[
    {
        "instruction": "Hello doctor,I am very depressed. I am so tired of being tired and fatigue all the time. I have low self-esteem because I am over-weight but I love life. I love my family, my kids, my husband. They love me. I cannot get a job to help pay bills. No one is calling me back. I am so depressed and down every day all day.",
        "input": "",
        "output": [
            "I'm sorry to hear that you're going through a difficult time. Depression can be very challenging for individuals to handle, especially when it affects daily life activities. It is important to discuss these feelings with your doctor or a mental health professional who can evaluate your condition and give you appropriate treatment options.\n\nIn addition to seeking professional help, there are also lifestyle changes that can help to manage symptoms of depression. This may include regular exercise, healthy eating, and engaging in activities that bring you joy and purpose.\n\nIt may also be helpful to seek support from your loved ones or a support group. As well as, explore job opportunities that match your skills and experience, network with people, and update your resume.\n\nRemember, depression is a common condition that many people face. With the right support and treatment, you can overcome these feelings and start to feel better.",
            "1)2) Your symptoms indicate that you are suffering from Depression.3) It needs a proper evaluation by a Psychiatrist for diagnosis and treatment.4) Medication like SSRI (selective serotonin reuptake inhibitors) antidepressants would help you to overcome your problem.5) Consult a psychiatrist for further evaluation and management."
        ]
    },
    {
        "instruction": "Hi doctor,I am going to undertake a water only fast for 14 days. Which vitamins and electrolyte should I take and in what dose? Just heard of refeeding syndrome. Any other precautions?",
        "input": "",
        "output": [
            " Hi, Thanks for posting your query. Fasting is not advised as it can lead to many complications. In fact, there are no scientific evidences that suggest fasting helps in any disease condition. You might have heard about refeeding symptom/syndrome which occurs when a person who has been starved for long periods suddenly eats food. This can cause low levels of electrolytes, calcium, magnesium etc. in body. It also causes muscle weakness and tiredness. To avoid this, you need to eat healthy balanced diet including fruits, vegetables, proteins and carbohydrates. You should also take multivitamin supplements before starting with fasting. Hope this information was helpful. Wishing you good health. Regards.",
            "It is not clear why you are undertaking water (only) fast for so long as 14 days. In case, you have decided to, I would advise you to do it under the expert supervision of an ayurveda or naturopathy physician who can monitor you closely. While fasting has obvious health benefits, prolonged fasting exceeding a week can have serious ramifications on one\\s health unless carried out under expert supervision. It is always safer and advisable to have shorter fasts of two to three days maximum, in regular intervals, than resorting to a long duration fast in a single go. Refeeding syn.  This can be fatal too. Precautions, that one must take in addition to the ones highlighted above, are as follows: "
        ]
    },
    {
        "instruction": "Hello doctor,I have had permanent cramps and a constant ache in both buttocks. I have pain down the back of the legs in the calf and when I walk it feels like it is about to cramp and I get pain in front of the thigh. I have a constant aching feel. When I press my skin on both thighs it feels sore. I had it for over two months. I have pain on both sides of my thighs and legs regardless of if I am sitting or resting.I got admitted to the hospital for two weeks and they did an MRI scan on my spine and found nothing. They did a lumbar puncture and found nothing. They also did a nerve examination and nothing was found. I am currently on Gabapentin, Codeine, and Paracetamol.",
        "input": "",
        "output": [
            "Hello,\n\nI'm sorry to hear about your symptoms. Based on your description, it sounds like you may be experiencing sciatica, which is a common condition characterized by pain, cramps, and numbness that radiates down the buttocks and legs. The fact that you have had an MRI and nerve examination done with no definitive diagnosis may suggest that the cause of your symptoms is musculoskeletal rather than neurological.\n\nThere are several potential causes of sciatica, including a herniated disc, spinal stenosis, or piriformis syndrome. However, it's worth noting that some cases of sciatica have no identifiable cause.\n\nIn terms of treatment, the medications you are currently taking can be effective at managing the pain associated with sciatica. However, other treatment options may also be helpful, including physical therapy, exercise, and certain types of injections.\n\nIt's also worth noting that lifestyle changes may help, such as regular exercise, maintaining a healthy weight, and practicing good posture.\n\nI recommend discussing your symptoms with your doctor or a specialist such as an orthopedist, neurologist or pain management specialist to determine the best course of action for you.",
            "1) The pain and tightness in your buttocks, thighs, and legs can be due to compression of the sciatic nerve at its origin from L4-L5 vertebrae. This could explain why you have pain radiating down the back of the leg.2) There is no specific treatment for this condition as such. You need physical therapy with ultrasound and TENS therapy to improve the symptoms.3) In addition, you may also try using a soft cervical collar and performing gentle neck exercises.4) Please consult an orthopedic surgeon who will examine you and give further details regarding the treatment."
        ]
    },
    {
        "instruction": "Hello doctor,My wife\\s last period date was two months ago. After one month, we came to know through blood tests that she is pregnant. She had her first ultrasound 10 days ago and the baby is fine at five weeks and five days with a heartbeat of 114. But for the last three to four days, she saw some blood in her urine. Today, there was some flow like a period and we consulted the doctor.We did an ultrasound today. They could not find the baby\\s heartbeat. So, we did blood tests. My wife is under a lot of stress because of bleeding and no heartbeat. Does this mean, she has got a miscarriage? Do we still have a hope to revive her pregnancy?",
        "input": "",
        "output": [
            "I am sorry to hear about your wife's experience. The symptoms you are describing, including bleeding and absence of fetal heartbeat on ultrasound, are concerning for a potential miscarriage. However, it is important to confirm the diagnosis with additional testing, such as a repeat ultrasound and bloodwork. Your wife's healthcare provider will likely discuss her options for management, which may include expectant management, medication, or surgery. It is understandable that your wife is feeling stressed and anxious during this time, and she may benefit from additional emotional support and counseling. While it is always difficult to experience a pregnancy loss, it is possible to have a healthy pregnancy in the future.",
            "If a repeat ultrasound shows no heartbeat then she has experienced a missed abortion. This means that after the arrival of the heartbeat, the heart has stopped and the fetus is no more alive and not growing. The bleeding is nature\\s way of aborting the non-developing fetus. This can happen because of possible congenital abnormalities or chromosomal abnormalities in the conceptual, which was deemed naturally unfit for further survival. The initial heartbeat of 114 BPM (beats per minute) was itself low. Ideally, it should have been more than 130 in a real fetus. The bleeding may continue for a week until she aborts completely. You may repeat the ultrasound again after a week to check for completion of miscarriage if the bleeding does not stop. For more information consult an obstetrician and gynaecologist online "
        ]
    }
]