily have to be due to earbuds causing otitis externa though that could be one possibility. There are others also. Can you tell me if you had a cold recently? Does it feel like there is a fluid inside the ear? Do you feel like you need to pop your ears? Is there any throat irritation? How severe is the earache? It could be secondary to middle ear infection also.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Please explain about interlabial pads. How is it used? Why do some women prefer it? ### Response: Interlabial pad is a modified version of the traditional sanitary pad. It is petal or leaf-shaped, and it is highly absorbing. It is designed in a way to have a direct menstrual flow to the center and prevents the blood leaking to the surrounding. It also prevents the blood flowing into the gluteal fold. It is worn within the two labia. Women would like to wear it because it is highly absorbent and it prevents moisture build-up and fungal infections. It is worn externally, and the chances of getting bacterial infections in the urinary tract and pelvic inflammatory diseases are low. It is small and comfortable. The doctor prescribes it to the women having stress or urge incontinence.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I fell this morning and I am pretty sure I broke a toe. It is a bit swollen, bruised, and painful. I landed on my knee and top of my foot. My knee is fine but the top of my foot is a little tender. It has a small bruise. My other toes are getting numb. Do I need to see a doctor? ### Response: Hello. I have gone through your history, as you have stated that you are having pain, swelling and bruising on dorsum (top) of foot region. In that event, I advise you to get: X-ray of affected foot (AP and oblique views) because we have to rule out any bony injury as management changes if there is a fracture. Do not put weight on affected foot as your swelling might increase further. Intensive ice packs need to be applied (10 to 15 minutes every 2 to 3 hours) to keep swelling to bare minimum. You can take OTC analgesic like Diclofenac, Ibuprofen, Paracetamol whichever is available and is not a contraindication for you. Keep your limb elevated over pillow at night while sleeping. Please contact me with X-ray of affected part and I can guide you as to further course of action.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Hello,I am a 27 year old female. I am feeling my heartbeat, breath, and pulse rate to be really abnormal since the past three weeks. It feels like my heart is pounding so bad. And then, I feel a difficulty to breathe, like I have run or jogged more than my capacity, even if I am sitting or lying. Sometimes, I feel a lot of pain in my lower abdomen area and on the left side of my belly. Please suggest me some remedy. ### Response: I went through your post. Your predominant complaints are palpitations and lower abdomen pain. Any person who notices a change in their heartbeats should go for ECG (electrocardiogram) to rule out arrhythmia. The most common causes of a one-sided pain in the lower abdomen are kidney stone or urinary tract infection. These are only the most common causes. However, there are more than 10 causes of the same. A USG (ultrasonogram) of the abdomen with a urine examination will help you come to a conclusion. Consult a physician with above investigations so he can help you. Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have mild vertigo for the past one month. There is no sweating or vomiting. I do not have any pain in the head and there is no problem of hearing and vision. I am only experiencing some balancing problem. My ENG test is absolutely normal. What will be the possible way to reduce this? ### Response: I understand your concern. I would like to tell you the causes of unsteadiness or dizziness. They are aural (disease of ear) and extra aural. Under extra aural there comes a long list of diseases. As your electronystagmogram (ENG) is normal, there is likely less chance of aural cause. Please consult your doctor for thorough examination and relevant investigation to reach correct diagnosis that may be managed accordingly.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a stabbing pain in the chest while taking TB treatment with four types of drugs (DOTS) since one and a half months. Please help. ### Response: Hi. This pain can be due to fluid in the pleural space, due to pleurisy or due to a cardiac cause. I suggest you take tablet Combiflam (Ibuprofen and Paracetamol), twice a day for five days. Consult your specialist doctor, discuss with him or her and take the medicines with their consent. Meanwhile, get ECG (electrocardiogram) and chest X-ray done and let me know.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 34 year old female weighing 300 pounds. My height is 5\2". I have a vaginal issue that I need advice about. I have a knot that keeps coming up just on the outside of my vagina, and it eventually bursts and bleeds for a while. This has happened twice now, and it has really started to scare me. The knot hurts really bad before it bursts. What can I do for this? Is it something serious that I need to go to the gynecologist? ### Response: From the description you have given, it appears to be either Bartholin\s abscess or a boil. Both cases can be recurrent if immunity is low, most common cause being diabetes mellitus. Following is my advice for managing the symptoms:

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Can we rely 100 % on Ovral pills to avoid pregnancy? What are the side effects? Is there any other option with no side effects to avoid pregnancy for two years? ### Response: Ovral pills (combination of Ethinyl estradiol and Levonorgestrel) are 100 % reliable if taken regularly. They have very few side effects and can be taken same time every day. If you miss one tablet it is okay, but if missed twice, can lead to failure in that particular month. No other contraceptive method matches it. You can use the Multiload but only after first pregnancy. It is used for 3 or 5 years depending on the brand. Implant are also available which is inserted under the skin by a small operation over forearm. The advantage is you do not have to take tablets. I suggest you do the following tests. So, choose according to your convenience and future plans. Feel free to consult for any problem.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 22-year-old female. About 20 days back, my history was this: I had diarrhea for two days (thrice a day). I had a low-grade fever too during those two days. I managed to carry it over with natural supplements. But it did not subside. The next day, it worsened with watery stools and I started getting dehydrated since I could not take anything inside. I had a fever and severe shivering. I took Doxicycllin (three tablets in one dose), but I did not get better. Then, I started vomiting up too. So, I was taken to the hospital and prescribed oral medicines since I hesitated to get admitted because I was to write my CA exams in two days. So, I took the oral medicines. They were: Orni-O, Pan DSR, and Bifilac. But I did not get alright still as I could not take any food inside and I vomited blue foamy.So, I was admitted and put on IV fluids and antibiotics. I felt little better but had the extreme discomfort in my tummy but I got discharged and followed oral medicines. The next day I was totally unwell, vomiting and watery stools (six to seven times). But the next day, on the day of my exam, this continued. So, I had to get admitted again and had a short session of IV fluids and medicines to stop my immediate symptoms as I needed to sit for three hours exam. So the JR there prescribed me to take Loperamide once in two hours. I took two pills as such and my loose stools got stopped and my bowel movements were nil.My stomach got bloated and I could not eat anything. So again, we went on a second opinion where they prescribed Racedotil, Endogen, Emecet and Pantocid diagnosing as viral gastroenteritis. After this course, I had my dehydration gone by and started taking fluids but I did not have proper bowel movements. Then started my severe constipation which ended up hurting my colon and I took Dulcolax. After that, I passed loose stools for two days but then now I stopped taking Dulcolax.But my botheration is my metabolism is still not alright. I am not able to eat as much as I feel hungry. I take bland foods only and on liquids too. But as soon as I take my food, my tummy is bloated and I need to walk but then it is not getting fine. Past two days, I did not have my stools. So, I took that soft stools drink and this morning with great pain passed out. But, I could not eat anything properly. My stomach is bloated and I feel like something hurts me badly in the stomach but I do not have a particular local pain but have some upper abdominal pain and discomfort after I eat.My questions are:Is it good to continue taking Dulcolax till my metabolism gets fine?Are these after-effects because of the viral gastroenteritis or do I need to check with any other specialist regarding this? I feel tired. Why do I feel so? It has been 19 days I am with this ailment.What type of foods can I take to ease my bloating? ### Response: It is always better to avoid regular use of Dulcolax (Bisacodyl). Your symptoms now are secondary to after effects of a severe diarrheal episode. This is self-limiting. You need to give time. Your aim now is to increase gradually your dietary intake and hy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am having type 2 uncontrolled diabetes. My endocrinologist is asking me to undergo a bariatric surgery. Kindly advise. Can you explain if it is required and how is it going to help control my diabetes and hypertension? ### Response: Hi. Bariatric or metabolic surgeries help to achieve long term remission from type 2 diabetes. These are scientifically proven, very safe and highly effective. They result in long term weight loss in individuals suffering from an excess weight problem, and also lead to long term remission from co-morbid medical conditions such as high BP and sleep apnea. Bariatric or metabolic surgeries alter hormones which control body fat stores and reset set value for fat storage to a lower level. Same hormonal changes are responsible for remission from problems like diabetes. Depending upon your weight, presence or absence of other medical problems, I choose different surgeries. Sleeve with bypass combination surgeries is more powerful and durable.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have had painful/itchy bumps on the inside of the upper eyelid on both eyes (outside corner) for over two months now. They started as red, irritated patches, and now are growths of some kind. My optometrist told me to use lubricating eye drops four times a day. It has not helped at all. What could this be and what should I do? (I am told the bumps are where my lacrimal glands are). ### Response: I have seen the images (attachment removed to protect patient identity). Sometimes they do respond to hot fomentation along with an antibiotic eye

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My father is 68 years old. He takes Novorapid 3 times, 8-8-12 and Lantus at night 18 unit, above that taking Olmesor 40, Rozucor ASP 10, Cilacar 10. For the past 8-9 months new problem of hiccups arises while taking food and drinking water and about to stop his breath. If he takes Nukast 10 then it is fine. Allergy test for IgE is 229 and full panel are also done. What is the solution for this? ### Response: Hello. I understand from your query that your father, who is diabetic and hypertensive, suffers from hiccups problem since eight months. He has hiccups while taking food or water. Can I get more details? Does he have hiccups or cough? Both are different.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My son is 17 years old. He is doing odd things, such as calling the police for ear pain. He is under a lot of stress from national exams and high expectations. He does not sleep much, but his appetite is well. After calling the police and talking to them, he was back to his room studying. Late evening he told me that he is doing well and not to worry about him. Overall, he is distracted, and his grades are dropping. I am desperate as I am in the health field and I know that can mean severe pathology or simply a reaction to stress. ### Response: It seems he is not in touch with reality, like calling the police for ear pain. Can you tell since when he has ear pain and how it started? Since how long has has such odd behavior and sleep problem? Does he express any other odd behavior? Is there any history of substance abuse or truancy? He might be suffering from adult ADHD (attention-deficit hyperactive disorder), depression, anxiety and ATPD (acute and transient psychotic disorder). The management depends upon the disorder he is suffering from.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have hyperthyroidism. I also have tendonitis in both my shoulders. I have been having joint pain for years and I work a lot of physical jobs. Lots of bending, kneeling, lifting and twisting. I hang my hands quite a bit as well. I have been getting hives for the last two months, I have been using tide and gain in my laundry for eight months. My mom is allergic to Tide. My endocrinologist mentioned lupus because of joint pain and hives. I have an appointment with a rheumatologist in four months. I am considering changing my detergent back to see if the hives stop. Could it all be coincidental? How long would an allergy take to show? I have always thought it was the onset of arthritis. I never got a butterfly shaped rash on my face. I am currently taking Methimazole 10 mg, Multivitamins, and Gianvi birth control. ### Response: Hi. Well, the hives do go in favor of urticaria. It can be a part of lupus or can be independent as well. But usually, it is an autoimmune process triggered by some allergen (it is possible it is detergent in your case). But the joint pains you have do not really point towards lupus since it is only restricted to the shoulders. Most of the time, shoulders have a mechanical cause, that is you are overusing it in the wrong way. But never the less, since your appointment is far away, I would suggest you get a few tests done. Even with urticaria, we do these tests. Meanwhile, change your detergent and take a course of antiallergics and see if it improves. You can let me know the results when available. 1. CBC (complete blood count). 2. ESR (erythrocyte sedimentation rate). 3. ANA (antinuclear antibody). 4. CRP (C-reactive protein). 5. Ultrasound of the shoulder. Anti-allergics. With reports.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am having a hard yellow thing accumulated in lower four teeth near gums. I do not know what it is? It just happened a few days ago. ### Response: The hard yellow deposit is calculus (mineral deposits) on lower teeth which are receding your gum (attachment removed to protect patient identity). It can be apical periodontitis and/or apical periodontitis with abfraction. Please share a good picture just focusing on lower teeth. As per treatment, if you have calculus then get ultrasonic scaling done. Oral hygiene. Abfraction. Apical periodontitis. Maintain your oral hygiene and get ultrasonic scaling done every six months.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a rash or bumpy area on the base of my ring finger on the side where it touches my middle finger. That occur several days ago while I was wearing a silver ring on that finger. I have taken off the ring but the area is getting painful with irritation and it seems to be getting worse. I have used an antifungal cream on it for one day so far, but I am not sure how to tell if it is actually fungal or not. ### Response: Hi. From the picture provided (attachment removed to protect patient identity), it is most likely to be a viral infection like herpes or a contact dermatitis. These lesions are usually tiny grouped blisters and cause pain. They last for about 7-10 days and resolve spontaneously. However, they may get infected secondarily oozing pus and spreading to surrounding area. You can apply Mupirocin cream to prevent further infection. I would also suggest you to see your dermatologist as you may require oral medications to prevent complications. Herpes infection, contact dermatitis, and fungal infection is the rare possibility. Tzanck smear or pus culture can help. Herpes infection. May require oral antiviral and analgesic medications.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My mother who is 67 years old is an osteoporosis patient. She has been recently operated for carpal tunnel in the left hand. A few months back, she had developed an ankle effusion which subsided after starting osteoporosis injections. She is on Gemtide and calcium. Recently, she has developed swelling in the right wrist with pain and stiffness. She had an ultrasound and an X-ray as advised by her doctor. The ultrasound report is attached herewith. The X-ray suggests osteopenia. Does the ultrasound report suggest she has tuberculosis? Please advise as to what should be done. ### Response: I went through your attachments (attachment removed to protect patient identity). This professional advice provided by me stands subject to the actual examination of report and image and is based entirely on inputs provided to me. It should be correlated with clinical findings. Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I need a consultation on my diabetes. My fasting plasma glucose is 226 mg/dL and in PP it is 390 mg/dL. I am currently on Diamicron MR, Volix 0.3, and Novomix pen 30/70. Please suggest. ### Response: Your sugar is uncontrolled and Vitamin D is low as well. You did not tell how much you are using Diamicron, Volix and Novomix. Please let me know the doses. Another thing is you should get checked urine albumin creatinine ratio and I think you may need a change in medication. Your overweight is also due to these medications.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I need help. Two weeks ago, I was at a friend\s gathering or party. And we filled a barrel with glass bottle drinks and a lot of ice and a lot of water. Everyone picked up their drinks from the barrel. I had a cut on my finger and constantly dipped my hand in the barrel for a drink. I later got to know some colleagues at the party are HIV positive. But I did not see the water in the barrel bloody or anything of that sort. And I cannot tell if someone had cuts on their hands as well. A week after the incident, I got this mild cold. And I am worried. Please, is it possible for HIV to have survived in the water? Should it be the case that anyone had a cut on his or her hand? Is it possible to have gotten infected just like that? Please help me. ### Response: Hi. I have read your query carefully. You are tensed about your exposure to HIV. Now I am explaining you everything. HIV infection is usually acquired through sexual intercourse, exposure to infected blood, or perinatal transmission. You have to keep in mind that the HIV virus does not survive for a long time outside the body. You also keep in mind that exposure through oral route is extremely rare. So there is very very little chance to be infected by this mean. But if you are worried after that explanation, you can go for a test named ELISA for HIV. But it needs minimum 2 to 3 weeks to be positive in the fourth generation test. And 7 to 8 weeks in the first generation ELISA todetect the virus after exposure. So you should wait.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My brother aged 35 years has undergone a kidney stone surgery on 21st and from 28th, he is suffering from high fever (mostly 104 F) with shivering. The doctor has removed the stent on 31st but the fever has continued with shivering. There is no detection of dengue, malaria, or sepsis. What is the cause of high fever? Please advise. ### Response: The stent and its removal induce inflammation which in turn can lead to fever. Paracetamol 500 mg SOS can be prescribed for fever. An antibiotic course can also be prescribed along with that to fight any mild infection if present. I suggest you investigate with CBC (complete blood count) as well. Consult your urologist for examination and discuss the management

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My age is 35. I have black patches on my face and pores on the cheek. Black patches first occurred 3 years ago for the first time. How to remove them and get a fair skin? Please suggest. ### Response: I have read your query. 1. Postinflammatory.2. UV rays (sun damage). 1. Sunscreen can be continued for a long duration.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I developed tinnitus all of a sudden last year. I am attaching the last year MRI images for your evaluation. Of late, I have some muscle pull in my calves. I am waiting for your evaluation. ### Response: Hi. I have analyzed your MRI images (attachment removed to protect patient identity). There are age-related minor changes in the scan. But nothing is alarming in the scan. The tinnitus which you have can be because of isolated eighth nerve or inner ear involvement. Regarding the muscle pull in the calves, I would like to know further. Please let me know the answers to all of the questions, so that we can discuss further. Revert with more information to a neuro surgeon online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 51 years old. I have had six low back surgeries including a fusion with hardware and screws. Today at work I lifted something heavy and had a very sharp pain that brought me to my knees. Now I am losing control of my bladder and bowels, and the pain is very bad. What could this be? ### Response: Hi. If you are developing radicular pain and losing your bladder and bowel, then it is an emergency and you need to quickly consult your spine surgeon. It could be due to some problem in the fusion segment or above that segment which is called adjacent segment degeneration. You need urgent surgery to decompress your spinal cord. I know it would be extremely mentally traumatic for you to get yourself again cut after six surgeries but the situation demands that and you need to fight it. Get yourself evaluated from a good spine surgeon and decide accordingly. Are you feeling numbness at your anal region?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Third time on Lexapro started again two months back. Taking 10 mg, after about 20 days, I felt good again. Then it stopped working after about two weeks. My GP raised the dose to 20 mg. Today is a full week without much improvement. How long should I wait to see if 20 mg will kick in for me? I am also taking Metoprolol. ### Response: First of all, try to stay calm because it is your third episode and medications take time to act. If you have come out of your illness twice before then this time too you will come out of your illness. Do not lose patience. As you have mentioned you are taking third time this medication. So this is your third episode. Lexapro is an antidepressant SSRI (Escitalopram). It generally takes 14 days to start the action. As you have mentioned you are taking it for the past two months and you started feeling good so you should wait for another one week for this medication to act before switching to another medication or adding a medication with it. Since it is working for you because you did feel good after taking the medication, so I would suggest you take the medication for one more week minimum to experience the effect.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My father is having enlarged prostate and has to undergo prostatectomy surgery. But, it is getting delayed due to ITP (idiopathic thrombocytopenic purpura). Right now he is under urine catheter. From past 12 days he is using Silodal-D 8 mg. Doctor said that after 20 days the prostate gland will reduce. Through ultrasound test we came to know the size of prostate enlarged is 54.6 cc. My doubt is, if it is enlarged to 54, is it possible that it can reduce through tablets? Or is it a must to undergo surgery? Right now the platelet count is 40,000. Please suggest a solution for this. ### Response: Your father was on medication and has history of urine retention in the past. Currently, he is on catheter. Chances of medical management will not be successful. He needs surgery of either TURP (transurethral resection of the prostate) or HoLEP (Holmium laser enucleation of the prostate) for prostate. Size is never a criteria for surgery. Enlarged prostate can shrink by 30% if Dutasteride is given. But, this does not guarantee that the patient will become catheter free. However, it reduces blood vessels in prostate and helps decrease blood loss in surgery. Dutas-T (Dutasteride and Tamsulosin) also contains similar medicines as Silodal D (combination of Dutasteride and Silodosin). His ITP needs to be tackled and with all due precautions and keeping platelet concentrates on standby. He can undergo endoscopic surgery with due risks. Laser surgery - HoLEP will be better for him if available.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 25 year old male, who weighs 240 lbs, and I am 5.10 feet tall. Tonight I had what I think was acid reflux or heartburn. I was not sure about it, as I have never had it. I felt like something is stuck in my throat, and also I felt a chest congestion when I tried to cough. I was reading online about the symptoms of GERD but also started reading about heart attack symptoms. I did not have any noticeable chest pains, but after reading about how people have a feeling of uneasiness, I had a weird feeling rush over my body for a brief second or two that felt like pins and needles and numbness, then I came back to normal. Is this a sign of anxiety, hypochondriasis, or a heart attack? ### Response: Let go of your anxiety. Gastroesophageal reflux disease is 80 % corrected by simple diet and lifestyle modifications. So, I would suggest you try the following. Your symptoms could also be due to multivitamin deficiency, especially, vitamin B12 deficiency. Hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 19 year old girl. I had unprotected sex. My last periods was before two months and still I have not got any. Is there a chance of pregnancy? I have had i-pill twice last year in a gap of 6 months. My periods are sometimes a day or two late. But, I am really worried as I really cannot afford a pregnancy now. Please help. ### Response: I totally understand your situation. Handling an unwanted pregnancy can be very stressful. As you had unprotected intercourse within the safe time of your cycle, it is very unlikely that you might be pregnant. If you still have a doubt then get a home pregnancy test kit and check yourself in case you do not get your periods in next two weeks. As far as i-pill is concerned, it does cause alterations in the hormonal balance and cause period disturbances. So, you should wait for a couple of weeks. If periods do not resume, we can start you on oral hormones to get your periods as well as regularize your periods.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Please provide second advice on reports. I would like to know if any other tests I should undergo apart from the existing ones. ### Response: I have gone through your reports (attachment removed to protect patient identity). Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I got married a couple of days back. When I tried to have sex during first night after some foreplay, I found my wife\s vagina was having a small hole and my erected penis was not able to penetrate. When I tried a little forcefully, the front skin of my penis rolled back exposing the inner soft skin of my penis. It was painful at that moment but uncomfortable now. It became a little dry and occasionally I get itching sensation.My wife is feeling a burning sensation in vagina due to forceful trying. Let me know how to prepare my penis and her vagina for sex. Our age is 29 years and 26 years respectively. ### Response: From the available description it appears to be that both of you are first timers. This kind of problem is commonly encountered because of lack of knowledge.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 32-year-old woman. My latest pelvic IRM imaging showed that I have a 4 cm subserosal fibroid that is undergoing myxoid necrobiosis. My question is: Does this type of fibroid need to be removed? If yes, does the surgery have any risks for the uterine? Is it fine to get pregnant while having this fibroid? ### Response: Fibroid in pregnancy may be increased in size and can hamper baby growth by occupying space. Subserosal fibroid does not affect conception but in your case, it is undergoing degeneration. This is a problematic part. Red degeneration is a fibroid degeneration in pregnancy which causes severe abdominal pain throughout pregnancy and surgery cannot be done. So I would suggest getting it removed. Subserosal fibroid removal has generally no effect on the uterus. But if it is deeply situated then uterus wall may become weak.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 27 year old serving army officer. Three years back, I met with an accident and got a traumatic brain injury. The initial investigation report and treatment undertaken is attached. Also, the NCCT scan taken 11 months ago is attached.Now, the problems involved are having cognitive issues in doing physical exertion and have mental stress. Now, I am not able to concentrate and grab the concepts while studying. I am having issues like I memorize a thing and later I am not able to recollect it fully. Further, I get tired after physical exertion.Initially, after a long run it used to take a day to recover and relax. And now, when I go for long runs I get tired, feel too exhausted and it takes five or six days to get back to normal. While searching on the internet I came along nootropics to boost memory. Can I take that? Please refer me some medication or herbal products to solve my issues.Also, when I\m having some sort of examinations, I thoroughly revise my subjects like earlier I use to do but now in the morning I\m only able to get few points not the complete thing. I\m able to recall but not at the time when it is required. It happens while conversations also some points skip and I\m not able to give all the points.I\m currently taking tablet phenytoin, and dietary supplements of super omega 3 capsules, 2 times a day, always nutrikite\s Siberian gingsek with gingko biloba, 2 times a day and focus factor tablets that are nutrition supplement for brain which I got from the US., 2 times a day. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity) with diligence and would like you to know that I am here to help you. The head injury has left some damage in your brain. The frontal area on the left side is affected. This area of the brain is needed for attention. Hence, you lack attention. Attention is an integral part of the memory. Even though your long term memory may be intact, you seem to have a forgetfulness because of lack of attention. There are two ways to treat this. Also, a combination of both the above will give best results. Consult your specialist doctor, discuss with him or her and take the medicine with consent. For yoga, I would recommend you to consult a yoga master. Please let me know the improvement in three months with this combined treatment.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had sex with a sex worker with a condom on but at that time, I had itching problem in my hip joints. I had sex for four to five minutes. That was my first time having sex. I am in too much fear of HIV. I tested tri-dot on the 31st day and it was negative. Before the test, I had a skin rash which was cleared by Levocetirizine? What should I do? How much percent cases were found to be positive after three months being negative on the first month? I have too much anxiety. I am unable to eat food too due to fear. Please help me. ### Response: The chances of transmission of HIV by protected intercourse is nil if used in a right way. Tri-dot being negative after one month is good. The chances of HIV tests coming positive later is almost nil. It would be better to go for HIV antibodies tests or tri-dot after three months to be relieved of anxiety totally. The rashes are not related to HIV. It may be due to fungal infection.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have itching problem in the whole body since last six months. When I take the Cetirizine tablet for this then it is fine for 4 to 5 days after that it again occurs. ### Response: Hello. It seems you have chronic urticaria. In more than 50 % of cases, the cause is unknown. The rest of the patients it can be due to any infection anywhere in body or thyroid problems or diabetes, etc. I suggest you get the following tests done. CBC with ESR, S.TSH, S.T3, S.T4. Also, please note if it gets precipitated due to some stimuli such as sweat, exercise, cold, etc. Follow up with the above reports.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am suffering from severe allergy. I tried different medicines for this, but everything was useless. Please help. ### Response: Depending on the severity and type of allergic reaction, the treatment is given. So, for commenting more, I need more information. Revert with more information to a family physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have an eye disorder (keratoconus). I would like to know whether I can continue wearing soft lens. The hard lens/RGP lens provides a lot of discomfort. Do I have other options apart from glasses? ### Response: Keratoconus is a degenerative eye disorder. This causes corneal thinning and leads to a conical shaped cornea. Though RGP (rigid gas permeable) lens are preferred for better vision outcomes, a combination of soft and rigid lenses are also available. If this option fails, then go in for surgical options like microwave thermokeratoplasty.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: There is something wrong with my right fingernails, but my left nails are fine. What to do with it? ### Response: Hello. I understand your concern but there is no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest you the appropriate diagnosis and treatment. Please send the picture of the affected area.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had unprotected sex before 1.5 years. I was in deep mental stress after that with no proper food. After seven months, I got admitted to a hospital with skin rashes, headache and vomitings. Doctors tested and confirmed that I got meningitis TB and given treatment for 10 days. I was asked to use Forecox tablets for nine months. Now, that is more than a year after my high-risk exposure; I was tested for HIV 1 and 2 under enhanced Chemiluminescence, which was non-reactive. Please tell me whether my HIV results are conclusive despite all these parameters. Would my TB treatment and immune system alter the HIV results? Because my WBC count is low while testing HIV when compared to before. Please advice. ### Response: Unprotected sexual exposure is a risk factor for multiple STDs (sexually transmitted disease), including HIV. However, the risk is quite low ranging from 0.02 to 0.04%. HIV infection has a window period of one to three months during which the test results can be false negative. According to WHO (World Health Organization), all results are considered conclusive at 12 weeks after the last high-risk exposure. Tuberculosis and HIV are known to have a higher coincidence rate together. But, as your test results are negative and well beyond the window period, you can be assured that you have not acquired the infection. Kindly upload the report to check the method used and the laboratory to confirm the same. 1. HBsAg, (hepatitis B surface antigen)2. Anti-HCV (hepatitis C virus)3. Revert with the reports to a HIV AIDS specialist online.-

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 19 years old. I have a habit of smoking from the last one year. I tried to quit smoking. But, it is not possible. Is it correct to use nicotine gum? ### Response: Hello. Trying to quit smoking is a very good idea and since you have only been smoking for a year, quitting now will be much easier than doing it any later. Nicotine gum and lozenges are both good replacements and have proven to be effective. Normally, side effects may occur some times such as: But if you keep to the recommended dose, you should get minimal side effects. Also, make sure you give at least an hour or two in between two pieces (2 mg piece). The long-term use is not recommended and you should also bring down the dose gradually. Hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 25 years old and had a pregnancy for five weeks. Four months back, I had used MTP kit. The problem is, even now I am having bleeding. Is this normal? How to sort this problem if it is not normal? Looking forward for your valuable feedback. ### Response: I understand your situation. This much of bleeding is considered unusual. Either the process of abortion has been incomplete, because of which the uterus is still trying to expel out the products of conception. Or you have some blood problem. Are you still passing clots? Or is it plain blood that is coming? Also, if you could tell me exactly how you proceeded to take the medicine it would give an idea of the cause of bleeding. For the time being, take tablet Tranexamic acid 500 mg, thrice a day. This will stop the bleeding, but not cure the problem. So, till the time we know exactly what is wrong, you can take this tablet. Incomplete abortion. Ultrasound pelvis for retained products of conception (RPOC) and CBC (complete blood count).

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I want to know a few things about the clitoris.1. How does the clitoris work and how it helps women orgasm?2. What kind of signals does it send to the brain? 3. What are the psychological effects it might have?4. Why people tend to misunderstand the most about it? ### Response: The clitoris is a substitute for the male organ in the female. It has some tissues similar to that of male organ but not that much active. It has receptors that can be stimulated by touch on having sex, especially at foreplay. During foreplay, these receptors when get stimulated can initiate local lubrication and prepare the vagina for better sex by having secretions locally. In a few women, the clitoris is too sensitive while in some it is less. But it is sensitive to touch, increase lubrication in the process of orgasm to have penetrative sex. Some women feel this process like masturbation.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have been diagnosed with sinusitis, cold and ear infection for more than 10 days. Took antibiotics with ENT doctor consultation, I could see improvement in sinus pain, cold but one ear still remains clogged, finding difficulty in hearing. When checked with doctor, I was informed that the fluid has entered deep and need steroids to recover it. I have been prescribed Prednisolone 5 mg for 15 days with 6 tablets per day for first five days, then 4 for another 5 days and two for remaining 5 days. Along with this steroid, doctor have given Clarinase and one more tablet named Gasec for preventing the stomach related issues as side effect of taking steroids.My queries are is it fine to take such tablets while trying to conceive? If not, how many months I have to wait for conceiving? Is it the right treatment for clogged ears due to sinus? What type of side effects can I expect due to this steriod? ### Response: Hi. If you are trying to get pregnant you must stop Steroids because it has a harmful effects on the nervous and immune system of the fetus but do not panic because you have taken a small dose of Steroids for a short period. You can start trying to be pregnant the next few days from stopping Steroids. Do not wait for side effects as the dose is small, the period of treatment is short.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: The following event has happened twice. I start feeling dizzy and extremely hot. I can feel my body heat through my shirt. I feel nauseated and was about to faint. Oddly, today, when I went to the kitchen to check my food in the microwave, I opened the fridge instead. When I tried to cut lettuce, I grabbed a spoon. I am not sure if that was a coincidence. I got anxiety after these incidents. After lying down in front of the air conditioner, I feel better. Also, cigarettes seem to intensify my feeling. Please help. ### Response: I think the main thing to consider is whether this is something significant related to any cardiac or circulatory problems or whether this is something relatively minor. I would certainly suggest you visit your GP or family doctor. You will need to undergo an ECG (electrocardiogram) of your heart to determine its underlying rhythm. You will need your blood pressure and heart rate checkup, along with your blood sugar level. Given that it has happened recurrently now, your doctor may want to send off some blood tests such as your blood count to check your hemoglobin level to make sure you are not anemic, along with your electrolyte levels to ensure that there are no endocrine abnormalities. ECG, observations (heart rate and BP) and blood glucose. 1.Cardiogenic arrhythmia.2. Presyncope.3. Endocrine dysfunction. Cardiac presyncope or faint.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I went to a salon to have a skin cleaning and they used on my face blackhead extractor. And I am worried now if I could get hepatitis or HIV if they did not clean it between the clients. Is it possible to get any disease? ### Response: Hi, Welcome to iciniq.com. If instruments are not properly sterilized and if the blood of any patient who has hepatitis, etc., present over that, it is possible that it can be transmitted. Usually, in salons the exfoliator they use does not penetrate the body and procedure is very superficial, it does not come into contact with your blood, the risk is very very low. For caution next time, you should buy your own instrument and bring that to a salon. You should not be worried now as the transmission risk of hepatitis after needle stick injury is very low and even lower for HIV.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am having a feeling pin and needles like sensations near my heart for the past two weeks. I do not know if my ECG is normal, I wanted to get it checked by you. I have no cholesterol issues, no blood pressure issues, no diabetes. I have low blood platelets count from years and recently my abdomen ultrasound showed mild spleen enlargement and prostate enlargement. I am 31 years old. I have anxiety issues for years. I also feel the warmth on my face after evenings until the time I sleep, but no fever. Weakness is there with pain in the left leg. Chest x-ray is normal. ### Response: I checked your ECG (electrocardiography) (attachment removed to protect patient identity). All is normal without no sign of any abnormality. The sensation you feel, does it come with shortness of breath? Or chest pain? Do you have a history of stomach ulcer or trauma to the chest region? Have you taken any medications so far?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I fell down from bike 10 days back and since then I am unable to walk properly. I have a problem in the knee. In the X-ray report, there was no fracture found. However, in MRI it shows ACL grade 3 tear. So just wanted to know if surgery is mandatory or any other option (without surgery) is available to treat ACL tear. If I do not go for surgery then would there be any serious consequences? Please suggest. I have attached my reports here. ### Response: At your age, if you have a complete ACL tear, then the best idea is to have surgery and reconstructed. This can also be treated non-operatively by physiotherapy and muscle strengthening of the hamstrings. However, this does not fully compensate for the ligament loss. If you still have symptoms of knee buckling after physiotherapy then also it is an indication of surgery. If you do not get operated, then your chances of developing late osteoarthritis increases which may later require surgery. ACL grade 3 tear.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have severe weakness in the muscles of the hips and butt. But no real pain. I stopped taking Rosuvastatin, Ezetimibe, and Paroxetine but I still use Enalapril (15 mg daily) to lower my blood pressure. Blood tests for muscle rheumatism are negative. Vitamin D is 95 nmol/l and I use a magnesium supplement to enhance my muscles. What is wrong with me? ### Response: Since when are you having this problem? Any history of trauma, or lifting heavyweight? Any perianal senory loss or difficulty in holding urine? What symptoms do you have like difficulty in walking, climbing stairs, etc?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 21 years old, I take Iron supplements for low iron and low ferritin levels and was on contraception pill for six years since four months back. I used a sex toy (dildo) this morning which is slightly bigger than my partner. After, which I noticed a bit of blood on the toy and a small amount came out afterward. I did not feel any pain during or after, I noticed it felt deeper than usual and a stretching sensation.Four hours later I noticed more blood coming out, I have continued to bleed what looks like my period. I have no other symptoms but more blood has come out, no mucous or clots either. I feel well. Could it be coincidental that my period has come back or could I have injured myself? What are the signs of injury and at what point should I get checked out?By the way of background, I have been waiting for my period since last year. I stopped taking the pill thinking my period would come but it never did. I had irregular periods prior to taking the pill (hence why I got on the pill). My periods were always relatively heavy. I also have had a number of ovarian cysts over the last two to three years which have caused me pain previously. I am not polycystic and have not undergone any treatment but for the removal of ovarian cysts three years back due to torsion. ### Response: Hello. As your history suggests that you experienced bleeding post insertion and usage of sex toy (dildo). There are two ways it can cause injury in women - one by frictional lesions experienced as stretching and vaginal wall tears leading to bleeding (reddish spotting to heavy) or presence of cervicitis or cervical erosions which can bleed after the act of insertion or intercourse (often darkish brown discharge to reddish spotting). This calls for a per speculum examination to rule out either -vaginal mucosal injury or cervicitis. Now that you have been amenorrhoeic (absence of mensuration) since last four months, there is all likelihood that post sexual act, due to orgasm and increased endorphins, your menses may have been initiated and have increased inflow in next few days without any discomfort. The chances of bleeding being menses and heavy is high considering there is no pain or fever and that you did not have your menses for the last four months. You should get an ultrasound pelvis done to check for endometrial blood collection which shall confirm menses and also a per speculum exam which shall rule out any cervicitis or vaginal mucous lesions. I hope I have answered your query in detail, Avoid use of sex toy till cause is ascertained and bleeding stops. Please consult your gynecologist.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My wife is suffering from chest infection. She is also having cough, vomiting, and fever every time after getting diagnosed with chest infection. Please suggest. ### Response: I can understand your concern. According to your statement, your wife has been suffering from chest infection, fever, and cough with vomiting. Does she have a history of repeated chest infections? You have not mentioned the duration here. Please provide the history of allergy, previous disease, medications, environment, family, childhood, acid reflux, etc. She may be suffering from chronic cough followed by vomiting. So she have to undergo CXR (chest x-ray), CBC (complete blood count), ESR (erythrocyte sedimentation rate), Hb%, circulating eosinophil, skin prick test, RAST test, reversibility test, etc. Reversibility test is done to determine the presence of asthma. She can take broad spectrum anbiotic like Azithromycin, nebulization with Salbutamol, Salbutamol inhaler, Fexofenadine, Montelukast, and antiemetic medications.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 16 years old. My eyes were yellow, ALT level was 226, Hepatitis E result was 9.4 u/ml. I went to a gastroenterologist for checking and he prescribed me few medicines Siliver, Sulvorid, Dexxoo. In the follow up he prescribed me Ipride. After taking that medicine I am having loose motion and feeling cold now. ### Response: From your symptoms and your test reports (attachment removed to protect patient identity), it looks like you have viral hepatitis, particularly hepatitis E. Viral hepatitis affects your liver cells and causes their inflammation which can lead to dysfunction in the normal functioning of the liver. The disease can vary from being self-limiting to highly fulminant. Hepatitis E has been known to lead to fulminant hepatitis which has quite a high mortality. Pro

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am breaking out around my groin and vagina. I have never had an unsafe sex. So, I do not think it can be an STD. I am on a birth control pill. I have attached images for your reference. Kindly suggest treatment? ### Response: I understand your concern and I have viewed the images (attachment removed to protect patient identity). Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I get stomach pain and diarrhea after meals. I do not want to do a colonoscopy because the preparation will cause more diarrhea. Therefore I want to know what can be done without colonoscopy for diagnosis? ### Response: Colonoscopy is an invasive procedure in which we can see the lesions directly. If we have doubt then we can take a biopsy and also if any lesion needs to be treated means it can be treated immediately. It is diagnostic and therapeutic also. CT abdomen, ultrasound abdomen and barium swallow, etc., are available but not possible to take the biopsy or treat the lesions. So, please consult your gastroenterologist. He will examine and treat you accordingly.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had a cold starting with a sore throat, followed by nasal congestion and post nasal drip/coughing. In the past few days, a yellow lesion appeared on my left tonsil. I have attached a picture. As you can see, capillaries have widened on this tonsil and it appears red. What is this? ### Response: Hello. I have seen the picture (attachment removed to protect patient identity). There is acute inflammation of your pharynx. That is the reason for widened capillaries. The yellow spot could be pus pointing or a tonsil stone. You need a course of antibiotics, decongestant, nasal spray and mouth gargles.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Does (Inozith-250) Azithromycin work the same as (Clavu-nova 625) Amoxicillin and Clavulanate Potassium Tablet USP? I am using to treat a back/chest problem I had two years back which the doctor prescribed Inozith-250 for me. I used the same drug when I had a similar problem and I am well. ### Response: No, Azithromycin and Amoxicillin plus Clavulanate potassium work via different mechanisms. Azithromycin is an antibiotic useful for the treatment of a number of bacterial infections. Azithromycin is a type of macrolide antibiotic. It works by decreasing the production of protein, thus stopping bacterial growth. That is, it is bacteriostatic. While not effective by itself as an antibiotic, when combined with penicillin-group antibiotics, it can overcome antibiotic resistance in bacteria that secrete \xce\xb2-lactamase, which otherwise inactivates most Penicillins. The doctor may have prescribed Azithromycin 250 mg twice a day earlier to you for maybe congestion or cold or some other problem but I would advise you to visit a physician in person and then take the medication. Then it would be of much benefit to you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: A few days back, I was diagnosed with minimal B/l hydrocele with the right simple epididymal cyst. The doctor gave me some medication, and the pain was gone. After a few days, I have to travel to another place for office purpose. Hence I took my medication in case required. I started the gym as well but now and then I have that pain in testicles and lower abdomen. I could not find the prescription tablets, and hence pharmacist suggest me to take Doxycycline. But after taking these pills, I have unbearable pain. I can attach all my X-ray and reports, but I could not find the option to attach files. Please suggest what to do? ### Response: Doxycycline is a treatment for any infection for urine. It usually does not cause abdominal pain. For the cause of abdominal pain need to be found out. You will need sonography of abdomen to see for cause if the pain is too severe then physical examination by a doctor will be required to see for the cause. Pain in testes can be due to infection of testes is called orchitis. Or occasionally lifting heavy weight can cause torsion in testes that are emergency condition and has severe pain. If pain is not critical, then you can take tablet Paracetamol for pain and continue Doxycycline for seven days. And will review with sonography of scrotum again. If you have any doubt, you can ask me.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a BB sized lump where my preauricular lymph node is, right outside my right ear. My dermatologist, who is treating me for melanoma in situ, is sending me to an ENT this week to check it out, but said melanoma in situ cannot spread. I have no other symptoms. It is not tender and he described it as rubbery and movable.I discovered it a few weeks ago incidentally because my jaw hurt a little one day, so who knows how long it has been there. It has not changed in the two to three weeks I have known about it. What are the possible things it could be (your differential)? Should I have it biopsied, and does it sound like cancer? ### Response: Hello. For swelling in the pre-auricular area, my differentials are: Since it is rubbery and movable, I feel it is more like a node only. Nevertheless, we need to investigate it. A fine needle aspiration cytological (FNAC) study will be required, but since the area is close to the branching of the facial nerve, we need to very careful with this investigation. An ultrasonogram of the swelling will be very useful for this. It demonstrates the likely contents of the swelling and indicates a diagnosis.The likelihood of cancer is there but not more than other possible differentials. Parotid tumors can occur in young individuals like you. They are not uncommon. Please revert back with details and we shall help you. Revert with more information to an ENT otolaryngologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Can you tell me why I get dizzy or disorientated when my brain expects something to happen but it does not happen? For example, if I try to click somewhere on my computer but my computer freezes before I notice so the click does nothing, it will disorientate me and make me dizzy. It will jolt my vision and make my head pound for a couple of minutes. It happens quite often, usually when I am not fully paying attention. I am 26 and male. I have had this problem for as long as I can remember. Currently, I am taking Thyroxine for Hashimoto\s disease. ### Response: Do you have a headache associated with it? Do you have nausea, vomiting? Have you ever lost consciousness? Have you ever had any visual problems? If the answers to these questions are negative then, what you are describing is not a neurological problem in a strict sense. It is probably a mental issue. If you have any associated anxiety, mood disturbances, fearfulness, please talk to a psychiatrist.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am getting a pain, which starts on the right lower back. It hurts when I breathe and also when I stand, sit and sleep. I know that is not kidney stones. But, I do not know what it is. I am a 45 year old female. My weight is 190. I am not on any regular medication. ### Response: I have gone through your query, and I can understand your concerns. Minor trauma or lung infection. X-ray chest, ECG and echo test. 1. Pericarditis.2. Rib fracture. Sprained rib.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My daughter had a root canal yesterday and now has a strong post nasal drip that tastes like hypochlorite. Should I take her to the doctor? ### Response: Hi. Typically, you will recover completely from a minor sinus issue like this within a few days, without any intervention from your dentist. However, if you are experiencing sinus issues that have worsened, or have not gone away after 2 to 4 days after your root canal or you believe you may be developing a sinus infection or you feel serious and significant pain and discomfort around your sinus or there is a metallic taste in your mouth, nose, or throat or you notice any kind of bleeding or pus in your nose or mucus, you should visit your dentist immediately.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 27 years old male. I was sitting in front of the computer for more than 10 hours per day for past one month. I have mild pain in my lower back, not a constant pain. the pain either left side or right side but the right side is more time the pain always shift its position. and while walking my right side bottom thigh got pulling pain at a step in and sometimes my lower limb feel pain. and I feel some weakness in the right leg and while I sit for Iong feel some numbness in my left bud and left bottom thigh.I have taken MRI and consulted the doctor, the doctor says lumbar spine looking normal. I consulted a radiology specialist and she said the hip and sacroiliac joint MRI essentially looks normal. The lumbar spine mild disc bulges causing radiating pain and numbness in the legs and feet described in detail as below:At L4/L5 level: Mild posterior-central disc bulge is seen indenting the thecal sac and encroaching bilateral neural foramina (right more than left) compressing right exiting nerve roots and abutting left exiting nerve roots. The annular tear is noted at this level. At L5/S1 level: Mild posterior-central disc bulge is seen indenting the thecal sac without any nerve roots compression. So, I consult another ortho specialist and he suggested to do physiotherapy and exercise for 10 days now. I completed 14 days but I did not feel any improvement. Previously two months ago I have taken treatment for erectile dysfunction and the doctor suggests taking medicine for one month, but I took for two weeks and stopped the medicine. I do not know any side effects from the tablets. So please advise me to take proper treatment. ### Response: I have seen your reports (attachment removed to protect patient identity). According to your complaints, I will suggest you few things. Do not sit in front of the computer for a long time not more than one hour after that at least walk for 2 to 3 minutes and you can get back to your work. Because of long-standing sitting in front of the computer, your shoulder muscles must be weakened. So, to strengthen your muscles you need to start exercises for that. Coming to your disc prolapse. You have symptoms for that if you have weakness in your legs then it requires surgery. Before that, I will prescribe nerve related tablets. Tablet Pregabalin 75 mg daily once after food for one month

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I would like to know why people have blackheads and when you try to remove it, it creates acne and blemishes on the cheeks and mouth area. It is concerning my skin on my face. I have been feeling insecure about my skin later due to the blemishes and acne on it. I get a lot of blackhead on my cheeks and jawlines. Moreover, I get a little bump rising when I wash my face or when I exfoliate it with natural exfoliators. Whenever I try to remove the blackheads, it gives me blemishes and acne scars which really bothers me. ### Response: Hello. Acne is related to sebaceous glands. Some individuals have acne prone skin in which normal follicles becomes clogged with keratin, sebum, organisms, etc., resulting in blackheads formation. When inflammation occurs blackheads convert to pimples and bigger pimples lead to cyst and nodule formation. Treatment of acne is important because it can lead to scarring if not treated early and properly. Its treatment starts with oral and topical antibiotics. For blackheads and whiteheads recommended treatment is topical Retinoid. Acne vulgaris. Tablet Azithromycin 250 mg BD for the first three days, then on alternate days for three weeks. Apply Clindamycin lotion over the lesions BD, apply Tretinoin gel plus cold cream at night on the whole face in small quantity. Wash face with mild soap and water. Avoid using irritants.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I wanted to ask which medicine I can take that does not have any side effects so that I do not discharge early as I have once taken Suhagra force which contains Dapoxetine. Is there any medicine for it without any side effects? And how often can I take it before intercourse?Secondly, I want to ask is there any medicine to increase the size and width of my penis? If yes, then how it should be taken? If there is any ayurvedic medicine then also you can suggest? ### Response: There is no medicine available to increase the size of the penis. But by cosmetic surgery, the size can be increased by one to two inches. Premature ejaculation is mostly psychological. First, you try to divert your self in between while having sex. If you are about to cum then squeeze your glans in between your thumb and index finger. You can also use local anesthetic gel but then it is better to use a condom with that.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Could you please check my blood test result? Does it confirm that I am pregnant? Could I know how many weeks? Do all the results look normal? Is there anything should I pay attention to? Do I need to do any additional blood tests or checks, such as for human chorionic gonadotropin and progesterone? ### Response: Hello. 1) From your reports, all blood reports are found to be healthy (but for platelet they have not mentioned the value due to clumped sample, but blood smear looks normal platelet, so that is taken as usual, for the value you can repeat it later). 2) Since your last period date was before five weeks, if you got urine pregnancy test positive, that means you are pregnant for five weeks five days now. 3) None of these tests are confirmative for pregnancy. Usually, pregnancy is confirmed by a urine pregnancy test, or blood test as you told (serum beta hCG), or by scan around six weeks. 4) So at present if you got urine pregnancy test positive means you are pregnant, no need to go for beta hCG now, do a transvaginal scan for viability by six weeks (means three days later from today), otherwise, the scan will be too early to see the pregnancy sac.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My daughter, 2.8 years old was diagnosed with nephrotic syndrome. She had swelling in limbs, private part, stomach, and eyes. She also had slight cold during that time, but no running nose or cough. I have attached her reports.From the last one week, we started medicine, post which the eye swelling (by 90 %), face, hand, legs have reduced and hand have also reduced, but the private part and stomach still have swelling. Overall swelling is still present. Urine check showed improved creatinine results after three days. Her weight has increased 1 kg from the last five days, everyday it is gradually increasing by 200 to 300 gm. Even prior to start of her treatment she had good appetite, she used to eat every few hour either a biscuit or yogurt or a fruit or bread slice.My questions are:In how many days does this swelling reduce?The doctor here suggests albumin infusion if the weight continues to increase or the body swelling does not reduce by five more days. Is it safe to use albumin infusion? Does it require admission into hospital? How many days should we wait before we decide on albumin infusion? Any other alternate to albumin infusion to reduce edema? When will we know if the medicine is working, the doctor say it takes maximum of 30 to know the impact?Whats happens if the child does not respond to the current medication, doctors here are not disclosing but I want to be prepared financially and mentally? What are the scenarios to take child immediately to hospital? Please help. ### Response: I can see clearly that your daughter's condition is improving (attachment removed to protect patient identity).