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ophycare

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icliniq-dataset-1

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Ophy Care, Inc. 5

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a fimbrial ectopic pregnancy in my left tube. I received my internal ultrasound pictures but do not know how to read them. I am wondering what the orange spots are meaning on my ultrasound and where the fetus would be? I was told it was about 2 cm. ### Response: Hello. I have seen the images (attachment removed to protect patient identity) An ectopic pregnancy happens when the fetus starts developing at a location other than the uterus. In your case, the pregnancy is developing at the end of the left tube which is called the fimbria. You can see in the pictures that the uterus is empty and a sac-like structure is visualized in the location which is probably the end of the left tube. The developing fetus is very small and looks like a small straight line in the sac. The orange spots are flowing blood and usually, the growing gestational sac has blood flow which can be seen like a ring in cases of ectopic pregnancy. Regards.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 18 years and I have been taking the birth control pill Yasmin for three months now. Today, I went to the pharmacy to go get another three months supply of Yasmin but the pharmacist gave me Elvina and told me it was the equivalent to Yasmin but I am worried to take Elvina because my body is used to taking Yasmin. I am wondering will it be fine to take this? ### Response: Hi. It is nice to hear from you that you are concerned about medication type before its use. You are a teenager, still under development stage of the reproductive system. Elvina is also a combination of two hormones (

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: A year before, I was getting regular periods. One day before period, I used to get spotting then bleeding for five days. I was on birth control pills. A year ago, I stopped the pills. So from nine months, I am having brown discharge with mucus before four days of periods, then bleeding for five days. I do not understand why every month brown discharge start so early before periods. Because of this, I am always with the due date of my periods every month. I visited a gynecologist, who said it is normal, but I am still not convinced. I am trying to conceive. Would it be the reason for not conceiving last year? ### Response: You have not mentioned for how long you took the birth control pills. There are many adverse effects of the pills, which women are not aware of and the doctors are also not telling.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 38 year old female. I have recently developed a skin rash in my groin area. This is the first time this rash has developed. I am currently under no medication. My menstrual cycle is normal. ### Response: Hello. It is dermatophytosis, a kind of fungal infection, which is common in a humid environment. I suggest Candid B (Clotrimazole and Beclometasone) cream morning and evening for few weeks. You will notice the improvement in 72 hours. Regards.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a boil on my inner thigh, which keeps recurring. I have had a boil in the same spot before. When I popped it went away, but now it has come back. It is also very painful. Please help. ### Response: I have read your query. It seems that you are having furunculosis. Boils (also called furuncles) are a deep bacterial infection of hair follicles. The cause of recurrence may be Staphylococcus aureus, which is most commonly carried in the nostrils, armpits, between the legs and in the cleft between the buttocks. It may be transferred to other sites from the nostrils through the finger nails. General measures to avoid the recurrence are as follows. Regarding treatment, I suggest oral antibiotics like tablet Augmentin 625 mg (combination of Amoxicillin and Clavulanate potassium) if you are not allergic to penicillin group. Take one tablet thrice daily for five days. Also, my suggestion is to apply Mupirocin twice daily for five days. Consult your doctor, discuss with him or her and take the medicine with consent.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I wonder if chlorine levels in a normal swimming pool kill all the microbes. If someone with a fungal infection swims in a pool, won\t it spread to others through the water? ### Response: Hello. I understand your concern. Swimming is considered as a safe recreational activity. But that is not totally true. Chlorination of water is known to kill most of the microorganisms (which include bacteria, viruses, fungi and parasites). But there are several factors to be considered like: 1) Type of microorganism (some organisms may be resistant to chlorination). 2) Adequate chlorination (if sufficient chlorine is not added, there could be a chance of acquiring infection). 3) Duration of chlorination (when a microorganism is introduced into the water, the chlorine may not kill the organism right away, some resistant organisms may survive longer in the water). 4) Microbial load (the stage of infection of the infected person is also important, during the acute acute/highly infective stage, chances of spreading infection may be higher). Consult a general practitioner online for further follow up -

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had a root canal done in one of my lower right teeth. It was done in one sitting with the help of a laser. Everything was fine for a week. Then, one day my right jaw started aching and I was not able to open the jaw more than half an inch. There wa mild pain below the ear and it increased while chewing.My dentist says it is spasm and it has nothing to do with RCT (root canal treatment). I am taking Flexon MR and doing few muscle exercises keeping the jaw in movement.What is the solution?How long will it take to heal?I am worried will it become permanent? ### Response: Hello. Yes, it can be due to muscle spasm but as it started after one week then it can also be due to infection in the root canal treated tooth. So, first of all, the exact cause needs to be ruled out. If Flexon MR (Ibuprofen, Paracetamol, and Chlorzoxazone) and muscle exercises are not resolving the problem then an X-ray of the tooth should be done to check for any infection. It can heal mostly within a week. No, it cannot become permanent and both conditions - infection and muscle spasm are treatable

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I recently lost a crown, and as a result, I have to get the tooth out, and I have to get an implant. I have two teeth missing on the other side already for the last 10 years. They are all are molars, top, and bottom on the other side. I read that this can change the shape of the face, and I am worried even though it did not affect the other side. Kindly advise. ### Response: Hello. Please do not pay attention to such misconceptions. The treatment has now become very aesthetic and sophisticated. You should not worry at all about aesthetics.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had unprotected sex on 11th of this month, and took an I-pill the next day and again on 13th, the condom leaked, should I take another I-pill? I finished my periods on 10th of this month. ### Response: Since you have taken an emergency pill within 72 hours of intercourse there is no chance of pregnancy. The pill will be effective for 72 hours of intercourse there is no need to repeat the same. However, if you have a doubt then get back to me

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My brother is worried about his marriage because of the same blood group. Both are having a B+ blood group. Is there any problem after marriage for getting a healthy baby? Please explain it to me so that I can talk to him. ### Response: Hello. Same blood group people can marry and can produce a normal child. There is two common universal blood group system that is ABO and Rh. If they both are relative then genetic counselling is needed. As far as same blood group is concerned, do not worry about that. If you want to investigate, then I personally advise you that they both should get tested for thalassemia minor by electrophoresis by HPLC method. You can inform me your electrophoresis report for giving further comment.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 58-year-old male. I am 180 cm in height and weigh about 85 kg. I have frequent constipation issues. I am currently on Obimet SR 500, Glimisave M1, Pinom 40 mg, Pivasta 2 mg, and Clopilet 75 mg. ### Response: Would you please answer few of my following questions. Please feel free to ask anything and answer my questions. CBC (complete blood count). HbA1C (glycated hemoglobin). TSH (thyroid-stimulating hormone). Serum calcium. Digital rectal examination. Ispaghol husk two teaspoons in a glass of water every night. Polyethylene glycol sachet in a glass of water every night for two weeks. Take plenty of water. Do 20-30 minutes walk daily.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: A 5-year-old boy has intermittent fever, muscle pain, cough, and blocked nose for the past four days. The temperature is shooting up during nights and is normal during the day time.The blood test results are:CPK 23056 U/L.SGOT 513 U/L.Leptospira IgM and dengue IgM tests in progress. Please advice. ### Response: Hello. The reports and history are suggestive of some viral etiology probably, however, it is advisable to do a blood culture also to rule out bacterial etiology. In the meantime, I would advise starting Ceftriaxone to be on the safer side along with proper iv (intravenous) fluid management. Other symptomatic management like nebulization and antipyretic medications to be given as per the symptoms. To trace blood culture, dengue and leptospira results and act accordingly. If symptoms worsen or do not resolve in the next five to seven days, detailed investigations in favor of Duchenne muscular dystrophy should be carried out.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: These are the reports of my kidney function test and liver function test. I was on antibiotic Amoxicillin and Ibugesic plus when having this test. Is this report really abnormal? Is there something seriously wrong with these reports? I am worried. ### Response: Hello. Your reports (attachment removed to protect patient identity) do not have anything to panic about. I hope it helps you. If you have any further queries please ask me.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My wife started her last menstrual cycle on the 22nd of the previous month. We had protected sex on the 27th of the previous month. Unfortunately, the condom ruptured but, I was able to pull it out a few seconds before ejaculating. Just to be safe, she took an I-pill seven hours after intercourse. She had light spotting after a week which lasted for three days. It has been almost a month since her last period and she is not showing any signs of PMS. Is there any possibility of pregnancy? ### Response: Hello. I have gone through your query and understand the concerns. I-pill has the usual side effect of delaying the next expected periods by two to three weeks. So, most likely her periods are delayed due to the pill. I will suggest her to get a urine pregnancy test done if the periods are delayed. If negative, then she can safely wait for the periods for another two weeks. Hope you found the answer helpful. Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 61 year old and was lately diagnosed by a doctor as sick in fibromyalgia. In the last three years during the night time, I am suffering from aggressive involuntary movements while asleep. Those movements include kicking in the air and arching and bouncing my back and the whole body. At first those aggressive movements started as a physical response to a dream where I was being attacked which happened once in a while, lately, it happens more and more often without any noticeable reason. As a result of the movements, I suffer from strong pain in my back and knees which lasts for a long period of time and restrict me to my house. I am also very depressed of my physical condition which projects to anything I do in my private life, family life and job. I quit my last job a year ago due to my medical condition. Can you please advice on physical/neurological treatment that will improve my poor physical and emotional conditions?In addition, I am using Lamictal 200 mg which according to the medicine brochure might rarely cause involuntary limb movement. Therefore, I wish to replace it with equivalent medicine. Can you please advise on a possible replacement? I have already tried Seroxat, Depalept, Gabapentin, Lyrica, Teril, and Cymbalta which did not help. ### Response: Well, these involuntary movements do not sound normal at all. It looks more of chorea/hemiballismus (movement disorder). If any problem there, we will have to treat it differently. I understand you have tried a lot of

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have composite veneers on both of my front teeth. Sometimes, if I sense my bottom teeth touching the bonded teeth, even lightly while eating or brushing or what have you, I worry that since enamel is stronger than the bonding material, this will somehow alter the bonding. I spent a lot of money on the procedure and want to know what exactly would need to happen as far as my bottom teeth making contact with my top teeth in order to actually alter the appearance. ### Response: Hello. As far as normal occlusion or normal bite is concerned, the upper front teeth should not touch the lower front teeth. There should be a gap of at least 1 to 2 mm. But, sometimes when you are eating or trying to make the contact then it is absolutely normal. This way the bonding is not going to get affected. The doctors generally plan the treatment really well before giving the veneers. So, you need not worry about the bonding. Hope you got your answer. Regards

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had unprotected sex at 11 PM but took I-pill the next morning at 9 AM. I have missed periods. I have heard about the disease amenorrhea. Is this pregnancy or a disease amenorrhea? If amenorrhea happens, can it be easily cured? How she I have regular periods? Is it a matter of fear or a common disease? Please help us. ### Response: Most probably, missed periods in your case, is because of I-pill. Please tell me the last periods date, date of intercourse, and usual cycle length so that I can guide you precisely

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 27 year old male. Recently, I have gone through a full body check up and I am attaching the reports of that. So, kindly go through all the reports and provide your sound medical advice based on reports especially on the liver profile, ultrasound, and chest X-ray. Also, advice about the type of food which should be taken and what are the things need to be avoided. What are the medications to be taken to improve the health? I was having some pain in lower stomach parts while traveling, also some pain is chest area. So, I have gone through all the tests. ### Response: Hello. I have reviewed your detailed query and all supporting documents (attachment removed to protect patient identity). There is nothing wrong with the blood and urine tests at large. Your heart is working perfectly normal and there is no abnormality found in the heart. Blood sugar is all normal and working fine. Your lipid profile is a little out of range but this is manageable with a change in lifestyle. You need to start working out (better would be to join the gym and do treadmill and cardio exercises under the supervision of a gym instructor). Take healthy and natural diet. No junk food and lazy habits. Remain active and keep calm. ESR (erythrocyte sedimentation rate) is high and the reasons can be discussed with your treating physician. Causes of high ESR can be inflammations and infections in the body. Your chest X-ray shows infection (bronchitis) and that may be a causative factor. Hope it helps.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: After eating and drinking anything suddenly I burp and it is continuously happening. Sometimes, it feels painful when I burp especially while sleep it was very painful. Even while smoking I burp continuously, and I cannot stop. Only for the last two months, I am facing this issue. So, I think it is a starting stage. What are the possible remedies for this issue? ### Response: This can be due to GERD or gastroesophageal reflux disorder. I suggest you stop smoking as it reduces the lower esophageal sphincter tone and further aggravates the condition. You can take a proton pump inhibitor like Pantoprazole or Rabeprazole or Omeprazole along with prokinetic agents like Domperidone or Levosulpiride or Itopride

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a sore throat since yesterday. There is also a slight fever of 37.4. I suspect my swollen tonsil. I had taken juices and gargled warm water with salt. For the fever, I took paracetamol if needed. ### Response: Hi. Do you have any other symptoms such as cough or difficulty breathing? Any recent history of travel to China? Or any exposure to someone who may be possible with Covid-19?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I daily take Pristiq antidepressant tablet 50 mg, which doctor had prescribed since a year. Now I am tapering the tablet gradually as per doctor\s instruction. The first week every other day and second week every two days and the third week every three days. And now this is my fourth week, and I am off completely. So my question is, can I use 5-HTP supplement tablet? So that my withdrawal symptoms will be less.And when I can take 5-HTP? Withdrawal symptoms are scary to me, and I want to completely stop this Pristiq because I tried many times to get it off, but unfortunately, I cannot. I had withdrawal symptoms, brain zaps, nausea, and diarrhea. I have some supplements like fish oil, b12, and 5-HTP but still waiting for a doctor advises. ### Response: You need to restart because of anxiety or depression disorder, not because of with

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have dry gray spots. After sunbath I got this and is uncomfortable while reading. ### Response: I understand that you are concerned. But the picture attached is quite blurry. Kindly send a clear and well-focused photograph to help you better.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: The period was two days late. When it started, it was watery. Then on the second day, it had some clots. Then it thinned up again and ended with brown blood. Why? ### Response: Hello. How are you doing? The possibilities for this periods are: For normal bleeding, you need a normal hormonal support to the endometrium, ovulation and the proper and complete bleeding. But, in your history I note your BMI (body mass index) is very high, Your expected weight is 52 to 56 kg. This extra fat is converted to hormones in the body which alters the normal hormone balance, leading to the poor formation and improper bleeding, which can appear as such a brown discharge, fleshy mass, and mucoid discharge. This needs only weight reduction by at least four to six kg. Any sudden increase or decrease in weight can affect these hormones. Another possibility is an infection around the uterus. If you have any yellowish or white or grayish discharge with or without itching or foul smell especially after sex and periods, pain in the lower abdomen before periods, feverish feeling, this could be an infection in the inner lining. So, the bleeding will be lesser in amount with fleshy masses, brownish and painful. This needs an evaluation by a gynecologist and a good course of antibiotics and antifungal medicines for you and your partner. Periods plus or minus seven days the expected date is normal, so two days is alright. Hope I have clarified your query. Do write back if any more queries.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a cold and have lost my voice. But my gum has swollen up significantly behind my last tooth in my lower right side. ### Response: I have been through your query and I can understand your concern. The swollen gum behind your tooth is a condition called pericoronitis. It generally occurs with the partially erupted last molar or teeth. The food gets entraped between the tooth and gum and it gets infected leading to pain and swelling of the gums. It is also characterized by the pain while opening the mouth. Also use Hy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: For the past eight months or so, I have had some problems with unusual headaches and sort of momentary feelings of lightheadedness, vertigo but it is like everything just shifts for a second instead of spinning. I have a background of stable migraine headache. I have had some face pressure as well and some momentary stabbing headaches. Some chronic low-grade nausea that can disappear for weeks at a time and is not usually accompanied by a headache. I went through the gamut with GP, he then referred me to an ENT, and then to a neurologist. I am still getting some headaches but have had a clear CT scan of sinuses. A full neurological exam was done and that was normal, and the neurologist did not seem to think that additional imaging (MRI) was needed because my exam was normal.Even though it was a CT scan of the sinuses, they would have seen the brain (particularly frontal lobe) and notified of any abnormalities they could see. I had a clear MRI approximately one year ago for some twitching and muscle pain. Do you agree that further examination is not warranted? In other words, with the above information is a structural problem unlikely? ### Response: Hello. You have been elaborate in providing your medical history and that always helps to form an opinion. Coming to your straightforward query, I really do not see any indication for a fresh brain imaging study like CT (computed tomography) or MRI (magnetic resonance imaging) in view of your transient, very short lasting symptoms and a normal MRI brain, just one year back. Instead, I would suggest here to get one electroencephalogram (EEG) done to look for abnormal electrical discharges in the brain during those episodes. EEG done during the time frame when you are frequently having those episodes will be more rewarding in terms of diagnostic importance. With a normal neurological examination and normal MRI, you should stay calm and assured that it is nothing serious. Lastly and importantly, anxiety is the commonest cause of such symptoms. Please start doing mental relaxation exercises, meditation, yoga and observe for improvement. I hope this helps.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have very thin and short eyelashes and eyebrows. I want thicker and longer eyebrows and eyelashes.Please help me. ### Response: Hi Thickness and size of eyelashes and eyebrows depend on your genetic inheritance. If your genetic makeup indicates your eyelashes to be thin then they will not grow bigger than your genes allow. In case your genetic material indicates your eyelashes to be thick and beautiful and because of some disease they do not grow well, the following steps will help: Consult an ayurveda specialist online for further queries

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I want to know that whether my kid has a tongue tie or not. My kid will be 3 years old after two months and he is still not speaking properly other than papa, mama, and OK words. ### Response: Hi. The frenulum is a normal structure. It is only that when it attaches close to the tip, it causes problems with tongue rolling. Ask your child to protrude the tongue. If it causes buckling of the tip, it is tongue tie. And see if he is able to slip undersurface of the tongue tip underneath his upper teeth.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have started taking Aripiprazole 5 mg tablets, after which I started getting spontaneous rashes. My question is, is this effect worrisome (should I go to urgent care)? ### Response: Aripiprazole can induce skin rashes though it is not commonly reported. It will be safer to get yourself checked to rule out any systemic involvement, especially if you have any fever, pain, signs of the exfoliating rash. So you need to be examined. Depending on the nature and severity of the rashes, you will be advised either to stop or discontinue Aripiprazole. So consult your primary doctor at the earliest.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a problem with speaking. I cannot speak fluently. I struggle with speech. I have doubts about anarthria disorder. Please tell me clarification of that disorder. My age is 22 years. ### Response: Anarthria means inability to articulate clearly due to neurological conditions. It occurs usually in Parkinson\s or stroke. it is unlikely that you might have any of the above at this age. It is very rare. What you might be having is stuttering

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am an 82-year-old man and noticed that my pulse was 54 late a couple of nights ago. I recorded it yesterday throughout the beginning with 8 am and ending at 10:15 pm. The pulse was 58, 60, 80, 78, 69, and 54. The 80 was after hiking 2.5 miles. I am concerned about the low of 54. I am currently on Valsartan and Hydrochlorothiazide 325 mg/25 mg and Amiloride 5 mg, each one per day. ### Response: Hello. I understand your concern about your health. Please do not be worried as it is nothing. It is perfectly normal to have a slightly low pulse as you age. It is a physiological change that occurs with aging perhaps 54 beats per minute can not be said to be too low. A normal pulse is between 60 to 90 beats per minute. This range differs with people. Age, body size, and activity level are some of the reasons for the variation. I advise you to continue your normal daily routine without worry. You can become concerned if it becomes lower as much as 40 and you experience symptoms like shortness of breath or faintness. Remain healthy. Best regards.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have had a swollen eyelid for over five years, in one eye only, and it is more bulged than the other eye. The swelling is constant, it rarely disappears for a few hours, and it is affecting my look. ### Response: I have gone through your photo attachment and can infer a swelling of the right lower eyelid (attachment removed to protect patient identity). It can be caused by a number of different conditions. The commonest non-painful swelling being a chalazion, it starts off as a painful swelling accompanied with eye rubbing and irritation. In case, these do not heal adequately they become painless and hardened chalazion. The other causes including swelling due to hormonal fluctuations, swellings due to tumors and due to conjunctivitis. I recommend that you visit an ophthalmologist for an examination to see what exactly this is. In case you feel that it could be a chalazion, giving hot fomentation with cotton or a clean cloth can help and the swelling may subside on its own, although some do require surgical treatment.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I broke my heel three days ago. The specialist said it is the worst break to get. My question is, should I keep the special boot on even with the fracture blisters. It is painful as it rubs on the boot. Should I keep it on at night also? ### Response: Plaster or a synthetic boot is designed for walking, and if you have blisters then a boot is not advisable for the reasons that you have found and that also indirectly means that you are allowed to walk but in reality, walking or lowering your leg will make the swelling and blisters worse. You need to be on strict elevation will heel above heart and ice the area 10 minutes at a time till the swelling is down. This also means that most are your activities are to be done on the bed until the swelling starts to recede.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am using skin lite cream for the past two years. This cream contains Hydroquinone and Mometasone. Now I am stopping the usage of this cream. Now in my face, I am seeing redness and itching like skin allergy. Please suggest the best creams or medicine to cure this problem. ### Response: Hi. You have developed contact dermatitis due to this medicine. As it also contains a steroid, skin becomes steroid dependent, so when this is stopped the face becomes red and inflamed. First thing for treatment is to use a good Sunblock OG SPF 60. The second thing is Metronidazole gel 0.75 percent and third is an oral antihistamine. Avoid all irritants and skin lightening agents further. Treatment will be long term. It will take time. Contact dermatitis. Apply Sunblock Spf 60 frequently every two hourly. Apply Metronidazole gel 0.75 % at night. Mix it with cold cream. Take oral antihistamine. Avoid irritants, maintain hygiene of area, avoid cheap creams available in the market.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am not getting a proper erection for the past three months. I consulted a sexologist, and the doctor told it as a sexual energy issue. Please help me. ### Response: The common causes for having an erectile issue in this age are stress, anxiety about erection, and due to certain nutritional deficiencies like Vitamin D. Take dates, raisin, anjeer, and almonds in your diet. Also, take Ashwagandha powder or capsules with milk twice daily. Practice kegel exercise and gomukhasana exercise daily. I suggest you take tablet Megalis (Tadalafil) 10 mg one tablet at night for three weeks and tablet Shelcal (Calcium carbonate with Vitamin D3) one tablet in the morning and night for four weeks.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have foot pain while moving feet to left and upwards or back since last night. The similar uncomfortable feeling started to happen to me before some time (like sudden feet muscle or vein cramp or pain while standing up from sitting). Before, when I was awake and just when it started I used to straight and stretch my feet and fingers and there was no pain or it was gone within five seconds before to start. If this is the same thing, this time it happened when I was sleeping. I was not able to stretch my feet and fingers so woke up with pain and then it started getting more painful. I started to feel pain in every step while moving feet to left and upwards or back. This foot is now bit puffy or swollen than the other. Any suggestion about medication, rest, exercise? ### Response: I want to ask some questions regarding your condition. This condition occurs in those people who stand a lot of time, or who recently had surgery and are on be

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 24-year-old bisexual male. 10 months ago a friend stroked his penis between my thighs, and suddenly his penis slipped and entered my anus for merely an inches, and he pulled out then we stopped performing it. And after four months I got constipation and hard stools, and then day by day I started to feel inflammation and burning sensation throughout my anus sometimes this burning pain moves to my perianal area and maybe in the rectum. As I read about the HPV infection, I got very scared, and I am in a deep depression. I do not know what this HPV or piles are? Kindly tell me what to do as I am in deep agony, pain, and depression. Please help. ### Response: Hello. HPV (Human papillomavirus), usually HPV infection does not cause any noticeable symptoms or health problems. Some time produce genital warts.For your complaints, constipation and burning sensation may be due to piles or anal fissure. So better go for the rectal exam and proctoscopy examination to rule it out. For piles and fissure try these medicines. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Tablet Pilex 1 t.i.d (three times a day) for 20 days. 2. Tablet Dulcolax (Bisacodyl) one or two for constipation. 3. Proctosedyl ointment use, as per instructions are given in box for 20 days.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have an infection in my root canal and also have wisdom tooth nearby root canal. So first what should I remove? Infection in the root canal or wisdom tooth? Please suggest. ### Response: From the X-ray, I understand that all your wisdom teeth are indicated for removal as they are erupting in the wrong path. However, I would suggest you get the one which is troubling you extracted first followed by re-root canal treatment for the adjacent tooth. It is better to get the extraction done first followed by the root canal. This sequence may vary from dentist to dentist and also based on patients preferences.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 60, weight is 44 kg, height is 5.6, diabetes for past 25 years, on low carbohydrate diet for 80 days, taking no medicine for diabetes now. Sugar levels are under control, checking every day. The problem from past 50 days is that there are feet and ankle swelling that disappears in the morning and comes back by night. No pain or weight loss. Kidney function test, liver function test, 2D echo, thyroid test, HbA1C, lipid profile, stool examination, B12 tests were done. Met local doctor, and he said it is nutritional pedal edema or malabsorption. Prescribed below medicine. Oroalbumen powder three times for 30 days. Revidox LB twice a day for five days. Lasilactone 25 mg once in the morning for three days. Along with the above, taking Thyronorm 25 mcg, Vitamin C, multivitamin tablet, Omega 3 fish oil, Ecosprin 75. It has been three days, did not see much improvement. Vitamin B12 was 1271. My questions are why is Vitamin B12 high? Could this be small intestine bacterial overgrowth? Taking lots of proteins and healthy food, but no use. Could you please help to get the food absorbed. ### Response: High vitamin B12 can result from multiple causes. Since your liver function test, kidney function test, peripheral blood smear, etc., are normal (attachment removed to protect patient identity), we can rule out these as the cause. Other causes like diabetes (which you have as evidenced by HBA1c), nonvegetarian diet (do not know your status) and vitamin supplementation (which you are on) can also cause mild elevations. Small intestinal bacterial overgrowth results in Vitamin B12 deficiency.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have darkness around my mouth area and forehead and dullness on my skin I suffer from acne scars all over my face and tanned skin. Please help. ### Response: Hello doctor, I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate treatment accordingly. Meanwhile, you can use the following medicines, 1. Tretinoin 0.05 % gel at night for scars. 2. Kojitin gel local application at night for dark areas. It is recommended to use photoprotection with above creams. Please send the picture of the affected area to help further.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My fiance fingered and rubbed his dick on my vagina. There was no intercourse, no clue if there was semen or not on dick and fingers. I was on the fifth day of my periods. Bleeding stopped on the second day. I have a regular period cycle. Four days later I experienced white sticky mucus high quantity in the evening. When is my ovulation day? Can I still get pregnant? There was no intercourse. Experiencing lower back and abdomen pain, high heartbeat, gastric issues. I am worried. ### Response: Hello. Overall chances of pregnancy are less because it is considered safe period for 2 to 3 days after the period to have sex, but if ovulation occurred four days later, then there are some but again fewer chances of pregnancy. Usually, ovulation occurs on the 14th day of the cycle. Also, since there was no intercourse, chances are less, but it also depends on whether there was any semen on his fingers or penis. So overall, chances appear to be less and do not worry about it at present. This will be cleared within two weeks. If you do not get period then get urine pregnancy test done.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am suffering from piles from nearly about a year. Suddenly yesterday, I felt pain around my anus, and I had 101 F fever. I saw that there is an infection around my anus. ### Response: For an advice specific to your problem, please upload the past medical records and a detailed evolution of your symptoms. And a picture of the problem site. Revert with more information to a general surgeon online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My 10-month-old baby had a viral infection with roseola infantum. It started fever 38.5 degrees and 39 degrees measured rectally on the second day treated with Ibuprofen 3.5 ml and Paracetamol (Panadol) 4 ml administrated after 6 hours (almost three days of treatment). The third day, the baby did not have fever at all and on the fourth day a rash appeared on his face, after his ears and on his back mainly, with mild signs on his tummy. Also, in the fourth day she had changes in his stool- kind of yellow with mucus and quite fluid with no fever.Five days later, the blood tests indicated severe neutropenia with 0 neutrophils on a test taken from her finger. As we got very scared, we repeated the test the next day and the result was 0.2 neutrophils so again a very low value.My question is that is it possible that this neutropenia is a consequence of the roseola infantum plus the administration of Paracetamol? The baby is fine now, she is very happy, playing, and eating normal. Also, would it be possible that these indicators can be so low due to the way of taking blood sample? We got it out of her finger, not through the veins. We were given Azithromicin just to be on the safe side, but I would not give her antibiotics if clinically she is well and shows no sign of being unwell. ### Response: Hi. The low count may be because of the disease process and less likely the Paracetamol or Ibuprofen. Another reason can also be the way the sample was collected (although I am not very sure about it). Do not worry about it if the child is currently fine. However, I would advise taking a fresh sample of blood from the veins and checking the counts again. If they persistently stay low on three consecutive occasions, I would advise a detailed workup to rule out any genetic disorders in the child.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My partner had sex with me before ten days. During that time, my condom was out and went inside of her without our knowledge. I did an ejaculation, and so she took one I-Pill on the evening. Now, we are worried about unwanted pregnancy. She says that her breasts have become big and her nipples are giving pain. Is this a symptom of pregnancy? Will that one I-Pill works? Can she take one more I-Pill now? Please advise us. ### Response: If she has taken I-pill (Levonorgestrel) in a proper dose within 48 to 72 hours of unprotected sex, without any vomiting, then it will work, and she will have bleeding within one to two weeks. Please mention about the menstrual history. It would be better, and I can guide you further. If it was not a fertile period of her cycle, then the chance to have pregnancy is less. Due to externally induced hormones, she can have engorged breast. Externally induced hormone interferes with the periods to prevent conception by stopping fertilization, ovulation or implantation. I-pill is beneficial in the first 48 to 72 hours of post unprotected penetrative sex. It is already a week. She will have bleeding in the coming days if the I-pill is taken in a proper dose.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 26 year old male. My problem is exhibitionism. I try to flash my penis to women. I know it is a bad habit. But I am not able to stop it. Please help me stop this bad behavior. ### Response: Hi. It is good that you have taken the very first step required for resolution of your problem and you accomplished that by seeking help. This is not recognized as a problem by a major part of the population due to ignorance or other reasons best known to them. There are various methods of treatment available for exhibitionism:

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am pregnant with my first child and I am 39 weeks and 3 days. I have been having mild contractions all day. For the past hour, they have been really intense and I have felt a lot of pressure. The midwife has told me not to come in as my contractions are still two minutes apart. I have just felt down below and I am slowly crowning. I am in agony and the midwife is determined that I do not need to go in yet. Shall I just go in? ### Response: Do not worry. This is not crowning, this is the last phase of the second stage of labor when the head of the baby is on your perineum. The rate of contractions will occur once in 2 to 3 minutes and will last for around 30 to 45 seconds. I would advise you to go in, as you have already reached the date, pain has been there for all day (that is quite a lot of time) and you feel they are increasing, along with the pressure feel. Suppose you break out waters, the pain will be even more intense and you will not be able to move out easily. It is always advisable for you to be around the midwife when you are entering the active phase of labor. Just feel for the rate and duration of the uterine contraction and also for the severity of contraction. If it is getting closer and lasting longer, you better not wait.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have vision-related tinnitus. I have been nearsighted for a while. Approximately, three months ago, I went to see a speaker, sat in the back and ended up looking at him out-of-focus for an hour. The next day, my ears started ringing. Looking at my computer tends to make it louder. I have special blue light blocking computer glasses. I got polarized yellow clip to use at night, in addition to three screens over my computer as well as a couple programs to warm the screen\s color temperature. But, I am still experiencing elevated ringing. My audiology test revealed a slight hearing loss in left ear, but nothing that would have brought on sudden tinnitus. I am currently on Nortriptyline to aid sleep. I have an appointment to see an ophthalmologist. I am searching for any immediate help possible. Do you like to give any suggestions for a particular polarized shade for to clip on or use over my prescription specs? ### Response: Hello. From what you have described, you have tinnitus that gets exacerbated on looking at the computer screen. There is no established connection between looking at a bright object and worsening of tinnitus, though there may be isolated reports. Tinnitus is usually caused due to an inner ear problem. In my opinion, you should seek an ENT consultation instead of an eye checkup as your main problem is tinnitus. An ENT consultation will help you find out the real cause for your tinnitus.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am realizing that I am an extremely sensitive person. I fear socializing with people. I think too much about what people think about me. There is a lot of fear within me. When people scold me, I take it too deeply and even my mouth vibrates. It is conspicuously visible. I have a lot of social fear mixing with people. While greeting people in my sister\s engagement ceremony, while smiling at a woman, all of a sudden mouth started to vibrate in fear. Overall, I am extremely sensitive to what people think about me. I feel depressed because of my embarrassment in front of them. I am sensitive even to sound and noise. Because of this, I find it difficult to go around and play or work in a group. If someone asks me something I fear before answering. I want to be calm and tough enough to face the society. Is there any effective medication? I am a law graduate as well. This problem is affecting my career and relationship. I am too shy and absent-minded. My first and final query is what is the disorder I am having? Please explain my disorder. ### Response: Hello. What you have is social phobia, anxiety and mostly is a result of a hard or strict education in childhood. Here are some ways you can build your confidence in life in general and help you rid yourself of social anxiety: Anything else? Feel free to ask me again. Have a good day.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am experiencing itching of the scrotum, below the scrotum area as well as in the tip of the foreskin. There is a dry and inflamed area on the right scrotum area. There is inflammation of the tip of fore skin. There is inflammation of the area below the scrotum. I am experiencing itching of the scrotum from the past two weeks. Please recommend an anti-fungal spray. ### Response: Continue it for 30 days even if there is an improvement. Consult your specialist doctor, discuss with him or her and start using the medicines with their consent. This will help you.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My son, who is 26 years old, now has been diagnosed with ADHD when he was 5 years old. He went to various psychiatrist to make sure that he is actually ADHD. Six doctors confirmed that he has ADHD and two doctors said he has bipolar disorder. He says that he was given Xanax as a treatment for the anxiety caused by ADHD and bipolar. He takes 10 tablets of 1 mg Xanax a day and sometimes, 11 to 12 tablets a day. Occasionally, when he takes less tablets, he smokes weed. He says that the combination of 5 to 8 tablets of Xanax with weed is equal to 10 tablets of 1 mg Xanax a day. He also takes tablet 300 mg Seroquel at night to help him sleep. My questions are is Xanax considered a medication for ADHD or bipolar? Is it advised to take 10 to 12 tablets of 1 mg Xanax a day? Is it fine to mix Xanax with weed? What is the appropriate medication for ADHD and bipolar? If xanax is appropriate for ADHD and bipolar, then how much is the appropriate dosage? Does he need to go to rehabilitation to clean his body of the high amount of Xanax and weed? Is it compulsory to continue a low dose of Xanax lifelong? ### Response: Attention deficit hyperactivity disorder also called as ADHD is a problem with hyperactivity and decrease attention. Bipolar disorder is the disorder in which increase talk, tall claims, decrease need for sleep and high energy are the most common symptoms. Xanax (Alprazolam) is a benzodiazepine. It can be given in low dose for the acute phase of bipolar. Also, it is not advisable to take around 10 tablets a day. Both, weed abuse and Xanax abuse are very bad for health.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Hello,I am a 52 year old female with a 2 mm acoustic neuroma on the right side. There is no hearing loss, but I do have dizziness, imbalance, pulsatile tinnitus. Also, an essential tremor developed seven years ago. I get migraines with aura occasionally. Ten months ago, I developed a coccyx pain which got worse upon sitting. My colonoscopy was clear. Three months ago, I developed bilateral diplopia, lateral and horizontal, but no nystagmus. I have also been getting headaches upon waking and in the evening. I consulted a neuro-ophthalmologist who suspected cranial nerve palsy and ordered blood and MRI tests. I will go over the results with him at the next appointment. I want to be sure to ask the right questions. There are two areas that I saw on the MRI that are obviously strange: The left lateral ventricle has a bright spot and looks larger with a different imaging, not at the foramen of Monro, but above. Also, the right clivus looks off. I would like your opinion and also want to know specifically what questions I should ask my neuro. I will submit a few of the scans. ### Response: Hello. I read your query and understand your concerns. You need to ask your neuro-ophthalmologist the following questions: I hope this helps you. If you have more questions feel free to write back to me

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My baby is 4 weeks old. I fed her a combination of breast milk and formula milk. I changed her formula to enfalac from friscolac slowly, and started solely on enfalac yesterday afternoon. I changed the milk (upon consulting with the pediatric clinic) because she was having constipation and gassy stomach. My baby had watery stool once yesterday and today (only after being completely on enfalac). She also is quite gassy (most days than not) and gets upset with it (cries last about 10 minutes). My worry is that if she is okay and, does the enfalac formula milk agree with her or she struggling with something else. I had to add formula milk due to insufficient supply of breast milk. ### Response: Breast milk is definitely best and first choice but as it is insufficient and you need to supplement with formula feeds, all these formula milk are cow\s milk. It is not clear from your query- which Enfalac formula you are giving as there are so many different types and also in the powder form and in ready to feed one. Watch it with the same formula milk for next 24 hours, feed more on breast feeding, and keep a watch on urine output. It may settle down slowly. If not then get, stool test - routine analysis, give Pedialyte - 15- 20 ml after each loose motion (give as small small sips), and better to give a milk formula which is HA (hypoallergic) like Similac or Nan or any other.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 58 years old and currently working in a meat shop, working always in frozen foods. My problem now is about my hands (fingers). It is numb and painful. I always feel this everyday and wake up with numb and pain. Any medicine or vitamins aside from Vitamin B1, B6, B12? ### Response: Hi. Long time keeping hand in freeze or ice cold things, your blood vessels constrict to avoid heat to escape from the body. Continuously blood vessels constriction will not allow blood to reach to the hand tissues and nerves. So, numbness and pain comes. If you are diabetic or hypertensive, condition will be worse. So, in between your work just rinse your hand and fingers in warm water, not very hot. Use thick rubber gloves to avoid direct cold to your hand.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 33-year-old woman. I am pregnant with my first baby in my 12 weeks. I had an appointment with my doctor two days ago, and she did an ultrasound to me, and she told me that th NT measure of the back neck of my fetus is 2.3 mm. She asked me to do a blood test called prenatest to be sure of that. Please advice what should I do? I am attaching the ultrasound report. ### Response: When NT (nuchal translucency) is towards higher value than a baby is more likely having a problem. Now there are two prenatal tests which can be done at 12 weeks. Most commonly done is a double marker test. And if high risk than how much is the risk, statistically like 1:148, which means there is a chance of one pregnancy to come positive for downs in every 148 pregnancy. So for further confirmation have to send liquid around a baby for examination. In that, we remove fluid under sonography guidance and send it for examination. They segregate fetal cells from it and do a DNA test for confirmation. But this test is directly invasive and also have some possibilities of side effects, so we avoid on the first basis. Because if it comes as low risk in double marker than no need to send liquid around the baby. So consult with your gynecologist and have detail about which test is carried and possible results.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a repeated rash behind my ear. I am pretty poor. So, doctors are not easy to come by. It just pops up sometimes. ### Response: Hello. I saw the picture (attachment removed to protect patient identity). You have erythematous (red) papules (bumps) behind the ear. I can list a few possibilities: I would like to know: Revert with more information to a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My sugar level is 210 after breakfast. Is it normal or high? Can I control sugar level? ### Response: Hi. The sugar level 210 after eating food cannot be considered normal. It is suggestive of diabetes mellitus. However, you should repeat your serum fasting blood sugar estimation, serum post-prandial blood sugar estimation, and HbA1c estimation to confirm diabetes. In this early stage, you can control diabetes with weight reduction, less fatty foods, and regular exercise.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had intercourse (he did not ejaculate) and took an i-pill the next day. I am suffering from PCOD and by doctor\s prescription, I took Meprate for seven days twice daily. But still no sign of periods. What can be the causes? Also, after taking the i-pill there is no withdrawal bleeding.My last period was before two months and it is causing stress and I am overthinking. Please help. ### Response: Do not worry, you have nothing to worry about. As you have PCOD (polycystic ovarian disease) your ovulation will not be on time. As you mentioned that he did not ejaculate and you took i-pill within 24 hours, chances of pregnancy are very low. Usually, you can wait up to 10 days after stopping. Because you had I-pill and Meprate your period would have got postponed. So I would advise you to wait for periods till 10 days after the last day of Meprate. If still no periods, just for confirmation get urine pregnancy tested. I bet it will be negative. Then take any of the oral contraceptive pills like Novelone, or Ovrel G, or Dear 21 or Diane 35 or Intimacy plus 3 twice a day for 10 days, throw that extra last tab. You will surely get periods within the next 10 days. If you get periods in between just stop the pills. In PCOD the inner lining of the uterus may not be thick enough, so your periods will be light sometimes with pink discharge only, so no with

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a habit of overthinking simple things, and I make them complicated. I always waste my time and energy on deducing the multiple outcomes of a simple thing, which others may not even think about it. I make things complicated, and I repeatedly contradict my own words. I feel guilty. I do not want to waste my energy on this act. Please help. ### Response: Hi. Sometimes we do not have control over our thoughts. The train of our thoughts goes running continuously, and sometimes it reaches a destination which is so different than the actual goal.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a cracked tooth. It hurts me a lot for a week. Now, I can eat only on one side of the mouth. What can I do to get relief? ### Response: Please say about the location of the cracked tooth. Please mention whether it is present in the front tooth or back tooth. If there is a pain, you can take Amoxycillin two tablets one at morning and night. You can also take Aceclopara (Aceclofenac with Paracetamol) for the pain along with it. You can take tablet Rantac before breakfast and dinner. If the crack is present in a front tooth or back tooth, consider going to the dentist to examine the condition. If it is present in a front tooth, you can treat it by bonding and root canal treatment can also be done. A crown can be placed over it for esthetic purpose. You can go for an implant also. If it is present in a back tooth, you can do a root canal treatment, and it can be managed by placing a crown over it. If the crack is too difficult to be handled by root canal treatment, then it can be extracted.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a question relating to my deceased father. I obtained his medical records after his death. While searching through his records to gain a better understanding of what may happen to me, I found he was positive for the rheumatoid factor and had been diagnosed with ankylosing spondylitis. However, the HLA-B27 gene test was negative. I brought this to my rheumatologist and she told me she thought he had something else, but would not elaborate. Does anyone have an idea of what she may thought because she still has not told me? Since then I have switched rheumatologists for that reason. My father passed away from leukemia brought on by myelodysplasia. I would like to know because doctors still have no idea what may be plaguing me. I have seen multiple doctors for my slightly high CK levels. I have been tested for myelodysplasia, rheumatoid arthritis, multiple muscle diseases, sarcoidosis, and many more. I have not received any answers as of yet. ### Response: Hello. Well, I do not think you should be worried about anything. Firstly rheumatoid factor is not transmitted genetically unlike HLA- B27 (human leucocyte antigen). Secondly, it can be positive in a lot of people but does not cause any symptoms. Thirdly, you have been tested so far and it has all been negative. Leukemia does carry a family history but you can get your blood checked every six months. One thing you need to understand is, there are no medications as such which can you take which can prevent autoimmune diseases. If it has to happen, it would or else not. But yes, stress would definitely make things worse. So I would suggest just take it easy since you have had negative tests and enjoy your life. Keep a regular health check. Eat healthily and exercise regularly. You have not got any answers since you are healthy. I hope this helps.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I woke up this morning with this dried up blood in between my upper front teeth and blood comes out when I touch it. It does not hurt, and when I brush my teeth, I can see it move. I have not noticed any changes in my gums or teeth. My gums usually bleed when the bristles of my toothbrush scrape against them. I am going to make an appointment with a dentist. But, I am a little freaked out about this as I am only 20. When I ate something earlier, it inflated a little bit, popped and bled without any pain. ### Response: I have viewed the images attached (attachment removed to protect patient identity). Periodontitis. Deep gum infection. Use a soft toothbrush to brush your teeth.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I want to discuss a sexual problem. I do not feel the desire to have sex. Although I try to have sex and also get an erection, I am unable to ejaculate. After some time, the erection just goes away without any ejaculation. I like to do foreplay but never really interested in sex as long as I can remember. I have never masturbated even. I got my testosterone tested and it was 241. I also have psychiatric issues for some time. Could the sexual and psychiatric problem be linked? What is the problem that I am exactly having? Is it treatable? ### Response: Your problem is treatable. It is called anejaculation. If you are taking any psychiatric medicine then your problem may be due to that. Psychiatric and sexual problems are mostly related. If you ejaculate in sleep then your problem is likely a psychological one

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I chipped my front tooth two days ago. I saved the broken tooth piece in a cup of milk in the refrigerator. The piece is fairly small (bottom corner chipped off). What are my options to get my tooth fixed? It does not hurt but it is a little sharp to the touch. ### Response: Hi. That is good that you saved the part of the tooth. But actually little chipped off part of the tooth cannot be reattached to the tooth by any means. But if whole tooth and its root somehow got knocked out of socket while you fell down or so and that tooth is kept immediately under your saliva or milk and then re-implanted at the same place within one hour then this tooth definitely gets saved. But, unfortunately, its broken part is hard to re-attach. You should get filling of it done as soon as possible and get sharp edges trimmed else it will hurt your tongue or lips. Stay happy and blessed.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 28-year-old with 60 kg, and 1.79 cm. My problem started as red skin on my glans, and the dermatologist told me to use Cortisone cream for two weeks, after that, my penis as had an inflammation, because I used Cortisone cream on my glans. (Now the inflammation is finished) but my glans is white, and my glans circle is purple and thickened, what can I do? ### Response: I checked your image (attachment removed to protect patient identity) if you have itching need to think of fungal infection. If no itching it can be PPP (pearly penile papules). Please share a clear image as it is blurred. 1. Do you have pain? 2. Did you have recent unprotected sex? 3. Do you feel any odor?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have tremors on my left hand. I am on Amantrel 100 mg tds, Frisium 30 mg and Propranolol 40 mg. I have been through two stents in my heart, but I have no myocardial infarction. I am on beta blockers Valent 40mg od and Retorlix 5 mg od. My neurologist says this as Rubral syndrome and my very senior physician said this is more likely to be muscle weakness because through a strict regime I have come down to 99 kg from 140 kg in the past 19 months. I would like to slowly discontinue Frisium because it makes me drowsy. My question is, should I taper one medicine after another just to see what works best? The physician told me to stop all medication completely which I do not think as a great idea. Can you please help? ### Response: I understand your concerns. Let me try to help you. Rubral Tremors (Slow tremors at rest). 1. Parkinson\s disease2. Parkinson-plus disorders (group of neurodegenerative disorders) Parkinson\s disease. Continue tablet Amantrel (Amantadine). Do daily morning and evening 45 minutes of walk. Revert back after two weeks to a neurologist online.-

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My 32-year-old brother has acne problem on the face and upper back since the last 15 years. He does not smoke or drink. ### Response: Hello. From your description, he is suffering from acne vulgaris. As it is spreading to the upper back, it is problematic.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am suffering from depression. I am having feelings of mild depression, but I do not know if I am actually depressed, but here is a bit of my life since I was a boy. I lost my mother when I was very young and did not have any memories of her. I grew up with my dad and my siblings, but I have always felt different, alone, cursed, and forgotten as nothing seems to work for me. Never felt loved, my dad was addicted to alcohol and, and most of my family members abandoned me till date.I struggled with the feelings of worthlessness daily as I grew up. I have little or no friends as I grew up, I had a lot of suicidal thoughts. My self-esteem was too low, had a dislike for myself, not able to express myself. I am short-tempered and a little caring same time. When I was 20, my feelings got worst, and I cried every day at night. I have extreme mood swings because when I am around people, it seems I am happy, but when I leave, I return to my hole. Kindly help. ### Response: You have described facing several adverse childhood experiences like losing your mother, and indifferent father addicted to alcohol and lack of loving support while growing up. These adverse life events could have potentially affected your feelings like, making you feel low, affect your self-esteem, and cause suicidal thoughts. Anyone in your situation would have probably felt the same. It is good to know that you had some support from a friend before. It is important not to isolate yourself when you are feeling like this. Try to meet supportive people regularly. If you are in education or doing a job, try to speak to a senior person and see whether they can be a mentor to support and guide you. If you are spiritual, try visiting holy places regularly if you find it helpful. You have said that you feel happy when you are around the people and low again when lonely, this is understandable. People feel better in practical social situations. You will also benefit by consulting a doctor who can do a full assessment of the nature and severity of your symptoms, and it will clarify whether you have clinical depression. Try to speak to your friend and family and make sure you get help. You may need some counseling support or therapy to help you move forward in life. Equally important is self-help measures like eating healthily, sleeping well, exercise regularly, keeping yourself gainfully occupied, and having positive social relationships.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have been suffering from depression and anxiety since 10 years. I went to a psychiatrist and he prescribed too many medicines, which made matters worse. My family doctor has put me on Mirtaz 7.5 and due to severe problems of falling asleep I am on Zolfresh 10. My depression is a little better as it has been 15 days, but still I am not being able to fall asleep. We have tried having the medicine earlier in the night so I sleep on time, but it does not help. I face erections problems too. Kindly suggest a medicine that works well with Mirtaz for falling asleep. ### Response: Hi. Serum TSH (thyroid-stimulating hormone) and hemogram. Depression with insomnia. Mirtazapine and Zolpidem 10 mg with careful instructions. Sleep hygiene. Revert back after a week to a psychiatrist online.-

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I had sex with a sex worker. I used a condom but I am still worried that I may get HIV or any STD. I did not see condom after intercourse whether it tore or not but I think the head of the penis was covered well. Am I safe? What are my chances of getting HIV? ### Response: As you have had protected sex, no chance of HIV, STD, or HSV may be there. If any symptoms appear then think about the test. At present, no need for ELISA (enzyme-linked immunosorbent assay) in 7 to 10 days. or RNA PCR on the 15th day or fourth generation CMIA kit test for HIV on 28th day. You can get any one test done. The last one is the best.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a 28 year old male and a regular smoker. I do smoke 10-15 cigarettes a day and have been smoking like this for almost 10 years now. When I started, I used different brands, from ultra mild to regular bidis. But now, for almost 3 years I am stuck with regular gold flake.Now, I am desperate about quitting smoking. I tried not to smoke for a day. But the next day, I would return back to the same. Recently, I came to know about a chewing gum called nicotex. It comes in 2 mg and 4 mg form. But I am not sure about this product.So my question is, does cipla nicotex chewing gum help in quitting smoking? Also to buy this chewing gum, do I need a doctor\s prescription? ### Response: This may include: These Nicotex chewing gums have nicotine in them in varying concentrations which allow a sustained but minimal release of nicotine while chewing. This nicotine is absorbed through buccal mucosa thus not allowing the with

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I recently had two spinal surgeries for cauda equina syndrome. I was told that the second surgery was required due to a dural tear. However, on reading my clinical notes, I now question this. I have the operation notes, which I can send (about a paragraph each) if you have a spinal surgeon who can decode them for me. ### Response: I have gone through your query with diligence and would like you to know that I am here to help you. Can you please elaborate what your question is?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am using Minoxidil for nine months now for the bald patches on my head. A little progress was seen between 3 to 4 months but no progress recorded afterwards. Can you suggest me what is wrong or if I should change my prescription? ### Response: 1. Sometimes there can be shedding of hair in between but you will recover from it if you keep using it. So stick to it. 2. You can also add tablet Finasteride 1 mg daily which is the only approved oral medications for an

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I was suffering from molar pain for the past two weeks and then decided to see a doctor. One of my molars decayed and I needed a root canal. But here is a thing, my tooth is very very short for a crown, it is between 1 and 2 mm in height. Is it fine to just put a post and then refill the tooth? How essential is the crown? ### Response: Hi. If your root canal is being in process and the crown length is very low, it is best to have post and core done on it after a final step of the root canal. This will strengthen your tooth and it will last long for like 10 years or more. If you do not get the post and core buildup on it and will go for a cap on such small crown portion the cap will be taken out in your chewing process more often and there will be a chance of breakage of tooth also that is saved through root canal treatment. So, I will advise you to get the post done. And one kind advice is that wait at least a week before your cap is placed so that you may rule out any pain or sensitivity issues of tooth in this time period, as once cap is placed and then you start feeling some sensitivity in the root canal or any symptoms of pain then cap removal will be difficult procedure. So, do not rush for the cap. Get post and core buildup done. Finish antibiotics, then take some time without medicines to see if all is fine. Then after a week or two get cap done. Stay happy and blessed.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My back upper tooth is feeling strange. But it does not hurt. I have checked to the dentist and doing some scan. But everything fine, what could cause this issue? Is it fine? ### Response: Hello. If x-ray also has nothing, it means there is no cavity. So the probable causes for your problem are, 1. Food impaction between teeth, which will cause such feelings for three-four days and will go away on its own. Use warm salt water for rinsing a few times a day for three days. 2. Sometimes sinusitis, i.e. infection or running nose, may cause discomfort of upper posterior teeth. For it, you should show it to a physician. If you feel there is specific pain which is increasing then show to one more dentist as the previous dentist might have left some finding. If you can, send the x-ray so that I can examine too. Use saltwater and a painkiller for three days and wait if it goes away.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am suffering from psoriasis for the past 24 years. I have tried a lot of ointments already. I heard one of the reasons is lack of vitamin D. Is it true? I am 54 years old now. ### Response: Hi. Psoriasis is a T-cell mediated autoimmune disorder. These reduce the excessive cell proliferation and differentiation seen in the skin cells of a psoriasis patient. A few of these

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I feel listless and tired when I return home in the evening. So much that I cannot exercise on the treadmill. I was on antipsychotics for 30 years which surely caused muscle stiffness and tardive dyskinesia. That could be one reason for the tiredness. Treatment for the above side-effects is now available and I will be starting it next week. Otherwise, it could be fatigue or something which I am asking you to pinpoint. Can you tell me what you suspect to be the cause? And what protocol we follow to resolve it? ### Response: The causes of fatigue are many including long-term antipsychotic medicines. Other causes include anemia due to iron and B12 deficiency, thyroid diseases, cardiac failure, diabetes, sleep disorders, and medications to name a few. You have not mentioned about your current medications as well as daily activities, your food habits, eating and sleeping habits exercise pattern. There is no mention about your stress level at work and at home. I would like to know the results of all tests done recently as well as the medication list you are currently taking. Do you do meditation, yoga, etc., to reduce stress? Nothing is also mentioned about your family history also. So, please provide all the details and I would suggest how to fix your tiredness. Please revert to me with the details I have asked for. Hope this was useful

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have to pop my sacrum every day for my hips to feel good. I do this by putting a pillow in between my legs and squeezing my glutes as hard as I can. My question is why does the sacrum not stay in place? What can I do to make it stay in place? ### Response: I read your query. There are many reasons for sacrum not getting in its position. Mainly posture as faulty posture while sitting, standing, even lying can lead to malalignment of sacrifice iliac joint. Again faulty or improper firing of gluteus and piriformis muscles and pelvic floor muscles can lead to this issue. You have to maintain posture and lying on a proper surface (I mean lying on a bed that does not sag and properly supporting the body) and maintaining glute, piriformis, and pelvic floor muscles strength will help you achieve a good stable SI (sacroiliac) joint

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have had lower back pain since the last one year. I got an MRI done and it is attached below. I saw a radiologist and he did not advise me much. I have a sitting job. Will running be beneficial in this situation? Do I need to take analgesics? I cannot sleep at night because of the numbness I get in my feet, and if I do sleep, sometimes I wake up because of it. ### Response: I read your query and understand your concerns about an ongoing lower back ache. I have seen the reports that you had attached (attachment removed to protect patient identity). I hope this helps you. Feel free to write back to me if you have more questions

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I underwent myomectomy surgery five months back for fibroid removal. I am planning for pregnancy now. Recently I did a follicular scan on the tenth day of my period and report showed that I have echogenic endometrium. What does it mean by echogenic endometrium? Does it mean my uterus is not healed completely and still have scars? Endometrium thickness is 8.2 mm. Kindly help me understand this. ### Response: It would be better if you can share black images of ultrasound. It looks like a cyst in one of the ovaries (attachment removed to protect patient identity)

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a male. I have had a long-term chest pain. It has been there for years, sometimes it is worse sometimes it is not. I am pretty scared of it when I think about it. I can feel the pain when I press against my upper left side of the chest (breast area). I cannot exactly pinpoint where the pain comes from but it is the upper left side of the chest where my nipple is. It has been like this for about two or more years. I cannot say it has gotten worse, it has stayed the same, just on and off in pain\s intensity, but always there, uncomfortable. Please note that my work has me in the seated position in front of my computer all the time. I do not know if it is the posture or something. I have not gotten it checked, my family has always been in a bad financial situation. So, I never bothered with it. ### Response: Hello. About your query, I need to determine what type of chest pain it could be. I advise you to do chest X-ray and ECG

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have a gap in front teeth may be it is diastema. Teeth are not fully separated apart starting from gum line like typical diastema. They have only slight gap below the gum line, may be less than an mm. I want to know:Whether this gap between the teeth require any kind of treatment other than for cosmetic purpose?In future, does this gap harm or shift adjacent teeth? I mean does this gap affect the functionality of front teeth as well as adjacent teeth?What areits causes and is there any exercise to close this gap like pressing the teeth together for 10 to 15 seconds. If I do that exercise, does it affect the functionality of teeth in a negativeway?In short, I want to ask whether one needs treatment for diastema if it is not showing any symptom or not affecting day to day life. I recently went for a regular dental checkup and the doctor told everything is fine no gum or any other disease. To the best of my knowledge, I do not have any tongue thrusting habit at present or thumb sucking habit in childhood. I am attaching the X-ray of the front teeth as well the real image of my front teeth. ### Response: The treatment is required for an esthetic purpose only. Radiographs look fine (attachment removed to protect patient identity) to me. Along the years, the gap might increase due to a shift of the two teeth leading to an increase in the gap. There is no exercise to close the gap. Please do not press the teeth to close the gap. If you are worried about your looks, then go for veneer, ceramic crown, or orthodontic braces. If you are fine with it, then you do not require any treatment. Just relax

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Why do I have fungus on the nail beds of my hands and feet? ### Response: Nail bed fungal infection could be due to either continuous exposure to water or immune deficiency. Immune-deficient conditions should be excluded. Please send me a photo of your nails in order to classify how severe it is

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have PCOS. I had my period a month back. My periods are mostly irregular and I usually have cramps in stomach and my breasts hurt before periods not every time though. I had oral sex with my fiance yesterday, he was wearing a condom throughout but he rubbed his genitals on my vagina. I took an I-pill and Regestrone just to be safe after three to four hours. But today my breasts are hurting and I am having cramps. My vagina is also dry. Is there any chance that I am pregnant? ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse, there is no chance of pregnancy. These symptoms could be because of hormonal changes due to the pill you have taken. So relax and do not worry. However, if you have a doubt then get back to me.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 21 years old and had ACL surgery six months ago in my left knee but I am not able to exercise for the previous two months. What will be the consequences? ### Response: Hi. Usually, it takes 1 to 2 months for recovery from surgery and 3 to 4 months for muscles to regain their usual strength after ACL surgery. Since you cannot exercise it means that your muscles have not reached their optimal strength till now. Arthrofibrosis is a common complication after such surgery that can prevent you from exercising. But to know the exact cause, I would suggest you have MRI or bone scan of the knee joint to know the exact cause. Also, I would advise you to have physiotherapy sessions.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My wife is 15 weeks and five days pregnant. Recently, she had an episode of a moderate amount of bleeding per vaginam. We immediately shifted her to the hospital where she was given some conservative treatment, and a USG was done. It was found that the inferior margin of the placenta was covering the internal os. The baby was healthy as per the reports. I am anxious. Kindly advise. ### Response: Hello. However, if you have a doubt, then get back to me with the reports so that I can guide you further

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My 10-week old projectile spits up after every nursing session. He is scheduled to have an ultrasound of upper GI one week from now to see if he has pyloric stenosis. Last night he was up until 7 AM screaming in pain. He is hungry all the time and I feel like I am doing more harm than good by feeding him all the time. At his two months check-up, he had gained weight, he was 11 lb 7 oz. He has very good urine output and I do not think he is dehydrated. He only has 1 or 2 bowel movements a week. Every day he seems worse even with Zantac three times a day. I do not know what to do for him while we have to wait a whole week to have his tests done. Is there any way I can help him? Should I take him to the emergency room? ### Response: Hi. I understand your misery. However, I feel the line of management chosen is appropriate. If you could arrange for getting a USG abdomen done earlier it would be good. An X-ray of the erect abdomen can also be done to get an approximate judgment about the same. Another study that may need to be done would be a reflux study (since you have mentioned Zantac is no good). Signs you need to take him to the emergency room include lethargy, abdominal distension, not passing stools for three days or more with recurrent episodes of vomiting. Beyond this, I do not think there is anything that can be done given the current scenario.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I cannot sleep at my usual timings. I took half Bromazepam tablets of 3 mg. Tell me how much time would I sleep now? ### Response: As far as sleep hygiene is concerned, stress should be avoided through medication and behavioral counselling so that you can get proper sleep. Yoga, meditation, and exercise are beneficial in reducing stress. To induce timely sleep: Hope this will help you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 51 years old and have been diagnosed with an enlarged liver showing fatty changes grade-3. Is it life threatening? ### Response: Fatty liver change is a progressive condition that leads to liver cirrhosis after years if not managed properly. Risk factors include obesity, high cholesterol, and alcohol. Please provide me with your alcohol intake history and your lipid profile and liver function tests. I suggest: If you have any questions, please do not hesitate to ask

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Firstly, I would like to inform that I had got married eight years back. For the past eight years, my sexual life was going fine. Recently within a few days due to workload and pressure, I am losing my sex interest and I am just 31 years old. I have a kid of 5 years old. And during intercourse, my sperms come off very soon (premature ejaculation). Please help me on this and suggest me some good medicine for the same. ### Response: As you may be aware, stress in most forms will affect sex. But since it is only temporary and will vanish once the stress is alleviated (or you learn to manage it), your sexual performance will also return to normalcy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My son is four and a half years old, and he is suffering from reactive airway disease (enclosing the reports and prescription). Kindly suggest based on the above medication that till how long we can safely go ahead with Montair LC Kid. Is there any upper limit of giving this. I am very skeptical about continuing it in the long run. He is completely fine with this medicine, but if I skip a single dose, he starts coughing just anyways and ends up vomiting everything he had. So I keep on giving him a daily dose of MLC kid. Also, he is a bit aggressive and impatient. I do not know whether these are the emotional changes associated with this medicine. Please tell me that is he losing his natural immunity due to this. ### Response: Hello. Please note that the medications prescribed are to the best of my knowledge. Montelukast has been prescribed for patients for prolonged periods extending up to even two years without any problems. It uses has shown reduced requirements of admission and improving the quality of life in patients suffering from hyperreactive airway disease. However, it would be good if we can omit the LC (Levocetirizine) content by just giving Montelukast alone in the form of tablet Montair 4 mg daily at 8 pm instead of Montair LC syrup (Levocetirizine, Montelukast).

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am a diabetic. Does chewing nicotine gum will increase sugar level? Does stress in the heart increase the sugar level? ### Response: Hello. I went through your post. Nicotine chewing gum causes dental issues and sometimes hair loss and flushing. However, it does not increase blood sugar. So, you can take that it is 1000 times better to take nicotine chewing gum than cigarette especially once you have diabetes.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have been having some issues with my throat from the past couple of months. I feel a tightness in the neck. I do not have a runny nose, but I have post-nasal drip and lots of phlegm or mucus in the mornings. I feel like I need to clear my throat a lot. The symptoms seemed to go away for a week or so, but now they are back. There seems to be a bloody spot near the back of my throat, and I have attached a picture of the same. ### Response: I have seen the picture (attachment removed to protect patient identity). Do revert back to me if you require any further support. Hope to see you in good health soon.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I have regular headaches and I have done a consultation with a doctor and he advised for MRI. Please check my reports and let me know the reports. Is there any critical issue? ### Response: Hi. Your MRI is grossly normal with some evidence of ethmoid and frontal sinus mucosal thickening suggestive of frontal and ethmoidal sinusitis. These can cause your symptoms of a headache and are probably due to chronic allergic rhinosinusitis. Furthermore, you might also have a migraine as you have been put on Sebilium. You can continue Cetirizine and use FluMist nasal spray (live attenuated influenza vaccine) in case you have a nasal blockage.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I use Melacare cream for the past four years. Now I want to stop using it. But when I try to stop, it produces irritation and turns my skin into very black. Can I use Keto soap to recover my skin? ### Response: Hello. 1. Your condition is known as topical steroid dependent face (TSDF). 2. Melacare has steroids and it is not advised to use it for more than six weeks and you are using it for the past four years. 3. Use the medicines I am prescribing. 4. No, Keto soap does not have any benefit in this condition. TSDF. 1. Tacvido Forte 0.1 cream once at night.2. Metrogyl 2 % cream once in the morning.3. Suncros lotion all over face before going in the sun.4. Tablet Allegra 180 mg once at night.For one month.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My question is regarding WPW syndrome. I suffer from WPW syndrome, I just came to know about it. I am a mining engineer and work for a mining company, my day to day work involves blasting and exposure to heat, dust, and low oxygen environment. The blasts are severe, the peak particle velocity (a measure of vibration in rock after blast) is around 150 mm/sec. Can this working environment be harmful to me as it may increase my chances of ill health happening due to WPW syndrome? ### Response: However, some patients could collapse and have a brief loss of consciousness with WPW episode. It is recommended that those patient work in as safe as possible environment like avoiding the situation that requires being on ladders, and it is better in your condition to avoid areas with low oxygen and where ambulance and emergency help might be difficult to get to. The risk of WPW is if the patient develops atrial fibrillation that could end up with fatal VF. Have you thought about WPW ablation?

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: I am 18 years old. Nowadays I observe that I am losing my hair on the head and getting ball head. Is there any precaution to be followed? Kindly help. ### Response: 1. 2. For routine, you should wash your scalp daily. 3. Do not apply hair oil as it can increase dan

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My wife is feeling pain inside her right ear. According to her, she feels the pain more when she lies on the bed or recline her head for any purpose. The intensity of the pain is also showing up around her ear too. It is her feeling that there is something inside the ear, which may be water or something like that. All these have started the day before yesterday. Please help. She used Paracetamol for the same. ### Response: Hello. Your problem could be due to an infection inside the ear or secondary to nose and throat problem. I would like to know if she has any nose block, excessive sneezing, or throat irritation? Any ringing sensation in the ear or giddiness? Any discharge from the ear, if yes, for how long? Any relief after taking Paracetamol? Please get back to me with the reply.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: Last month, a doctor with HIV gave an injection in my vein without using gloves. She did not use any cotton, she just put her finger to stop the bleeding. She also rubbed my vein with her hands when it was still bleeding. Am I at risk?I did HIV DNA PCR after 9 days, and after one month fourth generation ELISA test. One of the doctor told me that the window period is 90-180 days. What test should be done after six months? ### Response: Let me answer your query step by step. There was no risk of HIV involved by the injection given by HIV infected doctor surgeon. Even if she touched with her finger at the bleeding site with the naked hand, you were not at risk. HIV cannot be transmitted by touching HIV infected person. Your risk was unwarranted in the scenario you mentioned. The test which you took, was highly sensitive and specific and gives accurate results. Window period is the time taken for antibodies to develop after infection and then to be detected by a particular test. 99.9% of the people who are infected with HIV develop HIV antibodies by three months. It is good that you know your HIV status now, you do not require any further test. I hope this helps.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: A 39 year old female patient is suffering from acute lymphoblastic leukemia. She is currently being treated at a hospital by an oncologist. I am attaching her reports. Please suggest a treatment. ### Response: Hello. I am sorry to hear about the patient\s condition. I have gone through the reports (attachment removed to protect patient identity)

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: For the past three days, I ate something solid and it hurt my front teeth and since that day they are hurting and moving. What should I do? I do not wanna lose them. If I go to the dentist, what will he do? ### Response: Hi. I have gone through your question. I can understand your concern. The loosing of your teeth can be because of biting on hard object or fruit. You need to restrict yourself from eating things that may loosen them more. If the loosing happen on its own it can be because of bone loss. Mostly the bone loss may be due to deep bite (malocclusion), that may need orthodontic treatment (braces). If you can upload some pictures of your teeth in open as well as in closed position I will provide you with the better treatment options available for the dentist. Deep bite or overbite, trauma. IOPAR (intraoral periapical radiograph) X-ray. Grade 1 mobility. Mobility because of bone loss. Splint or orthodontic treatment. Avoid hard foods.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: My friend recently told me that she found out she had AFib and had to stop drinking hard liquor as it is a trigger. Listening to her I wondered if I was having the same issue. At night I sometimes wake up with a pounding heart. I always chalked it up to scary dreams as the heart-pounding is just like I get when I have a big scare. Currently, I am taking Citalopram 20 mg. ### Response: Yes, it is possible to have AFib (atrial fibrillation), but truly speaking symptoms may be very similar. However, during AFib one would be having a high heart rate, with irregular heartbeats and usually associated with shortness of breath, dizziness or chest pain. It is usually abrupt in onset and offset. So, you should check your BP and pulse rate during the episode. If you have a smartwatch to keep track of the rate or may use mobile-based rhythm monitor. Also, another option is Holter monitoring