Datasets:

ophycare

/

icliniq-dataset

like 0

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had nonpenetrative sex with my partner he did not ejaculate but a kind of sticky lube came from his penis which he wiped with his hand and then rubbed his hand in the bedsheet after that he used his hand in my private areas i am afraid that i might get pregnant please help ### Response: there is a possibility that you may get pregnant with preejaculate fluid itself if you were in a fertile period as precum also contains sperms it is better advised that you should opt for an emergency contraceptive pill like an ipill within next hours to avoid the chances for unplanned pregnancy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have peeling lips for past one year it started over last winter when i applied moisturizer even after i stopped applying the moisturizer it is peeling still i went to a doctor and he gave me a vitamin tablet but i did not get any cure with that then i visited a dermatologist and he gave me tacrolimus ointment and no improvement with that too now he has given me the same ointment along with tablets medrol biotin and celin now i feel it has progressed to my upper lip also could you please tell me how to cure this i am so desperate for this to be over i am under lot of stress because of this by the way the time when it started i was under stress i have searched in internet and i found that many people have been having this problem for many years some cured with anxiety medication and some by leaving alone what shall i do for this ### Response: i have gone through your history and can very well understand your concern kindly revert back with the answers to the above questions to a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female i have preauricular pits that have drained smelly discharge ever since i was born i have them in both ears the right does not drain often the left drains every day more than once a day the left has become really swollen and painful recently i am not sure of what to do because i now understand that the discharge means it is infected and it is hard for the surgery if infected plus they have been infected for so long i have also read that after surgery it could reoccur ### Response: let me answer your query in parts it is a developmental anomaly a branchial cleft anomaly once we remove the whole sinus tract it does not recur to see till where it extends one must do a fistulogram scan when infected we do not do surgery we do culture sensitivity and institute appropriate antibiotics and clear infection and plan for surgery later it is a curable problem do send us a picture of the ears both sides and send to me

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was on a course of deviry mg for days as i missed my period last month but i am not pregnant how many days does it take to get my period now ### Response: it will take a week or so to get back your periods so relax and do not worry do not take any medication without an expert advice however if you have a doubt then get back to me take care for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a cavity in the tooth the xrays show it was small but when the dentist drilled the nerve got exposed and is telling me i need a root canal along with crown he has put a temporary filling for now how do i know if i need a root canal for sure ### Response: hi if the nervepulp of the tooth is exposed there is no other course of treatment except root canal treatment you can confirm the same using xray iopa of the tooth if no treatment is continued or a permanent filling is placed the tooth will continue to experience pain the infection will spread deeper to the root and might even cause an abscess so it is very important to continue with the treatment you can send a picture of xray to confirm about the necessity of treatment for more information consult a dentist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother was diagnosed with breast cancer early this year she underwent mrm surgery and now undergoing chemotherapy her age is and the doctor advised for eight cycles of chemotherapy now she completed five cycles and now the doctor had advised more injections for hormone blocking we find more injections are too much and will be highly stressful for my mother could you please suggest an alternative treatmenti have attached a few essential reports for your reference please let me know if you need any more details ### Response: hello her cancer will be her neu positive in this scenario it is mandatory to give injections of trastuzumab otherwise chances of recurrence are high take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: if both the testes experience a reduction in blood supply and thus oxygen and hormones in the long run will it increase the risk of more spontaneous mutation present in sperms as lesser blood supply will affect the dna replication and repairing ability of spermatogonial cells ### Response: i have gone through your query what you have mentioned is theoretically true however reduction in blood supply and hormones will lead to atrophy of the testis and a decrease absence in sperm production eventually also right now it is clinically impossible to assess the presence of specific mutations in single sperm what is measured is indirectly the levels of dna damage

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my chief complaint is severe lower back pain and pain in upper thighs my medical history is as follows carcinoma of the breast three years back followed by surgery chemotherapy and radiotherapy i am on tamoxifen for past years and now i am taking arimidex i have been suffering from osteoporosis for over years before six years i had severe osteopenia with maximum bone loss of on and spine ribs trunk and arms with more on the left sidei had undergone the following investigations before three years i had fnac which showed invasive ductal carcinoma right breast er pr hercep score last month i had an xray and mri which showed focal altered marrow intensity lesions seen in bl pelvic bone sacrum and left upper femoral shaft consistent with metastasis i also had a pet scan which showed metabolically active illdefined lytic destructive lesions in post cortex shaft of left femur right inferior pubic ramus bl iliac bones sacrum and sternum right post ribs with midright paravertebral soft tissue lesion at level likely metastasis ### Response: i do not have full information regarding the case from your query the conclusion i can make from the information which you have given is that the patient has bone metastasis only the treatment for such a case is a change in hormone therapy your medication has already been changed from tamoxifen to arimidex i do not know since how many days or months you are taking arimidex this also helps in bone metastasis you also need adequate pain medications maybe morphine preparation to control your pain

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: kindly provide me some information about the keto is it safe or is it a good way to lose weight or a terrible way to lose weight ### Response: these diets were altered to treat epilepsy this diet will help to manage the weight reduction as it substitutes while changing the metabolism and force to work for with stored fat when the body utilizes stored fat weight reductions are visible but it is not suitable for long term as it has the own problems a short period of three months course will increase protein as well as helps to manage the deficiency and increase the stamina with proper weight reduction

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i would like to get a third opinion in regard to categorizing which uterine abnormality i possess the initial doctor said it is arcuate my current doctor thinks it is bicornuate but i am going to do a ultrasound in the middle of my next cycle to get a better idea i have mri and hysteroscopy photos to provide i have had two missed miscarriages the last one hemorrhaged two days before going septic and sent me to the er for five days i have also been diagnosed with a placental site nodule on my right side where both pregnancies have been could my problem be surgically correctedcurrently we are going through genetic blood clotting disorder and menstrual cyclehormone monitoring genetic counselor said low risk for any genetic causes but is still waiting to complete the blood tests which should be done in four weeks same for the blood clotting tests ### Response: hello having gone through the mri pelvis and hysteroscopy pictures attachment removed to protect patient identity it is evident that you have a bicornuate uterus with a single cervical opening and it is not a septate uterus or an arcuate uterus two different horns of uterus are evident on mri magnetic resonance imaging indicating the bicornuate abnormality the option which you have is called straussmans operation where both the horns can be cut in the centre and joined to make a single uterine cavity you may discuss the option with your gynecologist and make a decision

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old female i have too much dry skin i mean extra dry skin i use almond oil and moisturizing soap but it is not effective ### Response: the skin has to be moisturized well soon after a shower use a moisturizer which has ceramide in it like eucerine moisturizer apply to body as soon as you come out of a shower continue using a moisturizing soap avoid hot shower use warm water the common cause of

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a squint in my right eye and it has moved outwards i do not have a proper vision in my right i can not see clearly through my right eye even i recognize thing pretty hard i want to know whether it can be corrected so that both my eyes work together i am confused as i am now years old is the correction going to be difficult at this age i am looking up for a second opinion from you thank you ### Response: hi i have gone through the pictures of your eyes attachment removed to protect patient identity revert with reports to an eye care ophthalmologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old woman can i still conceive also can i conceive twins without any risks ### Response: hello how are you doing do not lose hope there is a solution for every problem hope i have clarified your query do write back all the best for more information consult an infertility specialist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a man with very less facial hair recent blood checkup shows that my dheas value is insulin checkup indicates that there is a high chance of becoming a diabetic patient my doctor suggested me ashwagandha and i have been taking it for a month two capsules per day not much gain so i would like to take dhea supplements for beard growth is it fine ### Response: i think it is very normal to have less hair on the face even if you have little hairs it is normal do not worry about your dheas level you should not be taking any hormonal treatment unless it is required and so you can consult an endocrinologist for it if you have normal sexual functioning you should not worry about it if it bothers you too much you can ask a hair transplant surgeon and get a nice beard transplant focus on a healthy diet and regular exercise

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male i am having a burning sensation and redness in my scrotum i consulted two doctors from the same hospital the doctor diagnosed it as scrotal dermatitis the first doctor prescribed the following motimesh cream to be applied at night for days abzorb dusting powder to be applied morning for days atarax tablet to be taken at night for days after taking this course after days the itching was gone but still there was considerable burning and redness and irritation so i visited the hospital again and the following course was prescribed venusia max cream to be applied morning and afternoon dazit tablet to be taken at night for days desowen cream to be applied at night for days now this course is also done and though there is a considerable improvement i am still having little redness mostly on one side of the scrotum and also some burning sensation kindly help me from this irritation ### Response: i have gone through your complaints and reviewed the attached photograph attachment removed to protect patient identity it is a chronic disease characterized by redness and burning on the scrotum if i was your treating doctor i would recommend you to take capsule doxycycline mg once daily at bedtime tablet gabapentin mg in the morning and tablet levocetirizine at bedtime along with this application of tacrolimus percent ointment on the affected areas at night and moisturizing cream during the daytime continue this for three weeks and revert for more information consult a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female i am having nausea every morning it comes and goes during the day i also have black stools belly pain and gas i am on lexapro mg pramipexole mg lamotrigine mg twice daily and mg once meloxicam mg metformin mg gabapentin mg and atorvastatin mg ### Response: your symptoms are suggestive of upper gastrointestinal intestinal bleed please stop meloxicam mg tablet immediately i suggest you take proton pump inhibitor medication like omeprazole mg tablet straightaway and take preferably cold water please check with an accident and emergency department for further care for intravenous proton pump inhibitor antiemetic medications and further lab investigations such as complete blood count bleeding and clotting time prothrombin time with platelets aptt activated partial thromboplastin time inr international normalized ratio stool for occult blood ultrasound abdomen complete liver function tests to assess the extent of blood loss through stools in case of evidence of ongoing bleed you will require packed cells and urgent upper gi endoscopy for diagnosis and stapling of bleeding esophageal varices do not take aspirin tablets or any other painkillers as they can worsen bleeding inside the gut stop alcohol spicy diet coffee and tea after emergency treatment i suggest the long list of medications be reviewed to see whether it can be simplified for more information consult a general practitioner online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i took the first abortion pill but until now i did not get bleed what is the reason ### Response: hello it is really a very short description of your concern it would be better if you would send me your detailed gynecological menstrual obstetric medical and other histories which pill have you taken and how much dose had you confirmed your pregnancy status before having the pill if not have serum beta hcg blood pregnancy test to have a clear idea about your pregnancy kindly send me your details so that i can guide you in case of a positive pregnancy test check again the level of beta hcg after hours from the previous test it will give us a clear idea about pregnancy progression or the effect of the pill on it as well if the second level comes less than the previous it is a miscarriage if the second level shows increase more than then it is a normal growing pregnancy if the second level shows less then increase it is alarming and you need a transvaginal scan to exclude pregnancy outside the uterus ectopic pregnancy in case of pain bleeding dizziness with a positive pregnancy test better to report to a tertiary care unit for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male i have no symptoms and i am not taking any current medication three years ago i once went to the hospital because i felt my heart was beating really fast and they did some ekg scans and a blood test on me saying that everything is normal they also gave me the holter monitor and when they checked the results they said this was normal i do not smoke or drink alcohol maybe three times a year i will drink i used to do some shisha but that has stopped for the past three yearssince then i have never been to a hospital for the health of my heart however since then my heartbeat has just been higher than everyone else but i do not get headaches or any other symptoms i used to stress a lot however things are going well now and it has cut down i wake up at times during the night but fall back asleep very easily i have done gym and dance classes for over a year and i feel fine when working outi went to the gp just a week ago due to my girlfriend having some concerns i asked them to do a regular check and they said my heartbeat at that moment was and he said this was fine however my girlfriend gets really worried about this and feels that something will happen to me she just needs some medical advice in order to get her the assurance she has been checking online for some answers and it is said stuff like arrhythmia tachycardia etc she also says that the normal is between bpm and why is mine on the top end is it a serious cause or does heart and pulse rate vary also i have been checking the prevalence of heart diseases etc online and it is very rare for someone at my age what more should be done ### Response: palpitations or the feeling of fast heart beat is an extremely common symptom i understand your gp has done the usual tests and has reassured you i would need a bit more history have you fainted anytime have you got your thyroid functions checked do you have history of any family member dying suddenly like in sleep is your blood pressure normal if none of the above mentioned problems are there it is likely that your symptoms are benign just watch out for fainting episodes the heart rate you mentioned is perfectly normal the best way to get your heart rate even lower is to exercise regularly athletes have very low heart rates only if the palpitations are really persisting and are really disabling we need to do further tests

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: the patient is suffering from loose motions kindly help me to deal with it ### Response: hello how many motions are you having in a day and since how many days it is likely to be enteritis take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male i have only one testis i have sexual feelings as a normal man would do i am masturbating about once every week will a single testis cause any problem in the future recently i had my first sex with my partner at that time i was tensed and also had difficulty while penetrating her vagina please help ### Response: it appears you are having a condition called cryptorchidism in which one of the testes is not present in the scrotum there could be one of the two possibilities either your testis has not developed at all or it has developed normally but has failed to move into the scrotum at your age if your sexual desire is normal and your secondary sexual characteristics like facial hair pubic hair growth is normal then your testosterone production is normal your reproductive ability will depend on the number of sperms produced by your normal testis i would suggest you visit your local urologist for a complete evaluation and identify the type of cryptorchidism you have

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: please explain about the causes of the ibs how can it be managed please advice ### Response: hi the other causes are stress anxiety hormone changes genetic factors and infections such as salmonella treatment depends on the cause we can do a blood test hormonal test coproculture thyroid function test colonoscopy and test for celiac disease to identify the cause after seeing the results proper treatment can be planned stop taking caffeine and alcohol avoid eating fatty foods eat a fiber diet it helps to get relief from constipation

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: when i was opening a powerful glue bottle two small drops of glue went into my left eye after two months i observed black spots on the whitish part of my eye please help ### Response: hi the cause of black spots may since childhood just like moles on the skin most probably they are not related to glue need an eye checkup once please do safety measure while dealing any such thing or any chemical use protective glasses if any accident happens then first of all wash your eyes with water as early and as much as u can and go to doctor revert back with the photos to an eye care ophthalmologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a years old woman my period got delayed by days i had intercourse with my partner i have mild pain in my abdomen and there is brownish vaginal discharge i took urine test and a faint pink line along with a strong pink line appeared am i pregnant if so what medication should i take to avoid pregnancy also if i take a blood test now will it be more accurate ### Response: a faint pink line does not confirm pregnancy the dark line is for control as your period is late by days both lines should be dark you can repeat the test after five days but if you have too much pain then you will need to do ultrasound test of the pelvis or transvaginal ultrasound without confirming or excluding pregnancy no medicine should be taken it may harm you also if the beta hcg level is in the pregnancy range then it will confirm otherwise you will need to repeat the test after two days to see if the level is rising or not that will be more accurate for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old girl i have a very stupid habit that has caused a lot of problem for me i have met a lot of psychologists but i could never talk about my exact problem with them it seems to be a ridiculous problem but i ask your sincere help when i was years old i watched a romantic movie which caused my problem since then i made an imaginary life with an imaginary man in my mind i have got involved with this problem for years when i was a child i had difficulties which i could not solve at that time so i started fantasizing and tried not to involve myself in real lifes problem but then there was no love in my imagination i was a very happy successful girl and i was a famous respectful personbut after i got defeated at a state level game i understood that i am not intelligent enough to achieve such goals i was so depressed with no enthusiasm in studying i got to know about sex and intercourse i was confused and hated my gender i thought of changing my gender i had depression and i was so disappointed about life then i started to imagine a man who lived with me and i loved him so much instead of facing my life problems i used to fantasize about him from last year i have imaginary sex with himthe problem i have is that my life is interrupted by my imagination i can not deal with other students especially boys i have lost my confidence do not have the enthusiasm to study i can not focus when i am in the class and i do not take any efforts to solve my problem i just keep imaging a peaceful life with no problems sometimes when i can not control my anxiety and stress i start having sex in my mind i do not know what to do and i want to stop this imaginary life how do i stop this imaginary life and love i know this man is not real and whenever my imaginary life becomes sad it has an influence on my real life i currently take tablet levebel mg two tablets a day ### Response: hi thanks for sharing your problem with me i can understand your problem you have given a complete elaborated history regarding your problem hope my answer helped you and feel free to ask whenever you need my help

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i and my partner had healthy sex the next day she had periods and after six days we had unprotected sex due to which she had taken ipill on that evening two months passed she still did not get her periods i am worried please suggest any solution two years back also she has taken ipill this is the third time she is taking is it possible that she may not have periods for the whole life please help ### Response: it is unlikely to be caused by ipill does she has any underlying periods problem it is probably not a permanent problem and she will have her periods soon at this stage we first need to rule out pregnancy she should undergo a urine pregnancy test twice at an interval of hours for confirmation if it is negative then she will need a detailed evaluation of the cause she will need ultrasound pelvis for uterus and ovaries and hormonal profile like thyroid function test serum fsh folliclestimulating hormone and lh luteinizing hormone she should visit a gynecologist once for examination and for these investigations medicine could be initiated after ruling out the pregnancy and finding the cause i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother has abdominal tuberculosis duodenum stricture and obstruction in rectosigmoid and distal sigmoid colon she does not take any food not even liquid food and she does not pass urine and stools from the past four months please help ### Response: hope i answered your query if you have any further doubts i would be happy to help you for more information consult a surgical gastroenterologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: can a possible wisdom tooth cause neck and arm pain my tooth hurts on the same side as neck and arm ### Response: hello it is not possible it may cause some throat pain but not arm pain maybe you have muscular pain just take rest and if your wisdom tooth is not in good condition then it is better to get it removed because it has no use in real world and if you have any neck stretch then just apply warm water bag and see if there is any change you can try mouth rinse of salt and lukewarm water for good results for more information consult a dentist onlline

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a student and i have been good at studies always and i want to be a doctor but i somehow could not manage to get a seat in government medical college i did not work hard enough i am now my parents are very supportive and i am preparing for exam but i am really scared of everything i know i am stronger than this but how can i stay calm and happy during this process ### Response: hi i understand your problem it is actually very tough phase but all you need to do is gather yourself back tell yourself that you can and will be able to do it try this make a fullproof plan executive with full motivation if you feel that there were some mistakes you did in the past then rectify them do not give up study in group or in library if you can not study alone or get distracted make short term plans you can have one or two counseling sessions if you want take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have bitten an olive pit accidentally and now one of my front teeth is moving there is no pain and i have a slight sensitivity to cold and hot foods but now i can not bite anything using my front teeth please advise ### Response: it is a case of mobility due to trauma on the teeth the sensitivity and mild pain are due to inflammation around the teeth follow these medications take tablet acelofenac mg along with paracetamol mg two times a day for five days it reduces the swelling and it helps to stabilize the teeth back in the socket if it is not more mobile then it will get healed soon within days if it is fractured or more mobile then you may need other procedures like splinting using wires to fix the teeth if it is broken anywhere then you may need rct root canal treatment

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a strange ecg from my watch no one else looks like mine and my primary doctor said that it is anxiety ### Response: i have thoroughly gone through the ecg results there are no specific changes that would indicate any pathological change ecg results might show different shapes and morphology but it does not necessarily mean it is abnormal i have to ask what are you doing about your weight you are overweight and it puts you at risk for cardiovascular disease i hope you have put in measures to help reduce your excess weight like dieting and exercise

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female a thyroid profile done recently shows the tsh at at and at i am on eltroxin mcg and folic acid i am planning for pregnancy please advice ### Response: hello i just read your query and from what you have mentioned it appears that you have hypothyroidism an underactive thyroid disease from the reports attachment removed to protect patient identity you have mentioned the hypothyroidism seems to be well controlled i suggest that you continue with the same dose of levothyroxine tablet till the time you conceive and then once you are pregnant then you can repeat the same tests and we can manage your dose accordingly wish you good luck and hope you found my advice beneficial for more information consult an endocrinologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: hair loss i want to increase my hair in some areas hair is not coming please suggest something ### Response: how are you i hope your health condition is good i have read your problem and have seen attached picture carefully attachment removed to protect patient identity and you mentioned that you have tried minoxidil now you want to know how to improve or grow more hair in some area shown in picture there are some options prp therapy oral finasteride increase the strength the strength of tropical minoxidil should be increased besides this you can take oral finasteride but there is some side effect such as deterioration of sexual function but this problem is reversible that means when you stop the

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have had every std screen known to man and kidney function tests my urine is foul smelling and dark this has been an ongoing issue for a year and it has started to affect my life i have tried everything antibiotics hydration douche apple cider vinegar azo pills yeast infection drugs uti drugs ### Response: foul smelling and dark urine is indicative of cystitis with highly concentrated urine if there is no blood or hematuria then renal pathology is unlikely or calculus you need to take at least to liters of water daily and foul smell is often vaginal and not in urine you may be suffering from bacterial vaginosis causing a foul smell avoid using soaps in the genital region while bathing use vaginal alkaline washes

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have had four follicles ruptured from my left ovary and one from the right i have had iui back to back for two consecutive days but my major concern is i have a unicornate uterus with a left rudimentary horn i recently had lap because i had a cyst on my right ovary the doctor says i have been ovulating perfectly every time i am depressed abt the fact that left tube is absent but four follicles ruptured on the same side please give me some hope of getting pregnant the endometrium lining is mm which the doctor said is very good and this is my first iui after lap ### Response: how are you doing i do not see any reason for you to worry the movement of egg into the fallopian tube is chemically controlled or attracted so no matter which tube is open or blocked the egg falls into the peritoneal cavity or the space around the uterus then it will be obviously sucked into the open tube so you have definitely a chance of pregnancy your doctor will have more job to do only after you get pregnant with lots of close monitoring and medications your chances of getting pregnant are on par with any other lady so just hope for the best and pray well all the best for more information consult an infertility specialist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a boy years old my right knee has clicking sound without any pain please help me out of this is this symptom of any big disease tell me some things to cure this ### Response: you will need to do a regular exercise of the knee and stretches of the hamstrings and most problems resolve once you stop growing no need to get tensed up for more information consult an orthopaedician and traumatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my infected sebaceous cyst has burst days back and daily dressing is being done by professional i was on antibiotics but the course is over what should i do next i do not want to go to the hospital and get the surgery done since more than ten years two cyst was there and of late it merged intoonemay be in the second week of last month i started getting an itching sensation andthe place becoming red and after a few days it burst since then regularly it is being dressedwith the removal of pus it has created a deep hole please help ### Response: do not worry i will solve your problem wound healing is a very common problem in diabetic and hypertensive patients even when they are controlled i will advise you treatment with some basic precautions and investigations check your blood sugar levels regularly pus is still present so the antibiotic course is required for further five days wound

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i suppose to get the sleeve bariatric surgery and i was taking adepix and i stopped it a week ago my surgeon told me he thinks i have to be off adepix for three months before surgery i only took it for three weeks is this true he said it may interfere with anesthesia ### Response: hello i understand your concern about your health condition and possible issues related to adepix but as per the literature and evidence stoppage of medicine one week before surgery is usually recommended so i do not think it should be a problem during surgery for more information consult an anesthesiologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: about four weeks ago my right testicle started moving in an uncomfortable not painful way i had a torsion and surgery to stitch down both years ago i went to the first doctor and he tried me on muscle relaxants nothing changed so he referred me to a specialist the specialist had a quick feel and then told me it was normal that i should not worry and that i would have to get used to it he also implied it has been happening since the operation and i just did not noticethere is still no pain only discomfort it varies normally when i walk i think that my right testicle is a tiny bit swollen and slightly squishier than my left and while i could live with this i really do not want to though i have suffered no injuries to my testicles recently i actually think that one of my stitches has come loose as i can feel the end on the stitch lump where i could not before i am kilos and have lost kg over the last nine months i have have been running more frequently for about eight weeks i am years old ### Response: i have gone through your query normally a detailed clinical exam to identify any other causes like a hernia or varicocele or hy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i weaned off of mg of paroxetine very slowly but my sleep was impacted and as of two months i have been suffering from extreme insomnia i have gone back to medication and i am currently on mg of paroxetine and mg of fluoxetine but my insomnia has continued i was prescribed ativan mg for sleep and it sometimes helps but not always even if i take a bit more i have taken up to total it does not always help me sleep my psychiatrist prescribed trazodone she suggested i start at mg and if i feel no effect to take another mg go up to mg in one night but i am concerned about serotonin syndrome from taking another medication that messes with serotonin can you advise if i should be concerned about serotonin syndrome if i take the or mg of trazodone additionally should i be concerned about anything else in terms of taking these three medications together ### Response: hello at least not when you have already been taking mg of paroxetine for years also trazodone is a safer and better sleepinducing agent when it comes to being used for sleep as per my knowledge in fact these two take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am and having an active sexual life i have two questions first i have noticed that my performance is erratic as in there are times when i can last minutes and then the very next day it can go to minutes it is different with different partners second and more alarming is that i have been experiencing a stinging pain in my scrotum on the left side it usually happens when i stand up while sitting or laying and sometimes while walking i tried finding the source of the pain by pressing in different regions but could not find one also it happens at the back side of the scrotum it is limited to the left side and has been increasing with each passing day i thought of uti but my pee does not burn can i have some suggestions for my problems thank you ### Response: i can understand your concern if there is any history of injury to scrotum then most likely it is a hematoma or infection post trauma the pain could occur because of pressure over testis by tight underpants this sometimes results in a picture similar to an infection i would advise you to get usg scrotum done this will rule out any hematoma or infection a urine analysis should be done to rule out the cause please provide the reports for further assistance thanks and take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: the gums where my wisdom tooth is present is in pain ### Response: hi what is your age wisdom tooth gets erupted in ages between to they put eruption pressure after every three weeks or so if its position is not vertical or they are tilted or are impacted in bone they start causing severe pain for it the first line of treatment is taking medications this will subside eruption pain the second line of treatment is if it is not getting better with medicines you should get it extracted so that it may not bother surrounding tissues and tooth meanwhile take tablet brufen mg eight hourly for three days give me followup after three days if pain will persist then you will be prescribed antibiotics stay happy and blessed

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had unprotected sex with my partner without any penetration i rubbed my penis over her vagina i might have a little semen present in it she usually has a periods cycle of to days but her periods got delayed this month is she pregnant why is there a delay in her periods is there any typical food available to bring her periods on time ### Response: just touching or rubbing will not cause pregnancy so relax and do not worry the delay occurs due to hormonal changes it happens due to stress and strain

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old girl and have a small vaginal opening my husband and i hardly have sex because it hurts me so badly what can i do to stop it from being so painful ### Response: a small vaginal opening can lead to a painful sexual intercourse i would suggest you use a good vaginal lubricant every time before the act it would help in smoother penetration of the penis thereby reducing the pain if this does not help you dilators can be used to expand the vaginal orifice which does help in many cases

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: a throbbing and recurring headache nausea and dizziness i am an female ### Response: hello it can be a migraine headache as throbbing in nature and one side with nausea you can be prescribed naproxen or ibuprofen for relief from an acute headache if it can not relieve a headache then rizatriptan can be prescribed if a recurrent headache occurs then prophylactic treatment with amitryptiline might be needed avoid aggravating factors for a headache like stress smoking lack of sleep hypoglycemia loud noise bright light etc it is advisable to check your blood pressure as well i suggest you consult a physician for examination and get prescription accordingly take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother is years old height weight kg and has been doing all the household chores since she was years she has no problems except diabetes since one week she started getting lower back pain the symptoms are if she is in a sleeping position and gets up and starts walking there is no problem but if she is in a sitting position and gets up to walk there is sharp lower back pain can you please let me know what could be the reason how can the pain be relieved any special exercises or chair or vitamin supplements etc ### Response: at your mother seems to be suffering from spondylosis which is nothing but wear and tear of the spine this is made worse after any period of rest and sitting usually makes it worse is there any radiation of pain to the leg i will recommend that you get an xray of the affected part like lumbar spine ap and lateral in the meantime i will also recommend that she tries hot packs or preferably ice packs over the site area to see if that relieves pain she can also apply dynapar qps spray take ultracet for pain one tablet twice a day please send me the xrays for further advice

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am having some allergy on the head part and the inner skin of my penis i have some white bubble like spots please help ### Response: hello allergy over the penis is very uncommon it would be something else please send photos so that i can identify it and give you the proper treatment

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am not able to conceive after trying for almost one year i was diagnosed with pituitary microadenoma and i am on medication my prolactin levels have now reached normal levels after two months taking medicationi suffer from hypothyroidism and on medication i have had this for five years now and it is well within the limits as per my endocrinologist now this is due to an autoimmune disease where my tpo thyroid peroxidase antibodies were high during the diagnosis five years ago my husband and i would like to know how should we best prepare for pregnancy and what to look out for we would have preferred to visit the clinic unfortunately i am not in a position to visit the doctor due to travel restrictions it would be great to get in touch with a specialisti am currently on euthrox mcg cabergoline mg once a week and folic acid mg daily ### Response: i have gone through all your reports attachment removed to protect patient identity and your prolactin and thyroid levels are well in control what is missing in the follicular monitoring profile of the dummy cycle and also your husbands semen analysis test you have been following the correct protocol using lh kits for ovulation and post lh surge if a natural trial or timed intercourse did not work then husbands semen analysis becomes mandatory then when both male and female infertility causes are ruled out then comes mechanical causes where positions and version of uterus need to be considered and measures implemented anyways please send these two remaining reports before we can proceed further

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old male i had an accident before years at that time my knee xray was done and i was reported to have osteoarthritis i have been suffering from pain for few years i have lower back pain and pain in some of the joints for the past few weeks i have pain in my left palm particularly in my finger joints and more on left middle finger joint also on my foot joints i also feel very fatigued and tired my blood pressure bp was mmhg a week back i am enclosing a comprehensive blood test report which was done very recently and i have advised to take tablet nusam for six months i have been taking for the past two months please suggest me the remedy and preventive measures ### Response: vitamin d deficiency and autoimmune cause ultrasound abdomen and pelvis rheumatoid factor mri of spine with sacroiliac joint and mri of the whole spine screening and ultrasound of hands to look for active arthritis hbsag hepatitis b surface antigen and hcv hepatitis c virus seronegative spondyloarthropathy rheumatoid seronegative spondyloarthropathy calcirol sachets vitamin d units once in a week with a glass of water for six weeks and tablet dolo mg acetaminophen for pain avoid alcohol and excessive weight also try to avoid painkillers as your liver functions are abnormal

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my right side jaw is paining while having food on consultation i was advised for physiotherapy what could be the reason for it ### Response: hello there might be several issues expected as you mentioned if there is only jawline problem then you should have physiotherapy and warm massage at tm joints tempero mandibular at the junction of the ear when you open your mouth it can be felt quickly do warm massage for days twice a day this will relieve symptoms definitely if it is because of the joint try not to yawn or open your mouth big do eat with a spoon do not have rice with hand these will relieve jaw pain if the symptoms do not get better with massage and exercise and you are having pain in some tooth then you might be having some infection in the tooth that needs root canal treatment or extraction if you can provide me with opg xray of your jaw i can tell you the exact diagnosis and the treatment plan tell me about symptoms as well do you feel more pain at night as compared to day time are you feeling hot and cold sensations tell me details so i could figure out the root cause of your pain take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have developed a small white dot on my thigh a few months back now the size has increased is this any sign of leucoderma ### Response: has this hypopigmented patch occurred after any injury or scab formation attachment removed to protect patient identity if not then it can be a sign of vitiligo or leucoderma but it can not be confirmed at this stage does anyone in your family have such illness if yes then it points towards vitiligo do not worry as vitiligo can be treated with medicines also search for other patches in the scalp and show to a dermatologist for treatment revert back with the answers to the above questions to an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was attacked by mumps around three years back and now my testicle sizes are different so i wanted to know about the treatment will i get rejected in visa medical test i am a petroleum engineer please help ### Response: i had gone through all the details posted orchitis is inflammation of the testicles which has happened three years back due to mumps there will be redness pain and no fluid around the testis for decrease of swelling and pain we need to use antiinflammatory agents if there is any bacterial infection then we need to use antibiotics in case of hy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have stretch marks on my whole body and i want to remove them as they are white please suggest me some medicine to remove them in a year as after a year i have my marriage and i get these stretch marks at the time of puberty and i had mentally suffered because of the stretch marks and i can not wear sleeveless clothes ### Response: stretch marks are formed in areas of a rapid growth spurt or weight gain due to side effects of certain medications or other medical conditions treatment will depend on whether your stretch marks are new or old color reddish or whitish and the cause of stretch marks laser sessions are quite effective topical tretinoin has a role but you should apply it only with the advice of your dermatologist you can apply emollients like coconut oil or olive oil and vitamin e for the time being you may put up some clear pictures of the affected area for proper evaluation and guidance

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother was not having her periods from the past five years but from yesterday she started bleeding again in these five years she has not even bled for a single day why is she bleeding all of a sudden what can be the cause ### Response: five years no menstruation and now bleeding needs some detailed examination and investigations consult a nearby gynecologist and let him or her see the source of the bleeding get an ultrasonography done if bleeding is from the uterus then your mom might need to get a d and c dilatation and curettage it is a minor operation and the tissues are sent for testing basically we have to rule out whether there any cancer cells or not she may even require a ct scan if nothing is found and every report comes normal then she will be given some medicines accordingly and no need to worry if something is found in the reports then it may require major operations but it will all depend on the reports so first consult a nearby gynecologist

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: good day please i was diagnose with hep b positive ago my consulting tild me my condition inactive and need no medication some month back i was feeling hurt at my chest i was later diagnose with ulcer some some weeks now have been having pains around my chest and most especially middle of my check please what is happening to me ### Response: hello welcome to i cliniq you have been diagnosed with inactive hepatitis b for that i will request you to send me all your laboratory work so that a decision about the treatment can be taken you now having central chest pain which looks like to due to esophageal ulcer called esophagitis and you may be also having some retrosternal burning with it for this i am prescribing some medications it will help out in this pain you need to take capesomeprazole before breakfast and sypsucralfate tid both of these should be taken for weeks and let me know incase you have no improvement egd if no improvement with medications esophagitischronic hbv esophagitis capesomeprazole before breakfastsypsucralfate tid before meals avoid spicy foods needs follow up for hbv

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i got bitten by what i am thinking a spider a week back i figured since it seemed to have a little white and liquid coming out so i squeezed it it has been four days and the bite is painful now i have a white circle where it once was just red and oozing i have tried cortisone but i do not see it getting better ### Response: hi it got infected now with necrotic material inside cortisone is not helpful it may worsen the infection you need antibiotics i would say topical antibiotics if necrotic material and redness is not there but now you need oral antibiotics consult your doctor he may prescribe you augmentin or doxycycline or other antibiotics for a couple of days redness is there it is a sign of spread for more information consult a general practitioner online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am having pain shooting down from my neck just behind my right ear down into my fingers also on my right side near my breast with a slight headache as well what it could be ### Response: it is likely a cervical pain due to compression of nerves between the spine does this pain increases on neck movement is it associated with tingling numbness in the arm or any neck trauma if yes then it supports the diagnosis you will need an xray of cervical spine aplateral view and further may need mri till that time he can have tablet neurobion forte once a day which is a nerve vitamin also you will need pregabalin after diagnosis is confirmed i hope this helps you and get back if you have any doubts

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had an umbilical hernia repair days ago it went fine but days later when i laid down my belly button pup out one inch then went back down the next morning my belly button is out half an inch my surgeon said just wait for a couple of days to see if it goes back down i need to know if i should wait or get in right away the belly button is a little tender ### Response: as it has been only days since your surgery i suggest you wait for a few more days and see your surgeon if necessary it is quite likely that there may be a small collection of fluid in the region which may get absorbed or may need aspiration it is quite unlikely to have a recurrence so soon unless the surgery did not go well if the swelling appears on coughing or straining it may suggest a recurrence it is best tested by the surgeon as attempting the same at home may precipitate a recurrence take adequate rest be active take a good diet avoid straining or lifting weight for at least six months see your surgeon if it still persists next week i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my baby is days old he is passing stool very frequently like times with little or more motion but not very heavy in the last hours the stool was curdy yellowish color not like runny or watery no greenish no blood no bubbles he had the same issue when he was days old and in between he was healthy but again he kept going motion and redness spotted in anus area with small spots of skin peelbaby sleeps well does not cry passes urine usually in a good number of times and only mother breastfeeding every two hours please request your advice on how to stop this frequent motion and reason for this happening and is this normal he also makes a noise like sounding from inside especially more during night time having trouble while breathing due to a chest cold so am giving rinoclear saline drops three to six hours once depending on his nose block please advise why baby makes such noise is it normali was feeding breast milk via bottle for four to five days when he was two weeks old since he was unable to suck through mothers nipple i stopped bottle when i encountered this frequent motion and with my doctors advice ### Response: i understand your concern passing motion too often is a normal phenomenon in neonates gastrocolic reflex make sure baby is passing adequate urine and playful redness over the perianal region may be due to prolonged wetness over the part or due to cleaning the area by rubbing cleaning not to be done by rubbing it can peel the skin try to keep the perianal region

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: if i get my wisdom teeth extracted do my second molars shift in that empty spot ### Response: no it will not shift to the empty space but it might tilt and that too very little because the third molar is vestigial if you have any associated problem with the third molar you can extract it if you do not have any problem do not remove it in case you have any caries or repeated pericoronitis you must remove it my answer is no shifting but slight tilt only for more information consult a dentist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am in love with my relative we both have each other in someplace in our mind and i know it she is a high achiever in her career and i work hard to achieve stuff and good at studies but not as high as her i faced real kind of depression earlier and often get it so i find happiness in everything what i find difficult is to commit to her in some way as i see she may get a better person who will be supportive to her achievement i do not underestimate myself but there is a dilemma which is hurting me in my mind please advice ### Response: hello you are very considerate that you want the best for your relative even at the cost of your love your cousin should be lucky that you have her best interests in your mind however if she reciprocates your feelings you better go ahead and commit yourself to the relationship if both of you love each other you can develop a supportive and robust bond always remember that academics career money etc are not the primary factors in a relationship of course they are essential but a successful marriage needs personal compatibility and care for each other do activities to improve your confidence try regular exercise yoga and have an open talk with a trusted family member or friend about your decision take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i suspect i may have tapeworms how can i be sure and what can i do to get rid of them ### Response: stool tests can identify tapeworm infestation however because the worms and eggs are shed intermittently the test may have to be repeated three to four times if the initial test is negative stool tests can also identify other intestinal parasites blood tests serological tests are also available including elisa enzymelinked immunosorbent assay and pcr polymerase chain reaction

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my periods started days before and i had sex eight days back should i take pills after unsafe sex if yes what is the procedure to take ipill ### Response: according to your cycle it is the seventh day of your menstrual cycle and considered to be safe if you have a regular day cycle then ovulation is less likely on day seven but if your cycles are irregular then it is difficult to predict the exact day of ovulation as to when the chance of conception will be there so to be on safer side you should take a pill today only it is known as morningafter pill or pill levonorgestrel mcg to be taken within hours of unprotected sex only once in case hours have crossed after sexual intercourse then also you can prevent pregnancy in this cycle by getting a coppert intrauterine device inserted and that too within five days of unprotected sex

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am suffering from a cold sore type infection in my mouth especially at lips same was occurred last year and again it repeated this year and as on today it is the third time it is coming and curing within a period of to days i want to add photographs but do not know how further currently it is on my lips and additional sores are there inside the upper part of my mouth there is no pain please advise so that this can be permanently curedi am currently taking acivir ### Response: hello i understand your concern i have gone through your query attached pictures and your previous prescription attachment removed to protect patient identity these cold sores are of viral origin and it is called herpetic stomatitis this has a high recurrence rate meaning as long as the immune system is little underperforming it can come again and again you should compensate by eating healthy foods and

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had an xray last thursday and i got the result today it says i have fibrosis in my right upper lobe i had a history of pulmonary tuberculosis two years back and i took a six months medication and i am done with it i just want to ask if fibrosis can be cured if i take medication and do exercise daily and eat healthy foods ### Response: fibrosis is a feature of chronic inflammation and your lung fibrosis is because of that tuberculosis is a chronic granulomatous inflammation and can lead to fibrosis fibrosis is irreversible condition and can not be revert back for more information consult a general practitioner online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am months pregnant and i have some doubts with my recent free and tsh levels my triiodothyronine total is what is it is it something to worry or is it normal my tsh is under control and it is now ### Response: i just read your query about your pregnancy and your thyroid function test results hope you find my advice of some benefit good luck for more information consult an endocrinologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a bump on the right backside of the roof of my mouth it is right next to the tooth that is farther back it has pain when i brush my tongue over it also giving me a slight headache and earache i recently went to the dentist for a cleaning and they said my wisdom teeth were not even showing so what could this be ### Response: i read your query and it seems that the bump which is painful and which gives radiating pain to ear and head is because of your third molar and this tooth is infected as the food gets entrapped between the tooth and soft tissue covering that tooth for this avoid eating too hot or too cold wash out oral cavity after every meal with mouthwash and warm saline do not apply external heat to that area especially keeping your hand on that area also take antibiotic and painkiller antibiotic you can use is amoxicillin and clavulanic acid combination in mg dosage bd painkiller can be ultracet tramadol and acetaminophen thrice a day

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my friend started vomiting last night and i noticed that his eyelids were red and bruised is there something else besides the vomiting that could have caused the bruised eyelids ### Response: from the history provided it seems that your friend is having red and bruised eyes following vomiting this is probably because of rupture of very small blood vessels in the eyelids during vomiting this will not require any treatment and it will subside in one or two weeks as the blood gets reabsorbed hence you need not have to worry about thisapplying cold compression over the eyelids will provide symptomatic relief attach a photo of the affected eye and consult an ophthalmologist online for appropriate treatment

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a chest xray and chest ct scan done and they both came back normal if i had emphysema would it have shown up on one of those two tests ### Response: hello significant emphysema in the lungs would have been visualized in the xrays early stages of emphysema are difficult to see on xray and are visualized only on hrct highresolution computerized tomography chest scan if xrays are normal then more likely that you do not have lung emphysema take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my daughter is years old she gets nose bleeding once in few months and also gum bleeding she complains about occasional back pain stomach burning and hip pain too my family physician has written down a series of tests and asked me to get opinions from a hematologist gastroenterologist and an orthopedic doctor respectively ### Response: from the medical history of your child i can understand that she is having bleeding manifestations with normal cbc complete blood count and coagulation workup i would like to know about the belowmentioned questions the most common bleeding disorder is a condition known as von willebrand disease i think she needs to be checked for it and the other condition which needs to be evaluated is platelet dysfunction investigations suggested are

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am facing erectile dysfunction for the last three to four years and also early ejaculation presently i am using medicines for bp tenormin mg and also for depression aplog mg pethidine mg and mirtaz mg for the past years my problem of ed and ee is from past five years for this i have used suhagra tablet to mg and some sprays and tantex capsules but there is no use i am facing an embarrassing situation kindly give me an instant solution to this problem ### Response: hello if your blood pressure remains in the normal range then that is good otherwise this should be controlled i hope your blood sugar levels are also normal you should get levels checked in order to rule out any altered levels over a period of time you should also get serum testosterone and prolactin levels done to rule out any hormonal cause tadalafil can be tried to make erection strong you can talk to your doctor about that for more information consult a sexologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female i lost my virginity about months ago with my boyfriend now after months has passed i found out that i have two warts inside my vagina it is white color although the one on the top started to have a slight pink color but the second one on the bottom which is much smaller still has completely white color and around the vagina blades i have a little while dots also there are very tiny warts line along the blades so when i went to see the gp near my house he had a look and said that there is nothing to worry it is still small but in my opinion i think it is quite big so the doctor gave me a prescription for condyline paint which he told me to use for three days only per week and i have to keep using it for three weeks and if it does not get better he told me to see him again now i have a few questions is this mean i have an hpv virus inside my body how can i make the virus go away permanently will gardasil injection make it go away if it does not go away permanently how can i make sure that i have no hpv viruses and so these warts will not come back again is this mean that i have this hpv from my boyfriend how to use condyline paint correctly i wash my vagina blades and use the cotton pads to dry it then i use start to use the condyline paint i only dip the swab once into the reagent and then i open my vagina blades so that i am able to paint the two warts inside my vagina as much as i can then i paint it all over the very tiny warts in the vagina blades area am i doing it correctlynow i have been using the condyline for two days but the very tiny warts that are around the vagina blades started to grow more is this mean anything can condoms prevent these hpv viruses if i break up with my boyfriend will this help my symptoms and health to become better i am very scared of whether this can leads to cancer i do not want this to ever happen to me again how can i prevent this to happen againif my warts are gone can i have sex with my boyfriend will these symptoms comeback again if i decided to buy the gardasil injection and injected it now then the next after two months then next after six months but during this time can i have sex with my boy friend will the vaccine still work ### Response: hello i have gone through your history and pictures provided attachment removed to protect patient identity i appreciate that you have consulted the doctor and begun the treatment as rightly prescribed condyline podophyllotoxin paint is very effective in genital warts wait till the paint

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male and i have never been able to fully retract my penis i have severe phimosis i know phimosis can be treated but my biggest concern is that i now have bluelooking veins from the shaft of my penis to the actual penis head that is supposed to be exposed is it serious i have an appointment with a urologist in two weeks but the suspense is really killing me is it common or can it be treated will i be able to successfully retract the penis head i also feel pain sensation when i touch the hole at the tip of the penis please help of note i smoke marijuana i have attached photos for your reference ### Response: i have gone through the photograph attachment removed to protect patient identity it looks like a case of phimosis it can be treated by a simple circumcision those veins seen are normally present do not worry about surgery it will not affect the blood supply to your penis phimosis is a pretty common issue and as i said it just takes a minor surgery and a couple of weeks for recovery for more information consult a urologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was diagnosed with tid years back i will run out of lantus before the next shipment arrives but i have plenty of novolog on hand my daily dose is units lantus at am and units at pm with a sliding scale for novolog typically to units what dosage or schedule would you recommend for temporarily relying on novolog only ### Response: i can tell you right away that your type dm diabetes mellitus is not being managed correctly those who have type dm can not make it without basal insulin so insulin it has to be provided you should be on balanced lantus and scheduled novolog and not sliding scale of novolog insulin aspart you can take novolog but it has to be every to hours and it has to be scheduled also you need to check your blood sugar every to hours before taking a shot that is a must you will run into very high or very low blood sugar and will see an erratic pattern you will have to adjust the dose accordingly watch and check your ketones to times daily should not stay without lantus insulin glargine for more than hours novolog dose at least should be seven units every four hours calculated from your current regimen you should need at least units of insulin every hour to survive if feeling sick with nausea vomiting diarrhea belly pain blood sugar less than or more than you should go to er or urgent care center you are at highrisk ketoacidosis for more information consult a diabetologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female here is my question constant heart palpitations and fluttering continuous feeling of adrenaline rushing along with palpitations very bad at night but also during the day when sitting in doing nothing palpitations often make you feel nauseous on a to scale they are about an eight all labs are normal ecg echo and holter monitor are all normaldoctor can not figure it out and prescribed propranolol mg told me to try these once a day yesterday after doctor visits heart palpitations for four hours got fed up and took one tablet one hour later all palpitations and adrenaline rush was gone slept for the first time without being woke up having to cough to stop the palpitations had angio done approximately two years ago due to suspected heart attack or arrhythmia at home with all classic signs crushing chest pain jaw neck left arm down to the floor nauseatedeven with that lab test came back good the next day had carotid artery surgery two years ago to remove a piece of plaque in right carotid artery none found anywhere else no stent needed again all labs are good cholesterol not high on statins and warfarin i must be perplexing to all doctors because they can not figure it out was put on warfarin approximately years ago due to dvts as a result of a surgery always therapeutic so i had a heart attack or arrhythmia a few years back the angio came out the great doctor said everything looked fine now i have these crazy heart palpitations that would not stop they go away as soon as i take the betablocker i am told that betablockers even though antiarrhythmic can also be pro arithmetic as well should i take this every day or should i only take this when i start to feel palpitations ### Response: hello welcome to ciliniqcom so palpitations may be due to cardiac arrhythmia anxiety and psychological problems or due to increased awareness of ones heartbeat now since your holter was normal during your palpitations it rules out the possibility of cardiac arrhythmia so these are likely benign palpitations in you it is not an antiarrhythmic take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a woman and last month i was hospitalized with a necrotizing soft tissue infection on my thigh i had two debridement surgeries and was discharged after days i was treated with about iv antibiotics i do not remember them all i recall seeing vancomycin and penicillin i was told that the infection was not mrsa but a slower moving bacteria they did not tell me what it was i was swabbed for mrsa in my nose and butt before both surgeries and was told i did not have it for the last day of my stay i had a roommate who had a bad mrsa infection on her butt and sometimes had diarrhea incontinence during dressing changes i had no physical contact with her but we had the same nurse i was discharged with a five day course of augmentinthe wound has been healing very well and has not gotten infected but three weeks after discharge i got an abscess under my arm i went to an urgent care and was prescribed clindamycin and told to return in three days for drainage the abscess did not improve or get worse over the three days i got it drained and was prescribed augmentin and told to also continue the clindamycin that was a week ago and the wound is healing well they called today and said cultures show it was mrsa and they prescribed bactrim and told me to stop the other antibioticsi am feeling devastated by this and wanting to understand why it happened could i have gotten it in the hospital i am concerned that it will not go away are those swabs at the hospital conclusive and mean for sure i did not have mrsa a month ago i have never had any medical problems before and these experiences have been very frightening is there anything else i can do to prevent recurrence i have read about everything from bleach baths and hibiclens to antibiotics in the nose ### Response: hi i am sorry for what you have had to go through as you previously did not have mrsa strains it is possible that now you have hospitalacquired strains in your blood as you were told to stop other antibiotics and start bactrim this means the strain you have got is sensitive to bactrim if there is anything else you want to ask please feel free to contact me

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a sufferer of hemiplegic migraine however i had unusual collapses three months back the first one was minutes i could not recall the whole of that period i came back with an injured knee and felt dazed i was fine after around two hours the next day i felt pressure in my head and as though i was about to die i then could not recall getting home or the rest of the night i was fine in the morning two days later i felt horrendous pain in my head felt like i was swimming then tried to go home and again could not recall from deciding to go home to around two hours later and i was foggy for the rest of the night i have had constant pain in the left side of my head above the temple for four years it does not go however in the past two weeks i have felt like it is throbbing and at times about to burst out i was meant to see my neurologist three months back but his receptionist did not follow the recommendation and now i am unsure whether to have the tests done i feel like we are playing with my life usually i am pretty relaxed about the possibilities and know it is a migraine but this feels different this feels like intense throbbing above my ear from the temple along towards the back of my head with a pain in my ear to just behind my jaw under my ear my instinct says that an aneurysm needs ruling out i do not know if i am just upset because it feels so different and this pressure is intense it is a weird feeling i currently take sumatriptan as neededplease can you advise what to do as it stands the next neuro appointment is after four months added complication is that i have been breathless and unable to climb stairs without stopping and panting for past four months i am having heart tests on the weekend but what do i do about my brain ### Response: hello i agree with you on the fact that when dealing with hemiplegic migraine it is necessary excluding a brain aneurysm or any arteriovenous malformation which may mimic this clinical situation that is why it is necessary performing a brain mri which would detect any possible brain aneurysm if present regarding the loss of conscience i would also recommend performing an eeg electroencephalogram to investigate for seizures although minutes is a long period for a seizure not typical i would also recommend you to monitor your blood pressure values and perform some blood laboratory tests as follows for more information consult a neurologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have been tested for hiv and many times my tests are weeks card test negative weeks elisa serum test negative weeks elisa serum and test negative weeks elisa serum test negative weeks elisa serum and test negative is hiv is still my risk but from few days i am having lots of pimple on my back and shoulders and they sometimes itch are they because of hiv or something else ### Response: i understood your concern and i have viewed the images attachment removed to protect patient identity your hiv screening tests are conclusive a screening test at and after three months mark from risk exposure is considered final and conclusive there is no need to test further the lesions that you have on your back are actually acne vulgaris i suggest you apply a topical benzoyl peroxide gel twice daily they are certainly not due to hiv

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old married male since two years i am suffering from premature ejaculation i tried to control it but did not get better result my wife is very much unsatisfied how to cure this issue ### Response: hi as you know that the first thing in medicine is establishing a diagnosis which is correct so i would like to ask you a few questions revert back with the answers for the above questions to a sexologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i slept with color contacts in my eyes and now i woke and took them out and there is a white cloud blocking my vision ### Response: hello a photograph would have been very helpful for making a diagnosis it is never advisable to sleep with your contacts here is the possibility of your situation epithelial edema in this case remove and stop wearing your contacts for one month take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old and unmarried i am a patient of pcod i also have a family history of breast cancer my fathers sister had breast cancer recently i am in a very big financial crisis so one of my friends suggested me to donate eggs will it be risky if i donate my eggs only once as i am a patient of pcod will i be able to conceive in the future will i be given some hormonal treatment to conceive later please advise me whether i should proceed with the idea of egg donation is there any chance of developing breast or ovarian cancer if i donate eggs please guide me i just want to know about its long term consequences as i am afraid of breast and ovarian cancer ### Response: a single cycle of ovulation induction for egg donation and then possibly in the future for yourself would not increase your chance of breast or ovarian cancer the heredity for a woman is decided from her maternal background and not from the fathers side so if your paternal aunt had it and your mother or maternal grandmother did not have it then there are very minimal chances that you should get it in future you can safely go ahead with an ova donation if you wish to without fear so whenever you decide to get pregnant conservative management of treatment can always be considered

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am having too many health issues for the last three weeks i feel sleepy all the time even i sleep eight hours already i am feeling weak tiredness dizziness and headache on the right side of my head pressure and dullness my bowel habit changed to three to four times a day i have attached my blood work do you think i have any abnormality in blood do you think i am having a stroke or heart attack do i have too much thickness in blood as high hemoglobin and hematocrit do i have any kind of blood cancer like polycythemia or polycythemia vera in spite of having too much hemoglobin and platelets why am i having weakness do i need to take blood thinner medicine ### Response: hereby i am giving opinion regarding your case first let me know do you have any stress or anxiety issues as severe stress can lead to hyperventilation and dizziness stress can change bowel habits as well and it can lead to headaches as well if stress is not present then the causes for weakness are overexertion lack of exercise depression kidney problems for that urea creatinine investigation done myositis etc as for three weeks you are not improving you can be investigated with emg electromyography ekg electrocardiography investigation for further workup answers to your questions are as follows i do not think this blood report is abnormal it should be repeated as two weeks passed in stroke vision problem half part weakness slurred speech like problem present so the stroke chance is very less but ekg investigation can be done here as dizziness present since many times your hb and hct are not much high that needs immediate concern i do not think it is polycythemia vera case repeat cbc to check hct and rbc value now for weakness rule out the above causes no of taking any blood thinner include green leafy vegetables and fruits more in your diet

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had fever two days ago then one day ago started frequent urination and i could not hold it every time it happened and there was pain during urination then started pain in the stomach today the urination is not that much but i have severe pain in both sides of my abdomen i am not able to walk because of pain ### Response: you can have kidney or bladder infection or it can be acute urinary tract infection you get the following tests done as per these reports the further management plan can be decided take care you can consult a urologist for the examination for more information consult a family physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old missed period for days now since my day of menstrual cycle was starting using duphaston drug once daily and finish the prescribed dose yesterday and my menstrual cycle is between days this month on the days of my periods i got cramps but nothing come out could this be side effects of duphaston or ### Response: i would like to know the reason why you had been taking duphaston if you have been planning for a pregnancy then it would be advisable to check your urine pregnancy test once if negative you can wait upto two week for your periods to come as you just finished your course of duphaston yesterday if you got pregnant this cycle then you may not have periods even after weeks so checkaccordingly please feel free to revert back anytime with any further queries have a nice day

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old female went through menopause but otherwise i am healthy there is a problem with my nails out of nails six nails have onethird of the nails separated from the nail beds with a v shape looking white underneath rest of the nails are looking pinkish pale the nails are painless unless i press them hard all the nails have some ridges i kept my nails short with no polish for over five weeks my fingers felt dry with mild skin peeling after a travel currently i have a mild skin eczema i also had seborrheic dermatitis in my scalp a few years ago but it is under control with special shampoo treatment i had one fingernail with a similar problem but it was in a milder condition i thought it was nail fungal i used mometasone furoate cream for my skin eczema it cleared up when my nails grew i have an allergy to pollen ### Response: hi i have gone through your attachment attachment removed to protect patient identity you seem to have a condition known as onycholysis which is characterized by the separation of the nail from its nail bed causes could be either a fungal infection onychomycosis or underlying skin eczemas like psoriasis for more information consult a dermatologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a cm endobronchial nodule in the right lower lobe i was a smoker for years i had a ct scan for cough and now new nodule is this cancer ### Response: i have gone through the reports attachment removed to protect patient identity it seems to be a very small nodule do not get afraid first anyway we have to confirm the pathology at present take treatment for cough you will need to take follow up if the symptoms continue or after three months if the nodule is progressive for more information consult a pulmonologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old female i am worried after reading about the effects of radiation from a ct scan i had two separate scans within a month both the scans were for the chest abdomen and pelvis the doctors were looking for a potential lymphoma but nothing conclusive was found i am worried about the future cancer risk please help ### Response: this kind of exposure to ct scan is not harmful though you must avoid as much as possible a continuous longterm exposure daily may cause harmful radiation hazards and ill health so do not worry about the exposure this very minimal exposure does not pose any future cancer risk consult a radiologist online to know about the risk levels of radiation exposure

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have serious constipation problems and dulcolax is the only thing that works in my body i take a lot of fruits tea and fiber supplements what can i do ### Response: hi at your age chronic constipation should be thoroughly investigated are there any other symptoms like blood in stool weight loss or occasional diarrhea alternating with constipation or loss of appetite i would advise you to get a colonoscopy done as this has become chronic if there is an underlying factor causing constipation laxatives will only provide temporary relief and will not solve it hope this helps take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am suffering from stomach pain i am taking sucramal syrup and aspas tablet i have an increase in stomach pain when the acidity condition increases i have done a scanning but nothing was shown ### Response: your stomach pain can occur due to gastritis or you can have a small stomach ulcer which may not be seen in ultrasonography you can take rabeprazole mg for one time a day for one to two weeks to heal the inflamed stomach mucosa avoid taking spicy foods cooked oatmeal can help in soothing the stomach take soft and bland diet more avoid having heavy fatty foods elevate your head while sleeping avoid taking excess tea and coffee if you have the habit of smoking please avoid it

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my question is when can i drink more than two glasses of wine a day or a whole bottle without it hindering the healing process after my dermapen session of micro needling and also because i was occasionally drinking a few bottles of beer after i had gotten it done does that mean my healing time has to be longer than six weeks by the way i did my acne scar regions with mm needles ### Response: hi alcohol use can diminish wound healing it increases the blood flow so it can also cause bleeding excessive alcohol intake also reduces the immunity of the body which can lead to delayed wound healing same principle applied to micro needling micro needling is also a small type of injuries created in the facial skin so that the healing process makes a healthy smooth skin and remove the scar so if you take alcohol during that process alcohol is going to affect that healing process and it can lead to infection so i advise that you should completely avoid alcohol if possible a small amount of one glass of beer per day can be taken if you can not control your urge to take alcohol i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am hepatitis b patient my current status is as follows hbeag negative hbv e antibody or ag positive and hbv dna quantitative pcr less than iuml please advise whether this can be cured to become negative as it is affecting my career ### Response: antihbc both igm and igg liver panel ultrasound of the liver inrpt and serum albumin if not part of the liver profile chronic hepatitis chronic carrier acute infection in window phase with less infectivity yes it is treatable but i would be able to give you a better answer once i have the complete set of blood work and ultrasound results revert back with the investigation reports to an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i recently got my cbc done as a part of a routine checkup in which my hgb rbc platelets wbc counts was entirely within the range except for monocytes my monocytes were i feel healthy otherwise and except for pcos have no other known medical condition my gp said that monocytes were nothing to worry about as tlc is fine and i am fine so can you tell me if it is nothing to worry ### Response: i read your concern and below is my opinion there are many causes for high monocyte count your monocyte count is high and can not be neglectedthe temporary viral infection also can cause high monocyte count you do not have any symptoms so temporary mild viral infection might be cause for high monocyte you have to repeat your full cbc with peripheral smear examination report after seven days if still monocyte count is high then you have to consult a hematologist for detailed evaluation i hope i have answered your question i will be glad to help you further if required

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: hi doctor i am weeks pregnant last week i undergone for nt scan the report was normal and the same time i gave double marker blood test yesterday from the hospital they called me for blood test because the first report shows abnormal i am so scared whether second time double marker test shows normal they didnt give the report of first test but simply told first test was abnormal so we sending for second time i am confused please tell me whether second time test shows normal result if it is abnormal is there is any early treatment to protect the baby from down syndrome ### Response: hello first of all congrats on your pregnancy let me clarify that double marker is only a screening test its not a confirmatory test double markers are not repeated if they r showing high risksonif the lab has asked for a second sample it may be due to some other reason it means even if we say ur second test shows a high risk chances of which r less it only means that this baby for some reason has a higher risk for a genetic problemyou still need to do an amniocentesis and do a karyotyping to confirm the genetic problem we see many double markers which r abnormalbut very few if those have an abnormal karyotype on confirmation so rest assured and enjoy your pregnancy let the results come nothing is decided by a double marker test so pls wait for the resulttheres no need to panic have a safe pregnancy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a frenuloplasty of the penis ten days back it all seemed fine at first and i had very little pain i have to say the actual incision and stitches were a lot larger than what i was previously led to believe i have been washing gently with salt water and rinsing twice daily i took a good look a few days ago and it seems that the stitches have come apart to be honest and i am not a urologist but it does not look like a good job though i may be wrong i went to see the doctor yesterday and she took a look and said that it all looks fine the stitches may have come apart slightly she told me to leave it for two weeks and if i am still concerned they will refer me back to the specialist i was hoping to get a second opinion this being my penis i am obviously concerned that it is not going to heal properly and i will end up worse than before the operation i am primarily looking for reassurance ### Response: hi i saw the photos attachment removed to protect patient identity you are correct a few stitches have come apart so be reassured that nothing has gone awfully wrong just wait it out till complete healing takes place hopefully it should heal well as the wound is healthy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: im having ache in lower jawlast time i visited dentisti had a root canal same sideafter a month i started experiencing pain in that jaw sometimesdoctor said root canal is fine and that i have impacted wisdom tooth after a quick x rayi am having pain now again in that jaw after monthswhat should i dodue to covid im not sure i should visit a dentist ### Response: this may be the pain from the same reason you had previously if you have an impacted wisdom tooth then that can cause you this kind of problem repeatedly but if you have pain on biting that may be from the root canal treated tooth do you have the xray can you send me a picture of the affected area and the xray in the meantime you can rinse mouth with warm saline water times daily if the pain doesnt subside you can take painkiller tab ibuprofen two times daily for days after meal please send me the pictures for proper diagnosis and better treatment plan thank you for contacting us take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a hiatal hernia i am wondering if protein shake hurt my hernia the pain is usually mild and comes and goes recently i have been not feeling too well and my hiatal hernia pain become moderate and doest really go away i am currently on rabeprazole and motilium ### Response: i reviewed your endoscopy and histopathology report attachment removed to protect patient identity you have a small hiatus hernia and it has no specification association with proteins shake your report also shows chronic gastritis which also adds to your discomfort this issue usually improves with medications but recurs after some time my recommendations will be some changes in your medications for some time and then will readjust and down titrate again meanwhile you need some precautions as well hiatus hernia leading to gerd gastroesophageal reflux disease or gastritis capsule rabeprazole one in the morning and one in the evening before meals for four weeks and then only in the morning for four weeks tablet motilium before meals for two weeks syrup gaviscon alginate ml three times daily after meals for two weeks and then as per need avoid late night eating no eating two hours before bed decrease coffee intake avoid smoking one hour regular excercise after days

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have bleeding after sex i have pain while having sex i have vaginal discharge and irritation while peeing and itching is this an infection or something else i took an unwanted before three days ### Response: postcoital bleeding often occurs due to cervical erosions or cervicitis it shows increased vaginal discharge and it can lead to secondary urinary tract infection with burning sensation and irritation during urination so meet your gynecologist for a speculum examination and a urine culture have a treatment after seeing the results

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a lot of stress going on right now and most of my anxiety is coming back on having oral intercourse with a guy but he did not ejaculate there was precum though i am on birth control but after doing the oral intercourse two days later i started my period that was a week early and lasted days can i get pregnant ### Response: no you can never get pregnant with oral intercourse only vaginal intercourse without precaution would lead to pregnancy during the fertile period and the periods you are having is not because of pregnancy but may be because of hormonal imbalance get your thyroid profile and serum prolactin and fasting insulin fbs plus ultrasound to know the endometrial thickness the birth control pill if you are taking may result in this if taken irregularly

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i often have elbow pain due to spending more time with computer and using a mouse or keyboard i work to hours daily in computer and pain is gradually increasing the pain earlier used to reduce by taking voveran tablet and using voveran gel the pain has become frequent now and i am taking tendoshot capsule for the last few days i also use tennis elbow strap in both hands while working and that gives some comfort i do a few elbow exercise but that seems not sufficient in reducing pain what is the treatment for elbow pain due to computer usewhether should i take voveran or tendoshot for pain reliefis there any other medicine to use for pain reliefwhether tennis elbow strap or sleeve will be appropriate for this purposehow to prevent elbow pain while using the computerhow serious can be this elbow pain in future ### Response: hello it happens due to excessive use of muscle which causes stretch over the tendon at the origin giving rise to pain so obviously best treatment is to somehow restrict the use of muscle as much as possible now you will not be able to avoid computer use but try to restrict other activities like the lifting of heavy weights and all the motion which involves the use of these muscles like twisting or rotatory motion till it heals it is not at all serious it may trouble you may settle with time or at extremes may need some local injection for the pain to subside next thing you should support your elbow as much as possible during use of computer like keeping on the edge of the chair or using pillows or some other support so as to reduce stress also rather than any medicines you should use sleeves or brace as much as possible if not adequately helpful then may have a local voveran gel diclofenac tablet voveran should be avoided as much as possible and only have if absolutely painful you may have in painkillers if you need safest is paracetamol like tablet dolo or ultracet if it is not helpful then comes voveran you may use hot water fomentation also visit local physiotherapists and get some exercises learned for it for more information consult an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i am suffering from stress chest pain for the past one year echo and ecg are also normal is it related to heart or gerd or chest walli am taking citas mg and pantosec ### Response: hello your pain at your chest wall may be due to stress or heartburn from acid reflux i am suggesting that you have developed a stress ulcer which can lead to acid reflux esophagitis are you on any form of stress lately if so please take some time off for adequate rest you can go ahead to do your echocardiogram to rule out any form of heart disease which can produce chest pain meanwhile you can continue the suggested medication for the pain and combine it with some antacids until you receive the outcome of your diagnostic test stress echocardiogram reflux hypertensive heart disease reflux esophagitis adequate rest and antacids reduce stress event revert back with the echo report to a vascular surgeon online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my wife was previously diagnosed with bipolar ii and was taking mg lamotrigine daily for depression maintenance she was on that dosage for nine years she recently suffered a more chronic depressive episode and went out of town for ketamine infusion therapy the infusions were very successful and the psychiatrist who was assessing her for the infusions suggested that she did not need the lamotrigine that it was ineffective for treating depression in bipolar ii she tapered off the lamotrigine which was very difficultit has been three to four weeks since her last dose of lamotrigine and nine weeks since her infusions she is feeling very moody and depressed irritability fatigue loss of focus the question is do you think she needs to go back on the lamotrigine or does she need to get a booster shot of ketamine both are difficult solutions getting off the lamotrigine was awful and getting ketamine requires out of town travel etc kindly advice ### Response: hello i can understand your problem ketamine infusion therapy has great roles in depression but regular maintenance treatment is needed and which results in a significant burden on patients even in maintenance treatment the take care