Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a red spot just above my left ankle about 4 inches in diameter which has been there ever since I had a large cancerous tumor removed from my left groin about three years ago. I have used various medicated creams on it but it does not go away. I have light shooting pains in it occasionally. I recently sprained my ankle and it got worse. I am 92 years old and diabetic. Is there some medication or medicated cream that might help? ### REPLY: After hearing your history I would advise you to use voting gel in the affected area. Volini Gel contains Diclofenac Diethylammonium Topical, Menthol Topical, Methyl Salicylate Topical and Ileum Line Topical as active ingredients. Volini Gel works by reducing pain and delayed onset muscle soreness, providing relief of musculoskeletal aches and pains, reducing the pain providing relief from pain. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old son collided with his sister(heads) full speed over a week ago and knocked him back on the cement and he blacked out for a few seconds. He recovered well but now has a half baseball sized squishy bump on his head near where he hit the cement. He has not complained and it is not terribly sensitive to the touch but I am concerned because I feel an indentation in the bones of his skull around the squishiness. He has acted completely normal and energetic. ### REPLY: Thank you for posting your question. The bump on the head that you feel is most likely due to local swelling following the hit. The indentation of bones however is not likely as the bones of a five-year-old are not normally supposed to be soft enough to give way to local swelling. Also, if your child is playful, eating well and not complaining of pain, serious consequences can be ruled out to a great extent. Having said that, if you still feel that his skull is showing some bony depression, I would suggest a medical consultation and if required at least an X-ray skull may be done to rule out skull fracture. If you have any more doubts, do write back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my baby 7 month old , did stool test consulted by doctor having somach ache....report:- 0-2 pus cells, reaction:acidic, colour:yellowish, consistency:semi formed, bacteria:++, all other options:nil, medicine:topcef, injection:taxin..but no good sign..still stomach ache ### REPLY: Hi... Thank you for consulting in . This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to .  Unless the air comes out like burping or flatus this discomfort will be there and next time check if she is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief. The two best ways to relieve this distress is - 1. Do not put the kid in lying position after feeding till the baby burps out the swallowed air.2. If the baby is still crying - put in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 57 year old male. I recently started taking pumpkin seed oil to help arthritis . The next day, I was shocked to find I was pooping John Deere green. Christmas green in fact. I felt fine otherwise, but I quit taking it and the stool returned to normal the next day. Does Pumpkin seed oil do that? Is it a health concern, or should I simply get used to pooping in technicolor? ### REPLY: Hello There. Welcome to  forum. Since your stool turned to normal color after stopping the pumpkin seed oil I would suspect it has cause for your green stool. Pumpkin seed oil is considered beneficial for arthritis, BPH, Irritable bowel syn .  Reducing cholesterol level etc. If you find it beneficial for your arthritis I would advise you to continue using it. Hope this helps. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im having throbbing, shooting pain from the back side of the lower right side gum line to the middle of my jaw. It feels like a cavity because i cant chew on that side without causing pain.  i had an X-ray done because it was so bad but nothing showed up.  the dentist gave me a mouthwash to use with a syringe and it helped for awhile but the pain is back and seems worse. I havent had a cavity since i was a child and my family has a good line of healthy teeth.  I dont know what to do now. can you advise? ### REPLY: Hi. Thanks for the query. I have gone through your query and can understand your concerns. As per your complaint it seems that pain in lower right back gum radiating to the middle of jaw might be because of inflamed gum flap around wisdom tooth also known as PERITONITIS. Other cause can be fractured crown or Root portion of tooth that can occasionally be missed in an x Ray. The treatment of irrigation with mouthwash indicates that might be PERITONITIS is the cause. I would however suggest you to consult an Oral Surgeon and get evaluated, and he can advise a full mouth x Ray and evaluation of teeth, jaw AA well as the jaw joint will be done to rule out the probable cause of pain and treatment can be done accordingly. As of now you can take higher painkiller like TRAMADOL or Motorola as it is suitable to relieve severe pain. Avoid chewing from painful side. Take a soft diet. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had the lymph nodes on the left side of my neck and some part of the tongue removed due to some throat cancer being diagnosed. I am 64 yrs old and the successful surgery was 1 month ago. I seem to be having trouble regaining my strength (as evidenced by my golf swing ). Is this common and/or should I just give it more time? ### REPLY: HIT hank for asking to ChatDoctorI sorry to hear that, and I really appreciate your concern as long as the strength is concern it is not being lost or decreased, but you have need to feel this, no matter what the disease you have got the strength remains there only, but of course your mental stress stops your feeling and makes you weak, no need to worry forget every thing and enjoy the, hope this information helps you, have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Very sore left leg where Verrucous veins are. Pain left there and started in the chest, esophagus and went up into the jaw. Now all pain is gone except for some pain in the upper back between shoulder blades. Feeling very worn out and tired. Could this be associated with the heart. Mother died of hardening of the arteries email address is YYYY@YYYY ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. This kind of pains that you explain might be generated from heart. The first think to take in consideration is ischemic heart disease. This means possible problems with heart coronary arteries. Ischemic pains have some characteristics. They in general are retro-sternal pains like heaviness, tightness. They irradiate to one or both arms, to the neck, jaw or between shoulders. Furthermore, they last from 5 to 30 minutes. Usually they begin during efforts. Other heart problem that might give pains like these are aortic problems. They might give pains between shoulders like you explain. So, if I was your treating doctor I would recommend you to seek medical attention. Your hereditary history all sow makes this mandatory. Of course this might be nothing, but it is better to make a simple check up with an electrocardiogram, an echo-cardiograph, a blood analyses. After these doctor will decide what to do next. Hope I was helpful. Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 17 and in good health I eat healthy although I practically only drink Mountain Dew and have for the past four to five years. I ve noticed however that occasionally my chest hurts around my heart and I describe it as my heart feels like it s pumping grease or just that my blood feels really thick. I think the two may be related but wanted another opinion ### REPLY: Hello! Thank you for asking on ! I understand your concern and would like to explain that your complaints seems to be mostly related to increased stress and anxiety, as it looks like a kind of palpitations, and nonspecific chest discomfort. There are several factors, why you experience such feelings, and the heart reacts that way. Smoking, several stimulants like excessive alcoholic .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir.i am 23 year old college girl.and i m suffering from acne problem from since 6 month.from last 2 months i am taking homeopatChatDoctoredicine and from last 3 days using TOPI BERBERIS cream at night and day.but its not helping out.suggest me something which can work out faster.recently i m using saslic facewash(by cipla) and olay age defense cream.thank you.please suggest something effective. ### REPLY: Hi, Acne treatment depends upon the severity and type of lesions. The treatment is given in the form of oral medicines(azithromycin/ doxycycline/ minocycline and/or isotretinoin) along with topical(clindamycin, benzoyl peroxide, Darlene retinoid) etc. As you said you want faster results, that can only be delivered after a thorough skin examination so that a personalized skin treatment can be suggested. However, you may follow these basic suggestions to prevent and treat acne1) continue with seismic face wash. Use it twice daily2) you any continue with Olay cream, if it suits your skin well3) get your blackheads and whiteheads removed regularly and apply retina a cream in come done prone areas4) treat your active acne lesions with application of clindamycin gel and retina a cream. Depending on your acne grade severity, oral therapy might be required, for the same consult a dermatologist nearby. You may also discuss the option of chemical peels with your doctor as peels give good results in short time and also take care of pigmentation and scarring. Hope that answers your query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor. Im boy 18 years old.I would like to ask that one day I masturbation  4 or 5 times. Is it ok with my health or any problem ? when I did it finish during 1 day my face has a lot of ance... What happen and Is it any problem if I lost a lot of sperm per day ? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have been indulged in masturbation frequently and now facing problems problem of getting acne over face.First there is myth in a mind of common man that excessive masturbation is the reason of all problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. All the problems that you are facing now are mind related and due to anxiety. To masturbate at the age of adolescence is common, however it should not become a habit and one should not get addicted to it. What ever sperm one ejaculates are reproduced by testicles within 24 hours. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Currently i m laying down and im having severe chest pains but only on the left side. It s happened before and i m assuming it s just the fact i have GERD which has been flaring up lately. For some reason this pain feels different it s not so much pressure but more of a burning sensation ### REPLY: Thanks for your question on . As a rule in chest pain, we have to rule out cardiac cause first. So better to get done ECG first to rule out cardiac cause. If it is normal than your pain is mostly due to HERD. For better control of HERD try to follow these steps.1. Avoid stress and anxiety. 2. Avoid hot and spicy food.3. Avoid large meals, instead take frequent small meals.4. Take proton pump inhibitors. 5. Go for walk after meals.6. Keep 2-3 pillows un .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my 5 years old child has big problems when ever he wants to go to toilet. He told me that he has pains when the stool comes out. Most of the time he prefers to start his kaka on his pants and he goes to toilet. Yesterday I saw that he has very inflamated anus, what would be the cause and solution for this problem. Thanks ### REPLY: Hello and welcome to . Painful defecation and sore anus may be due to following reasonsAnal fissures:Prolonged constipation and straining can cut the anal skin leading to anal fissures which is a very painful condition and can exacerbate the situation by creating fear of defecation and retention which lead to leaking stools and soiled pants. To rule out this condition he needs to be examined by pediatric surgeon. I advise Xylocaine gel, sitz baths and stool softener in such situations.  Pin worms:They irritate TH sensitive skin moreover itching can also lead to raw skin. Contact of stools with raw skin will hurt a lot specially if the stools are hard. Local examination, Stools inspection and stool routine examination will confirm the diagnosis. I prescribe zinc oxide cream and Albendazole syrup in such situations. Food allergy:It makes the stool acidic which irritates the skin and similar condition develop as in pin worms only that acidic stools will burn the skin more. Stool test for reducing sugars can confirm the diagnosis. Zinc oxide cream and omitting the alleged food will be my advice in such situation.4th Condition which is very sensitive and grave matter both for you and us(your treating team) that is sexual abuse must be kept in mind. It can lead to sore/inflamed anus and fear of Defecation. AND you MUST be very vigilant to keep an eye and must INTERVENE if such situation is possible. Hope you find this answer helpful. Good luck! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr,yesterday I went for follicular studies on my 17th day doctor said that both sides got ruptured and suggested me to take gestone200mg endomet is 13.3 is this reading is possible to get pregnant and I want to know the meaning of ruptured pls do answer my question ### REPLY: Hi, Your follicular study suggest rupture of ovarian follicle/ovulation. It suggests ovulation has been occurred. You have to do unprotected sexual intercourse with in next 24 hours to 2-3 days to become pregnant. Thickness of endometrium is enough for implantation. You can take gemstone: it will make uterine environment favorable for implantation and support pregnancy. You can also take ova care to support pregnancy. Avoid stress, take healthy diet, . Hope this may help you. Contact further if follow up needed. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I started taking allegra about a month ago and I thnk about a month ago I started to have pain in my left leg. It is not a cramp or rls but a pulsating slightly burning uncomfortable pain that wakes me from sleep. As soon as I get un the pain goes away. I was wondering if there is any correlation between the two? Thank you ### REPLY: Thanks for your question on . I can understand your concern. No, Allegra can not cause such pulsating leg pain. Allegra is having fexofenadine. It is antihistamine. It has nothing to do with such leg pain. So there is no correlation between your Allegra ingestion and this chest pain. In my opinion, you should get done left lower limb arterial and venous color Doppler to rule out DVT (deep venous thrombosis) and varicose veins as both of these can cause similar kind of unilateral pulsating pain. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi 1 1/2 yrs ago mymom was diagnosed with advanced cirrohsis of liver caused by Hep-B.her ascites has become unresponsive to the diuretics .Doc has suggested for the TIPS procedure.Could you tell me about it,its sucess rate ,risk involved and the cost for it. ### REPLY: Hi there, Im sorry to hear about your mothers' diagnosis.  TIPS for ascites has an excellent success rate, with 90% of patients having a good response and decreasing the amount of paracentesis they have.  The most significant risk is worsening of encephalopathy (altered mental status). This can vary, but usually can occur in up to 20% of patients with cirrhosis. Again, this depends on how advanced her disease is. Another complication is that the stent can become thrombosed (clotted) which would require another procedure. Finally, there are risks such as bleeding and infection, but significant bleeding and infection risks are low, likely under 5%. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when i checked up my blood they said tpha+ , doctor told me that bring vdrl report they give RPR=nr, and doctor told me that " if one time tpha positive in life it will be positive he no active disease no treatment necessary . i would like to go work abroad so they unfit me medical    . is it possible to make tpha negative by using any medicine ### REPLY: HelloSign you are TREPONEMAL TEST i.e. TPA is positive. At this point there is no value of v . So please upload all symptoms, contact history of syphilis, treatment which had taken and in which stage. Once positive, these usually remain positive for life but 15 % to 35 % of patients if treated in primary stage may become serologically NONREACTIVE in 2 to 3 years. Treatment depends on stage of syphilis, so write down all in detail. Hope this will help you. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, i have 16yr old daughter who just passed out at school in womens restroom after urinating. She stood up and and passed out and bumped her head and got up 10 min later. This has been happening at least 1x per quarter for past year. A specialist diagnosed her with Vertigo. All blood tests normal. What else can we do? ### REPLY: Hello! Welcome on ! I understand your concern and would explain that her symptoms could be related to a post-mixional syncope (if they occur only after urinating) or to epilepsy seizures. Does she lose her conscience during these episodes? Does she remember the circumstances in which these episodes have occurred? Vertigo is a diagnosis based on episodes of dizziness and motion sickness. This disorder is not usually associated to loss of conscience. From the other hand some epilepsy seizures are associated to dizziness before the seizure. That is why I would recommend consulting with a neurologist for a physical exam, an EEG and a brain MRI to exclude this possibility. A head Up Tilt test would help exclude possible orthostatic intolerance, associated to post-mixional syncope. You should discuss with her doctor on the above issues. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A 37-week-old infant was delivered by cesarean section and discharged from a Connecticut hospital when he was 10 days old. Two days later he was lethargic and had a fever. When he was readmitted to the hospital, he had multiple brain abscesses caused by Citrobacter diversus. After a prolonged illness, the baby died. A second infant with a normal pregnancy and delivery died of C. diversus meningitis after a short illness. Nine infants in the hospital nursery had umbilical cord colonization by C. diversus. Environmental cultures were negative for hospital equipment.a. What is the normal habitat of this gram-negative, facultatively anaerobic, non-endospore-forming, lactose-positive rod? b.Provide a plan for identifying the source of infection and preventing further infection. ### REPLY: Thanks for your query at ! Sorry for the loss. C. divers us is an Enterobacteriaceae group bacteria which is found in soil, water and waste water, part of intestines, etc. It commonly does not cause infection in immunocompetent individuals. But neonates can sometimes get infected. I suggest get the high vaginal and stool of mother tested for ACTED/routine bacterial culture aerobic and anaerobic. Then based on sensitivity the treatment must be started with .  The swabs must be taken from infants as well and sent for above tests. The phoenix automated system can also be used for this situation to test panel of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having severe abdominal pain. Not pregnant; had partial hysterectomy. I have diverticulosis/itis, and every time I eat anything, I have an attack, as of this week. They are getting worse and worse and feel like labor pains!! I also have PCOS, degenerative disc disease, hbp, diabetes, and possibly IBS, colitis and fibromyalgia. I cant take much more of this pain! Because of all of my health issues, its difficult to pinpoint anything. Help!!! ### REPLY: Hi, Thanks for posting your query. Do you have acidic belching/ abdominal discomfort/ gargling sound in abdomen/ abdominal bloating after taking meals? Does he have retrosternal burning pain causing difficulty in swallowing? Do you have fever/ spasmodic abdominal pain? Pain after eating is very characteristic in cholecystitis, pancreatitis and peptic ulcer disease. You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up. You should also go for complete blood count, Ultrasound imaging abdomen, thyroid profile, blood sugar, x-ray abdomen and serum electrolytes. Meanwhile, you should take proton pump inhibitors along with prokinetics for relief of your symptoms. You should also take tramadol for relief of your symptoms. You should also take plenty of water and perform increased physical activity. Avoid oily and spicy food, tomatoes, citrus fruits, excessive tea & coffee, chocolates. Take soft diet along with yogurt. Take care,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a ultrasonography yesterday my last LMP date is 23 dec 2013 according to doctors till 20th week the growth was normal TL ,UL,HL,FL was 28,29,31and 33 mm respectively. But now they say that TL measures 20.6 mm .and there is abnormalities in growth of limbs. Can u please help me out by explaining . ### REPLY: Hi, Thank you for asking question on . For assessment of fetal growth ultrasonography is essential. Intrauterine growth retardation clinically will not become evident before 20 weeks and seldom before 28 weeks.IUGG may occur due to maternal diseases or maternal malnutrition. May be certain chromosomal disorders or congenital malformations responsible for these abnormalities. Spinal defects occur due to maternal folate deficiency. Better wait till the baby is born as nothing can be done now. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my aunt was diagnosed with stage 4 cancer.  It originated in her colon and has spread to her liver.  She has had 2 chemo treatments but is not having more.  We were told that she will be starting hospice.  She has gained 40 lbs in the hospital in 2 weeks.  Her legs and feet are extremely swollen.  She is confused at times.  How do we know if she has 2 days, 2 weeks or 2 years to live? ### REPLY: Hi, Thanks for writing in. Sorry to know about your aunt who is suffering from stage 4 cancer. Colon cancer might be violent at times and even after surgery about half the patients develop spread to liver, lung and brain. The expected survival of a stage 4 cancer patient is up to 2 years from the date the cancer detection was confirmed in the liver. The maximum survival depends on many factors like age of patient, response to treatment, progress of disease, general health condition and mental outlook. In case of your aunt, it is important to know if the liver and kidneys are functioning normally. Swelling in legs indicates a problem in liver, kidney or heart. If there is a complication in the liver or kidneys then survival is reduced to 6 months. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a very high sex drive and a very short temper. I lose my temper at the littlest things and I really hate myself when I get angry with my daughter cause of my short temper. I am wondering what there is I can take or do to help with these two issues. ### REPLY: Hi, I can understand that you are distressed by your anger outbursts. Your problems regarding high sex .  Much more information would be needed to come to a definitive conclusion. However, you definitely would benefit from a psychiatric consultation. Evaluation will be done to determine whether your problems are due to underlying mood disorder or due to personality traits and accordingly treatment with medications or psychotherapy may be offered. Hope you found the information useful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: l am experiencing bad leg pain and back pain. I have been given 800 mg ibuprofen and acetaminophen with codeine. I took ibuprofen about 2 hrs ago no relief cant sleep. Can I take the acetaminophen ### REPLY: Hello and welcome to Ask A Doctor Service.  I reviewed your query and here is my answer. Yes it is safe to take acetaminophen with ibuprofen. It is usually given in condition like yours when a single painkiller cant subside the pain. So don't worry and just go for your medications prescribed to you and take it regularly according to prescription. Hope I answered your question.  Feel free to ask more if I can help you further. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My doctor says I have a thyroid problem, but the only symtom I have is being tired a lot of the time. should there be other signs ? ### REPLY: Dear patient, Welcome to  forum, You might be having borderline hypothyroidism and so it might have not manifested all the symptoms of hypothyroidism. Other symptoms of hypothyroidism include weight gain, puffyness of face, hoarseness of voice, loss of temperature sensation etc. Firstly you cross-check your reports with other standard lab and if that also is positive than you need management for hypothyroidism. Hope this helps, thanks, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently I have been treated for several MRSA abscesses that are hopefully going to remain cleared up. However, my boyfriend had several abscesses lanced today and I was wondering the risk of my developing more now that he has some and what we can do to prevent it. I have had several series of antibiotics and he is now on Biactin. ### REPLY: Hii had gone through your history and I can understand your concern.nowadays, MRSA is spreading rapidly all over world. Source of infection most probably is hospital. And this staphylococcus organism is resistant to methicillin. So you have visited your nearby physician and get done your pus culture and antibiotic sensitivity tests done. So that you will get to know along with MRSA any other organism also causing the infection. And also you can take the antibiotic of MRSA suseptiblevancomicin tab is good for Masai hope I have cleared your query thank you take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 21 years old, 150 pound male. I work 3 jobs, one of them being a performer 2 other jobs as a cook and another job as a writer. For the last few months Ive been getting sharp pains in my chest, sometimes Ive had to catch my breath. The feeling is as if something is constricting my inside of my chest. Now I dont think its a heart condition, Im 21 years old and dont think I could already be doing damage. Have no other medical problems. Any ideas? ### REPLY: Hi thanks for contacting ... You have only constricting chest pain.... So first rule out cardiac cause by ..../blood pressure checking / ECG / treadmill test.... If coronary artery disease there like angina then nitrate given sublingual... If needed angiography might be done... Second if your ribs tender to touch it could be Costco . ... Brufen given for it.... You are doing three jobs, by which you can have stress and that can lead chest tightness.... Try to avoid stress... Yoga and psychiatric counselling useful.... If still cause not clear chest x-ray and auscultation done for rule out resp causes .(although chance of it less)Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...my partners dad has recently been diagnosed with advanced pancreatic cancer. Toniit hes been rushed to hospital in agonizing pain, morphine is having no effect. What cld this mean? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has advanced pancreatic. It is stage 4 cancer. Surgery is not useful in this stage. So treatment options are chemotherapy and radiotherapy. But it will not cure the disease. It just works as palliative therapy. Despite all treatment prognosis remains poor. Life expectancy is not good. Sorry to say but it is fact. Morphine is used in terminal stage cancer to relieve pain. It is also not working, so it is very bad sign. No treatment should be given according to my opinion. Consult your oncologist and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to an orthopedic surgeon who told me my left hip was coming out of the socket. He also told me to wait as long as possible because of my age. I have two questions. When I walk, I get a sharp pain in my knee and my leg locks up for a moment. Is this normal for my condition? And, how do I know when the hip replacement is absolutely necessary? ### REPLY: Hi their total hip replacement is indicated when your pain becomes so severe that it interferes with your daily activities and when common pain medications have failed to help relieve the pain and your hip function has becomes useless because of pain. All pain treatment modalities must be exhausted before thinking of doing a total hip replacement, and we like doing it for patients older than 50 years of age. A younger person might require a hip replacement when all other treatment options have failed to alleviate pain. Pain in the knee can be coming from a hip problem but your knee need to be examined as well by a doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Could you please tell me the prognosis of Liver Cancer. ? My friend has just been diagnosed with it and the tumours are on the blood vessels. She attended for Radioactive injections yesterday and will and will be told the results today.She has been told that they are malignant but they don t know where the Prmary is as the only tumours to show up on the MRI scan were on the Liver. Appreciate any information. Thank you. ### REPLY: Thanks for your question on . Liver is the most common site for metastases.  The reason for this is reach blood supply of liver and suitable environment for tumor growth. And to find liver metastases is an accidental thing. After this we need to search for primary.  For this PET scan is best. So the radioactive injections you are talking about must be PET SCAN only. This will tell you the primary site of tumor. Possible primary sites are1. Lungs2. Kidneys3. Intestines etc. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctors - I am suffering from stomach tuberculosis, can you advise what is the cure for this?is it dangerous?i suspected too late. I am very worried. I am a divorcee. I want to get this cure beofre my second marriage.. is it possible. Please advise Thanks ### REPLY: Tuberculosis is a curable disease. You don't have to worry about that. Only thing is that the treatment is of very long duration. Of 6-8 months duration. In India, government provide it free of cost at all the DOTS center. You have to register yourself, and then you can start taking medicine. Remember one thing that compliance is very important.  You have to continue the treatment until the treating doctor declares you cured. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a bluish spot in my cheek.  Previous to finding the spot, I had noticed a place on my gum (on the same side as the spot, but behind a back tooth) which the oral surgeon told me may be a fibroid.  Soon after that, the "fibroma" went away, but I still have the bluish spot on my cheek.  He is planning a biopsy shortly on this spot.  Does this sound like the correct thing to do, and what do you believe the spot could be?please cancel this asI wasnot told it would cost anything. ### REPLY: Hello, for your problem, all the medical and dental examinations including laboratory tests such as blood test should be done. There are many lesions which can be present in oral cavity. If the doctor feels to get the biopsy done, then let him/her go ahead. Many such focal pigmentation could be present like vascular malformations, post inflammatory pigmentation, pigmented nevus, etc. so it's better to rule out by various tests. Thank you for your query take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im asking a favor can you please explain me the result of semens anlysis of my husband, im nervous for the result because i felt we cannot have baby we are married for 3 years this coming november and we always pray to have a baby. if the result is not okay can i ask if their is a treatment available for this? Thank you so much its a big help for me most specially emotionally. details: ph 6.8 odour normal viscosity normal volume 1.5ml round cells 0.8m/ml sperm viability 4% sperm concentration 0.4m/ml total sperm count 0.6m/ml leucocyle 0.4 motility 2% immotile 98% tapered head Kaye Mariano - Ong ### REPLY: Hi, The report however descriptive is not very clear. It seems the count is less than a million which is true is less and can prevent conception. Also, the leukocytes suggest infection. I advise you to seek help of a Urologist or upload your test report on this site by asking a Specialist or a Direct query. If there is infection then I would advise a Semen culture to know what bacteria are causing the infection and what antibiotics to treat it with. For the low sperm cunt you can take Speak an Ayurvedic formulation made by Himalaya .  But it would be best to take Specialist advice. I would also be able to advice you're better seeing the complete report. Take care, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My right side of the head getting pain.just near to right eye and back side of the head And some times my front head upper to eye getting pain.my teeths getting collapse time to Time and maximum my left right thooth getting pain.I scanned Plain CT scan of Brain & PNS. Repot is problem in PNS 1.Soft tissue attenuated lesion s/o mucosal thickening seen at the right Maxillary antrum. 2.Mild Hypertrophy of right inferior turbulent seen. 3.Mild deviation of the nasal septum towards left side seen.Kindly give the solution for this problem. . ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. Solution is to Undergo Displease consult an ENT Surgeon at the earliest Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi... My baby is 6 mths old... Till 3 mths i breast fed her but as i had to join my work back i started giving her Buffaloes milk as well as other solid food like Khicdi, Ragi, Fresh fruit pulp etc... is buffaloes Milk Harmful for her. please advice whether i can switch to Nan 1 ### REPLY: Let me emphasize on the fact that breast milk is the best feed for a baby up to 6 months of age. Beyond that, the baby needs a mashed version of adult diet low on spices, introduced step by step. Milk becomes an optional component at this age if other sources of nutrients are included in diet. Cow or buffalo milk has high protein content and hence is difficult for a baby to digest. Most formula milks are cow milk based, and although they are not directly harmful and may be given, but I would prefer homemade semi solids made from boiling rice and pulses along with vegetables and giving it after mashing it. You are doing the right thing by giving Chichi, Reign and pulp of fresh fruits. Most of these would be more nutritive than the available formula, and so I would not speak in favor of formula like NAN or buffalo milk. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my tsh is also 0,016 and ft3 ,ft4 in range, but my doctor said i have hoshimoto. I have some symtoms like palpitation, itchy eyes,headache or actually forehead pain,sharp pain in my chest:( its really hashimoto? i spend to much money for my health :/ i forgot - is one important thing- i use to take Roaccutane for acne,and after finished my treatment i start have all these problems...is is thyroid problem..or something more serious? ### REPLY: Hello, generally Hashimoto present as hypothyroidism, which means your thyroid is working on lower side, but here the TSH should be high) normal Cleveland in most lab - till 5.  Now your Ts his very low, it means you have hyperthyroidism from any cause, which fits with your symptoms of palpitations And other s. Some tests to confirm Hashimoto is s anti TPO, anti thyroglobulin and anti-microsomal antibodies.  Any one of these three are positive in most of the cases of Hashimoto.  Roaccutane can cause autoimmune hypothyroidism, i.e. Hashimoto. You should stop it immediately if proven as the cause. Also, some symptoms may be due to roaccutane.  Hopefully I could bring some insight.  For any future assistance, you may upload tests and clarify @ Http://doctor. ChatDoctor .com/doctors/ .  Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 67 male and have had follicular lymphoma for 2 years on watch and wait. I recently fell off my bike and have had a fractured skull approx 2 weeks ago. My worry is I have a lump come up on my elbow outside edge where I fell and I also have a cough and cold which has lasted over 10 days... Can you tell me what to do go to dr or consultant? Thank you very much John ### REPLY: Hi John! Good evening. I am  answering your query. If I were your doctor, I after a proper clinical examination of your elbow and the chest, would apply a pressure bandage on the lump presuming that it could be a hematoma following the trauma which would gradually get absorbed. In addition, I would also prescribe you with an anti-inflammatory and a proton pump inhibitor and a serratopeptidase product for a symptomatic relief. If the cough has lasted for over 10 days, this would be an indication of going for an x-ray chest PA view to rule out any gross pathology in the lungs. However, both need to be assessed by an orthopedic surgeon and your treating doctor for the lymphoma. Therefore, I would advise you to get assessed by these doctors in your place. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I just had my first shot of depo provera and never knew the fact that it can grow facial hair, if is supposed to happen when will I notice the efect? Also is there any way to prevent facial hair to grow? How can I get rid of it? I am now really stressing as I never thought of having hair on my face! help please ### REPLY: Dear is the facial hair growth was not like this earlier, you must report the side effect to the gynecologist. The mechanism by which it occurs is due the inhibition of the FSH and LH hormones from a part of the brain .Thus, the further release of female hormones is inhibited and that is how it is effective in birth control. Probably there is increase in an .  Or an estimation of hormones that 1. Prolactin 2. Dishy ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my baby is 10 weeks old and has had a swelling on the right side of his head near his far since birth. I have been told by numerous people it is a haematoma but i thought it should have gone by now. It started to go down but now it seems to have got bigger again. It is very soft and squishy to touch. Wot could it be? ### REPLY: Hello, I can understand your concern. The swelling that you have described might be presence of a cyst. Cysts are fluid filled cavities which are lined by layer of cells. However, there are many other lesions and tumors that can look and feel the way you have described. I would advise you not to ignore the swelling, and you should get it checked by a pediatrician or an oral & maxillofacial surgeon reading its exact location, size, color, texture, consistency etc. Your son might need to go for biopsy and surgical excision of the lesion. I hope this information helps you. Thank you for choosing . Take care. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been feeling unwell for a little over a month now. I have swollen lymph nodes behind my ears. My legs are covered in bruises, which I have done nothing to get. I m extremely tired all of the time. Sometimes to the point where I feel like I may actually fall asleep. I recently went to the doctor because of all of this and some throat problems. I was told that I also have three knot like things on my throat as well. The doctor who examined me was puzzled as she didn t know what was wrong. She ordered some blood tests. I m worried, any ideas? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some throat infection.  Because of that your lymph node is enlarged.  You should go for routine blood test and take a course of antibiotics.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am five weeks pregnant according to the scan result, I am suffering from very bad pain since last week. My doctor said it could be because of vaginal infection. So, she gave me vagi hex 10mg. but it advised in the medicin do not use in your first 12 months of pregnancy. I am confused now.should I use it? I do not have access to my Doctor until Monday. I am really worried now. ### REPLY: Hi, how are you doing? I would advise you NOT to have that medicine. Magi hexagon or Hexatidine doesn't have enough studies for use in pregnancy. If I may advise, forget the pain, if not severe. If pain is unbearable, then have a short course of antibiotic, Tab. Azithromycin 500 mg once a day for 3 days, 1/2 hr before food. You can also have vaginal suppositories of natural micronized progesterone 200 mg at bedtime. This would be quiescent You’re uterus. Hope I have clarified your query, do write back if anymore queries all the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have bothered with certain things that I eat. I had a colonoscopy last Wednesday and everything was good. The next morning I had sausage for breakfast and shortly after I started with a pain on my right side and my stomach bothered me all day. I have not had any more pain but my stomach seems not settled with a couple of things I have eaten. ### REPLY: Hi. Thanks for your query. If the pain is initiated with certain foods this is an allergy and intestines respond by spasmodic contraction to get the thing removed out of the system. Colonoscopy may be absolutely normal in such cases. It is possible that you are suffering from Irritable Bowel Syn .  I would advise a Contrast enhanced CT scan in all such cases to rule out any organic problem like appendicitis, lymph node enlargement, small bowel problems like thickening or obstruction due to a particular cause. The primary treatment is avoidance of all such food and beverages which enhance this problem. If the stress is a contributory factor, it has to be treated by psychotherapy, avoiding activities causing stress and anxiety and if required, some medicines, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: for about 3 days my husband has been experiencing lower left pain between his stomach and his thigh area pain is increeasing and he is most comfortable in a fetal position he can only have painless urination by sitting.standing upright is unbearable.considered a hernia but he has not done anything strenuous being that he is a hospice( last stage copd)  patient he has not done any extensive physical activity.thanks in advance for any advice or diagnosis ### REPLY: Hi. Thanks for your query. Note the history about your husband having hospice due to last stage COPD, severe pain in the area between stomach and thigh area where he is comfortable only in the fetal position. He can have painless urination in sitting position; standing upright is unbearable. Considered hernia but he has done nothing strenuous. This can be confirmed by examination of the area for any bulges, that increase on coughing and reduces on pressing on, if positive then this is hernia, but hernia when in such a pain is not reducible and needs urgent surgery. By the way the pain is explained, there is possibility of a slipped disc in the thoracic region causing this pain or neurological origin. I would advise you to have him examined clinically by a Doctor as this may be a serous problem and needs special investigations and care as he is a hospice care patient. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have this odd swelling in the base of my neck around collar bone area, I just simply feel swollen could this be an allergy as I get out of breath and just feel as though my throat is gonna swell shut when these areas get obviously puffy and noticeable. my family dr. said its just fatty tissue build up.What casue ### REPLY: Hello have read your query. You may need to rule out lymph node infection leading to enlarged nodes. As per your doctor there can be possibility of lipoma which may not require treatment. Blood investigation like CBC, ESR, CRP.RA TEST along with MRI may help to confirm diagnosis. Another possibility of lymphoma. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, doctor my daughter is 11yrs old,  seeking typhoid fever  since 15 days,  he, s culture report during giving antibiotics  is NoGrowth found . cBc is good,  but the ESR report is 77 kindly give suggestions,  I was giving cefixme 250 in one time in last 10days ### REPLY: Hello Dear I evaluated your concern in depth.@ ESR gets raised in many clinical conditions one of which is inflammatory response of the body due to various infections @ As she is suffering from typhoid fever, it is likely that her ESR will remain high still for some time period, it will gradually settle down once the systemic issue is getting fixed with proper care.@ So don't get panic, relax, take good care of her as per doctor's advise for diet & medications. Hope this will definitely help you. Feel free to ask any further doubt in future anytime. Thanks for using  . Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am having a 6 yr old girl and now I am planning for a second child. I was getting my periods regularly and my reports were all normal but only thing I could not conceive. I have diabetes. I was adviced to take glycomet 500 mg morning and evening after meals. After taking glycomet after 10 days I got my periods and then soon after 17 days I again got my periods and this time a heavy flow. Please suggest whether it is safe to continue to take glycomet ### REPLY: Welcome to . I have gone through your question. As far as glycogen is concern it does not cause menstrual problem. So no need to worry about continuing glycogen. As you have one child already then I would suggest histosalpingography HSG to rule out tubal blockage. And make sugar level in normal range also as diabetes is also a cause for infertility. Hope I answered your question. Would be happy to help you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am having pocs from 4yrs...i took krimson-35,metformin for about 1 year but my peroids did not regulate.....i  get periods only if i take medicines........i am 21 yr old and wt 51kg height 5.3...plzz suggest me any best medicine. will homeopathy work better than allopathy ?? what about ayurvedic medicines???is their permanent cure for pcos??i also had thyroid problem.. but it is under control now. ### REPLY: Hi It would be helpful if you can brief more reports in terms of PCs and THYROID profile. In regard your question if there is permanent cure to PCs, is a difficult one to answer, since ayurvedic medicine can get you so far as to be asymptomatic. That is regular periods and absence of PCs symptoms. If alternate medicine is what you are looking for I would recommend you the following- Kumaryasava (Ottawa or Ayurvaidyashala pharmacy) - 3tsp - thrice a day-after food (without mixing water. However you can consume water after the intake of syrup)M2Tone syrup (Charge Pharmaceuticals) - 3tsp - thrice a day-after food Kanchanara Juggle (Ottawa or Ayurvaidyashala) - 2 tabs - three times - after food. This above prescription is aimed at two things 1. To regulate your periods2. To get the PCs to a stage where it ceases to give you any symptoms. Note : - Since you have a history of PCs for 4 years now you may have to continue the same for about 2 menstrual cycle minimum after the intake of this medicine to .  Also, to device the average time span you may require to take it on the whole. Also, your weight seems to be a little on the lower side in comparison to your height. Another couple of kg s should be no harm, though it is important to maintain it so.Some yoga poses recommended - Suryanamaskar (For both thyroid and PCs)Prakrit padottasana Fishponds have with Havana (concentration on the uterus and its appendages)While performing yoga make sure you are concentrating on your breathing. You may enroll into a yoga class or simply follow authentic yoga classes on YouTube. Please make sure you are on at least 2 hours empty stomach for an effective yoga session. Pranayama-Ujjai (Both PCs and Thyroid)KapalbhaatiAnulom Vilma hope this was helpful. Have a great day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have undergone a kidney stone surgery four days ago via urerthal ballon dilatition. One small stone was removed from the left kidney. There is a stent inserted for atleast 3 weeks. My question here is Will smoking Pot will affect my kidneys or stent inside me? ### REPLY: Hello In my view smoking is harmful to anyone and in your case its more dangerous. Post surgery your wound healing process take some time with right nutrition, rest&vitamin supplements to encourage college formation it will be more quick.Whereas, smoking,retard wound healing through impairing tissue oxygenation. If the oxygen supply is effected you will have slow wound healing and may even cause bacterial growth as Nicotine causes blood flow to slow down by constricting the vessels. To prevent all the possible complications my advice; if I were you treating doctor would be to avoid smoking at least till you recover. Hope your question is answered. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I did a liver function test and found out that the values for SGOT/AST=126 on a scale of up to 40U/L.37c, SGPT/GPT=143  and GGT =129 I had a negative hepatitis B and C result respectively and was placed on livolin for 60 days.Can You please advice me when to go for another Liver function test to see if there is any improvement. I stopped drinking for about six years ago .I equally did a scan and was told by the doctor its a fatty liver condition. ### REPLY: Hello and welcome to ask a doctor service. I reviewed your query and here is my answer. As your doctor said you have a fatty liver disease, so treating that will bring your tests back to normal. For that you have to avoid fried, roasted and fatty meals. Have a daily exercise for at least 15 minutes. You can repeat your these test after a month to see for a change. Hope I answered your question.  Feel free to ask if you need further assistance.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, 2 years back i have some small seizures normally of 2-5 seconds and 1 times a day. Then i consult a neurologist and the told me to do a CT Scan of my brain. The report impression was Calcified granulomas in left occipital and right parietal region . Then my neurologist starts a course of tegrital CR-300 and folvite tablets for 2 years. I was taking the medicines regurlarly. And now my neurologist told me to take a MRI of my brain. and the report impression is Tiny Nodular Non Enhancing Rounded Area Of Altered Signal Right Parietal & Left Occipital Region With No Perifocal Edema s/o Old Inflammatory Granuloma Likely Neurocysticercosis. so what are your views about the reports. Because my neurologist is on leave. Please tell me what ever disease i have is curable or not. And when i will get fine ### REPLY: Hello, Such calcified granulomas in brain are either due to tuberculosis or neurocysticercosis, and there is no definitive to distinguish between these two, particularly when granuloma is small and calcified. Generally followed method is to treat for neurocysticercosis first as treatment is for shorter duration and see how patient responds.Maybe a repeat scan be done. If patients fails to respond then start TB treatment.  In your case there is no harm in taking addition neurocysticercosis treatment. Its short duration treatment without much side effect. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 18 year old son has had chronic fatigue since he was 13 years old. He also has Gilbert s Syndrome . My question is with his elevated levels of bilirubin in his blood count which I believe can also cause tiredness would lowering his bilirubin levels improve his health. He eats a diet full of vegetables, fruit, lean meat, wholegrains and has no lifestyle bad habits. ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). If it is only Gilbert's syn .  It is a benign disease, and it will not harm in any way throughout life. Serum bilirubin will increase and decrease spontaneously, and it will never be more than 5. Tiredness may be due to some other cause or may be due to apprehension due to increased bilirubin hope I have answered your query and this will help you. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from an ulcer (small cavity)in my tongue at the right side edge causing from teeth sharpness.So many times I have visited dentists and finally removed 2 teeths No 6 and 7.But still it has not been cured and now a days No 5 tooth and the no 8 tooth are disturbing during chewing anything.It is paining very much.What s your suggession? ### REPLY: Hello & welcomemaam removal of tooth is not a solution of your problem at all. You have to visit to your dentist for a permanent cure. If there will any sharp edges teeth than selective grinding of teeth may be done.  Some occlusion problem may be there & reason may be tongue thrusting, collapsed arch etc. for that you have to opt for orthodontic treatment. Till than start up with multivitamin capsules & topical anesthetics. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, am making very slow recovery from cellulitis ( now 5 weeks) in my left leg Now pain and red, purple colour mostly gone from lower leg and thigh and can walk again without the extreme burning pain In my foot. Colour remains in ankle but much lighter. Current problem is the swelling that occurs each morning in my foot, ankle and shin/ calf area when I start to move about. Also pain returns but not too bad, and the outside ankle bone area becomes very purple A small weep has occurred in this particular area. Spent first 2 weeks in hospital and now 3 weeks under GP. Have had X-rays,ultra sound on ankle and am booked next week for ultra sound on legs to determine adequate blood flow. Also had swab of the ankle and results back soon. Any advice. Am inGladstone QLD ### REPLY: Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As you had cellulitis, now the concern is about the swelling you are facing. For which I will recommend you to undergo physical therapy for cellulite. With physical therapy after a thorough assessment of your condition the therapist will make a plan for the rehabilitation. It will be a 4 weeks plan mostly or more depending upon the choice of the therapist program. Exercises are usually recommended after hospital discharge in cellulite. As there will be weakness in the muscles of the lower limbs, the muscles needs retraining. Also, as the muscles become stronger the vascular flow comes back to optimum. Besides, you may need to undergo a modified cardiac rehabilitation as due to aging and lack of mobility the cardiovascular functioning becomes slower which requires an attention to boost up. As in my clinical practice I see patients with cellulite, and post discharge after a thorough assessment the exercises are planned. Post which there is a change in the over all body status. Exercises even helps the absorption capacity of the .  My clinical practice has shown results of 99% success in patients. I advise you to undergo the physical therapy, and you can discuss the same with your physician. RegardsJay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m having chest pains like crazy. They re located in the middle of chest and spread out about and inch or two and radiate up the front of my neck. I m also slightly light headed almost as if I ve been running too much. What could this be? Thank you for your time.-Amanda ### REPLY: Thanks for your question on . I can understand your concern. Chest pain with dizziness is commonly seen in high blood pressure and heart disease. So better to first get done blood pressure monitoring, ECG and 2d echo. If all are normal than no need to worry about hypertension and cardiac diseases. Stress induced HERD (gastroesophageal reflux disease) can also cause central chest pain and dizziness. So better to avoid stress and tension. Start proton pump inhibitors.  .  You may need anxiolytic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I bumped my shin today (trying to be funny) and it hurt and I immediately hit a good sized bump that hurt. I put ice on it for a good 45 min and took 4 Advil and the swelling went down by tonight it has come back up some and is throbbing. Any advice?Thank you. ### REPLY: Hi there, thanks for your question at  A bump or bruise on the shin would usually take around a week or two days to resolve. Rest, Ice and bandage application over first 2 to 3 days accelerate this process of healing and reduce the amount of pain and swelling. I suggest you to continue the same. I would suggest you tense your physician if you have pain on standing or walking, the swelling doesn't subside by a week, or you are on blood thinners. Otherwise, you will be better in a weeks time. Hope this helps. All the best. Regards.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my father is 76 yrs old .he is having enlarged prostrate. with psa 1.8..two months back he had severe uti with psa 10.with use of antiobiotic it came to 2.5 and now 1.8.at time he was diagnosed diabeties also. his free psa is18. what should we do his prostrate is hard while on dre. dr has suggested mri .can he have prostrate cancer. we r confused and tensed ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has high chance of having benign prostatic hyperplasia.  It is very common problem in old man when his prostate glands enlarged due to hormonal change.  His PSA level is not so high, so chance of prostate cancer is very low.  He should go for trans rectal ultrasound guided prostate biopsy.  It will give you exact diagnosis whether it is benign prostatic hyperplasia or prostate cancer. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has a diagnosed heart murmur since birth. We never really thought it has affected him. However I have seen some strange symtpoms in the last 5 years which nobody seems to be able to put together. It has been seen as a behavior problem only. I, on the otherhand believe otherwise. He has poor concentration, is foggy brained at times, requires an enormous amount of sleep just to function normally. Appears to have a learning disability. Sweats like nothing I have ever seen. Thyroid has been seen as OK. He has come to me with worries when his heart palpates to 130 beats per minute and not doing anything to make that happen. We have tried every ADHD medication on the market with no success. He is 13 years old now and school as well as life is a struggle for him. I had asked the doctor for a sleep study and she laughed at me. I have spent thousands of $$ trying to find out what the problem is and nobody can help me. He has 2 pediatricians which have run with the behavior thing. I don t agree, I think we are missing something and it has to do with his oxygenation? Please help! ### REPLY: I have gone through history and work up done so far. Your anxiety as a mother is quite justified. Murmur in child of 13 years is suggestive of some congenital defect in heart, though it may be simple and may not be serious. But you must get his color Doppler echocardiography done to rule out serious defect in his heart. His behavioral problem may not be related to it. Better to complete heart check up.my best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a software profesional with "panick attach" as described by a pschatrist he gave zotral 50mg,pregalin75 and epitril which iam continiuing daily along with medication for epilipsey and chronic asthma getting fedup with medicines and people around me dont understand its just like any other i dont want to say even disease kindly advice bcoz iam getting concious and confused talking to eveyone abt me and family please ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make following suggestions for you:1. First, as you have both asthma and panic attack, I would like to confirm diagnosis as sometimes one can be mistaken for another. Were I treating you, I would suggest you spirometry with post-bronchodilator study to measure your lung capacity and component of asthma.2. I would also suggest you allergy testing as it will help you identify the substances causing troubles to you as well as the measures to avoid them.3. I would like to know more about you like whether you have other allergy symptoms like running nose, sneezing, etc.; what is the frequency of your asthma; how so far you have been treated for asthma; etc. etc.4. At present, I would suggest you regular montelukast and to use albuterol or levosalbutamol inhaler on as-and-when-needed basis for asthma symptoms.5. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.6. I would also suggest you regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) which will improve your lung capacity and immunity respectively.7. Stress is very much linked to all three of your complaints - panic, epilepsy and asthma/allergies. So I would personally suggest you to be involved in some stress reduction activity like meditation, Yoga, relaxation, etc. It may also improve your general well-being and self-confidence. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a bad back & took a fall in a public facility when I walked into a restroom with over flowing water. I have a hematoma on my elbow & tonight my back is feeling like a painful heartbeat. What has suddenly happened? The fall happened a week and a half ago. I am a Coumadin patient so my options are limited. I had a cat scan on my head but no bleeds. My back was not checked out. Why would pain start a week later? ### REPLY: Dear patient Back pain after trauma needs to be taken with care and investigated.  As you have got significant trauma possibility of minor fracture needs to be ruled out.  Back pain after a week might be due to muscle spasm or infection of the hematoma. Are you having fever ? If yes than abscess may be there. I would advise X-ray of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities.  Ultrasound of back is also advised to rule out collection. Start tab diclofenac plus serratiopeptodase combination twice a day for pain relief.  Also start antibiotics. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, my 15-monoth-old baby boy is continuously spitting the food that i give him for about the past month..i took him to the pediatrician and she gave me prescription to deworn him and i did that too...but no improvement. only if he forgets himself by playing with some new toys or playing in tap water, he swallows in..else he spits out..what can be done...any suggestions....i would appreciate your advice ### REPLY: Hi, This looks like the baby is not liking the food. He might be choosy I guess! I would like to suggest you try different varieties of foods and present the food before him in some attractive ways: colorful dishes and garnish with Jews/tomato sauce. Play with him and feed. Invite other kids/friends also and make competition among child .  So give them short and frequent diet.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with congenital hip dysplasia. I was wondering if that is what is was that I have? When I was born my hip stuck out and grew that way during my mother s pregnancy. I was born with one hip (the entire side) completely sticking forward but was fine. The doctors decided to break my hip and put it in place. They told my mother to just use extra diapers and watch me extra. Did extra tests all that as a baby. I have always had problems and just thought I was broken I did not know about being born wrong and having that happen until I was older. now I have other problems stemming in the spot where my spine is twisted as a result. I have osteoarthritis in that spot and degenerative disc disease. My doctor said that essentially stretching me out will fix this. I have had it my entire life and am tired of being in pain and walking with a limp. Is this the right diagnosis (the congenital hip dysplasia)? What can I do to help my pain? I have alot of health care professionals look at me odd because i m 26 with these issues. I have problems walking and can t run more than a short sprint without pain or stand in one spot longer than a few minutes without my legs locking up. It s becoming more of a problem and I have 4 children to think about. I refuse to be that laid up mom. I have also with my youngest had a dural puncture through my spine 2ce (brilliant people there) which caused many problems by itself. 2 years ago I couldn t even hold a pen. The degenerative disc disease and osteoarthritis were discovered after avoiding car on my bicycle on the way to work and falling via the e.r. about a month ago. Thanks! Sorry it s long. ### REPLY: Dear patient, usually congenital hip dysplasia, is painless, but with limp on walking. it's true that this lurch while walking affects the spine causing it to tilt, and getting degenerated early. In your case an X-Ray can be diagnostic, and at your age you can think of getting a hip replacement done, so get it done if quality of your life is at sake, the worst thing that can happen with a replacement is that you may need revision surgery in the future, but that is the price we pay for getting good quality of life, and it also will help your spine. I hope that makes your decision clearThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir I have been suffering from depression or bipolar(Confused) disease for 11-12yrs.This time I am taking Valance OD 500 mg.My Psychiatrist doctor is Dr.Smita N Despanday,Ram Manohar Lohia Hospital, New Delh but I am not satisfied with her.Plz guide me which medicine should be taken or not.Without DR advise I have left medicine for 3 months.In future any problem may be. Plz guide me... ### REPLY: Hello welcome to  public forum Valance OD contains divalproaex sodium which is a mood stabilizer used in bipolar disorder... however, there are various other . ...... But start your medication in close work up with psychiatrist Secondly you are not taking any medication now.......... so in future there is a possibility of further episodes as your illness is chronic If you can tell your problem in detail then I can guide you in a better way Good luck thanks ### END