Chinyemba/medical-QA huggingface dataset:
### Instruction:  Disease name:

    Pre-Diabetes

: What Is It?

In pre-diabetes, blood sugar levels are slightly higher than normal, but still not as high as in diabetes. If diabetes is "runaway blood sugar" think of pre-diabetes as blood sugar that is "halfway out the door."  People almost always develop pre-diabetes before they get type 2 diabetes. The rise in blood sugar levels that is seen in pre-diabetes starts when the body begins to develop a problem called "insulin resistance." Insulin is an important hormone that helps you to process glucose (blood sugar). If usual amounts of insulin can't trigger the body to move glucose out of the bloodstream and into your cells, then you have insulin resistance.  Once insulin resistance begins, it can worsen over time. When you have pre-diabetes, you make extra insulin to keep your sugar levels near to normal. Insulin resistance can worsen as you age, and it worsens with weight gain. If your insulin resistance progresses, eventually you can't compensate well enough by making extra insulin. When this occurs, your sugar levels will increase, and you will have diabetes.  Depending on what a blood sugar test finds, pre-diabetes can be more specifically called "impaired glucose (sugar) tolerance" or "impaired fasting glucose." Impaired fasting glucose means that blood sugar increase after you haven't eaten for a while – for example, in the morning, before breakfast.   Impaired glucose tolerance means that blood sugar levels reach a surprisingly high level after you eat sugar. To diagnose impaired glucose tolerance, doctors usually use what is called a "glucose tolerance test." For this test you drink a sugary solution, and then you have blood drawn after a short time.  Having pre-diabetes does not automatically mean you will get diabetes, but it does put you at an increased risk. Pre-diabetes is also a risk factor for heart disease. Like people with type 2 diabetes, those with pre-diabetes tend to be overweight, have high blood pressure and have unhealthy cholesterol levels.
### Instruction:  Disease name:

    Pre-Diabetes

: Symptoms

Pre-diabetes is often called a "silent" condition because it usually has no symptoms. You can have pre-diabetes for several years without knowing it. Certain risk factors increase the chance that you have pre-diabetes. These risk factors include:
### Instruction:  Disease name:

    Pre-Diabetes

: Diagnosis

The same blood sugar tests that are used for diabetes are used to diagnose pre-diabetes. For diagnosing pre-diabetes, your doctor can order one of the following:
### Instruction:  Disease name:

    Pre-Diabetes

: Expected Duration

Pre-diabetes sugar levels can remain slightly above normal, can return to normal, or can increase to a range that leads to a diagnosis of diabetes. As many as 1 in 10 people with impaired glucose tolerance will develop diabetes within one year. What happens to your pre-diabetes depends on whether you are able to prevent insulin resistance from progressing. If insulin resistance is kept in check, pre-diabetes may never become diabetes. If you do not adjust your lifestyle to increase exercise and improve diet, blood sugar levels will probably eventually rise to diabetic levels. Once this happens, medication is usually required to bring your blood sugar back to near-normal levels.
### Instruction:  Disease name:

    Pre-Diabetes

: Prevention

It surprises many people to learn that they may be able to prevent pre-diabetes and diabetes. To reduce your risk of both pre-diabetes and diabetes:
### Instruction:  Disease name:

    Pre-Diabetes

: Treatment

The purpose for treating pre-diabetes is to prevent diabetes from setting in. The same measures recommended for preventing pre-diabetes (see above) work for treating it, too.  The most effective treatment for pre-diabetes is to lose weight and exercise at least 30 minutes a day. Weight loss and exercise can improve insulin resistance and can lower elevated blood sugar levels so that you don't progress to develop diabetes.  Additionally, the drug metformin (Glucophage) can lower the risk of getting diabetes, and it can add to the benefits of weight loss and exercise. Check with your doctor about whether taking metformin to prevent diabetes is a good idea for you. If your doctor feels that you have an especially high risk for progressing to diabetes, you may want to consider preventive treatment with this medication.
### Instruction:  Disease name:

    Pre-Diabetes

: When To Call a Professional

It's best to have annual glucose tests to monitor pre-diabetes. Also, look for symptoms that can suggest the development of new diabetes, such as:
### Instruction:  Disease name:

    Pre-Diabetes

: Prognosis

If you have pre-diabetes, you have about a 10% chance of developing type 2 diabetes within one year. Your chance of developing type 2 diabetes during your lifetime is roughly 70%.   Fortunately, improvements in diet and exercise habits can help to delay or prevent type 2 diabetes. Research has shown that people with pre-diabetes who lose 5% to 7% of their body weight and exercise about 30 minutes a day can reduce their risk for diabetes during the next 3 years by almost 60%.  People with pre-diabetes have a higher risk of heart disease than average, even before diabetes develops. With the onset of diabetes, your risks for heart disease and stroke increase sharply. Diabetes also leads to complications such as blindness, kidney failure, foot ulcers, pain with walking due to poor circulation, and nerve damage. That's why it's important to take action to improve your health when you are diagnosed with pre-diabetes.
### Instruction:  Disease name:

    Premature ejaculation

: What is it?

Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition. As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem. Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation. Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.
### Instruction:  Disease name:

    Premature ejaculation

: Symptoms

The key symptoms of premature ejaculation include:
### Instruction:  Disease name:

    Premature ejaculation

: Diagnosis

Premature ejaculation is diagnosed based on typical symptoms. To understand your problem, your doctor will need to discuss your sexual history with you. Be frank and open. The more your doctor knows, the better he or she can help you. If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation.
### Instruction:  Disease name:

    Premature ejaculation

: Expected duration

Sometimes, premature ejaculation goes away on its own over weeks or months. Working to relieve stress or other psychological issues may help the situation to improve. Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period. Effective treatment is available.
### Instruction:  Disease name:

    Premature ejaculation

: Prevention

There is no known way to prevent premature ejaculation. However, you should consider the following advice:
### Instruction:  Disease name:

    Premature ejaculation

: Treatment

Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the "squeeze technique" is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed. Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil). Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis) and avanafil (Stendra). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose. Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.
### Instruction:  Disease name:

    Premature ejaculation

: When to call a professional

Speak with your doctor if you consistently ejaculate before you want to. Remember, one instance of premature ejaculation does not mean that you have a condition that requires treatment. Your doctor may refer you to a sex therapist if premature ejaculation is causing major problems in your sex life or personal relationships or if you would like to consider behavioral therapy.
### Instruction:  Disease name:

    Premature ejaculation

: Prognosis

Many men experience a brief period of premature ejaculation, then improve on their own. Even for men who require medical treatment, the outlook is usually good.
### Instruction:  Disease name:

    Premature ejaculation

: Additional info

American Society for Reproductive Medicine

https://www.reproductivefacts.org/
### Instruction:  Disease name:

    Premenstrual Syndrome (PMS)

: What Is It?

Premenstrual syndrome (PMS) is a collection of symptoms that many women experience during the one to two weeks before a menstrual period. These symptoms may be physical, psychological and emotional. They disappear soon after the start of menstrual bleeding.   Researchers are not certain what causes PMS. The most popular explanation is that PMS symptoms are related to cyclic changes in:
### Instruction:  Disease name:

    Presbyopia

: What is it?

As we age, the lens of the eye becomes increasingly inflexible, making it harder to focus clearly on near objects. This is called presbyopia. These changes happen to everyone as a natural part of aging. In order for us to see images clearly, light rays enter the eye, where the lens bends and focuses the rays on the retina. The lens changes shape to allow the eye to focus on objects at different distances. Beginning early in life — perhaps as early as age 10 — our lenses gradually stiffen and begin to lose the ability to change shape. By the time we are in our 40s, the lens has trouble focusing up close, and we begin to experience blurred vision when we try to do tasks that require up-close focus, such as reading or needlework. The lens continues to stiffen until about age 65, when nearly all its flexibility has been lost. Presbyopia eventually affects everyone, even people who are already farsighted (hyperopic) or nearsighted (myopic). Because people who are farsighted already need to work when focusing on near objects, they may experience presbyopia a little earlier in life. People who are nearsighted will still experience presbyopia when wearing their corrective glasses or contact lenses for distance. However, for looking at objects or letters closer to them, they will likely be able to see quite clearly when they take off their glasses. This is where the term "nearsighted" comes from.
### Instruction:  Disease name:

    Presbyopia

: Symptoms

Presbyopia causes the following symptoms:
### Instruction:  Disease name:

    Presbyopia

: Diagnosis

Many people over age 40 diagnose presbyopia themselves based on their inability to read clearly at a distance that used to be natural and comfortable. Because the condition comes on gradually over many years, most people don't notice small vision changes and delay seeking professional help until the focusing problems interfere with daily life. Many optometrists joke that patients seek help only when their arms become "too short," unable to hold printed pages far enough away to see clearly. Presbyopia can be diagnosed by an optometrist, ophthalmologist or physician, who will take a complete medical history to determine the extent of your vision problem. He or she will test your vision by having you read text at a distance that is typically comfortable to you. If the doctor diagnoses presbyopia, he or she will do a test to determine the extent of the focusing problem and the appropriate lens prescription. In this test, the doctor has you look through corrective lenses, and continues to increase the magnification power until the words on the page are clear to you and you are comfortable reading.
### Instruction:  Disease name:

    Presbyopia

: Expected duration

Presbyopia cannot be reversed and gets worse as we get older. Vision changes stop around age 65. The only exception is that which occurs when people develop a type of cataract that causes them to be myopic (nearsighted). Such cataracts cause "second sight". Reading vision returns but of course distance vision becomes blurred.
### Instruction:  Disease name:

    Presbyopia

: Prevention

Nothing can be done to prevent presbyopia. It is an inevitable part of aging. However, people who do a lot of close visual work, such as working with a computer or intensive reading, may develop presbyopia earlier than others. If you do close work, take a 10-minute break every one to two hours to relieve strain on the eyes. Allow your eyes to focus on objects at a middle or long distance away to give your eyes a rest from close focusing. Be sure to use bright lighting when reading to help your eyes focus.
### Instruction:  Disease name:

    Presbyopia

: Treatment

Presbyopia can be treated with corrective lenses. Glasses are the simplest way to regain your ability to see close objects clearly. If you already wear corrective lenses for nearsightedness or farsightedness you may need two sets of glasses — one for distance vision and one for close vision — or glasses with bifocal lenses, in which the upper portion of the glass corrects for distance and the lower portion for near vision. Your optometrist or vision professional can order the appropriate prescriptions. If you don't already wear corrective lenses or you wear contact lenses, you may choose to wear reading glasses only when necessary to magnify up-close objects. The strength of reading glasses is categorized in increments of .25. Glasses with +.50 have a minimal amount of correction — only two steps. Standard lenses are available up to +6.00 (24 steps of reading correction), but typically range from +1.00 (four steps) to +2.50 (10 steps). Your vision professional can tell you what amount of correction is best for your eyes. Standard, inexpensive reading glasses are available in most drugstores, supermarkets and office supply stores. They are rated on the same vision correction scale, so if you know the amount of correction you need, you can purchase the right pair for you. If you don't know how much correction you need, test the glasses in the store by trying to read text at a comfortable distance using different magnification strengths. The one that allows you to read most clearly is the right power for you. Standard, off-the-rack reading glasses may not be right for everyone. Many people need different amounts of correction in each eye, and therefore require custom glasses. Also, custom glasses usually are made of better materials and are shaped to allow your eyes to focus properly across the full range of the lens. Because presbyopia continues to get worse as we age, the magnification you need may change over time. Contact lenses also can be used to treat presbyopia, although many people find it difficult to adjust to them. Bifocal contact lenses can be made, or you can get monovision lenses, in which one eye has a contact lens with a prescription for distance vision, and the other eye has a contact lens for up-close vision.
### Instruction:  Disease name:

    Presbyopia

: When to call a professional

Although there is no harm in delaying treatment for presbyopia, optometrists recommend seeing a professional whenever you have blurred vision because this can indicate other vision or health problems. For example, cataracts also can cause blurred vision, and diabetes, multiple sclerosis, vascular disease and other diseases can affect vision. If your vision suddenly blurs, or if you have eye pain or double vision, see black spots or light flashes or have other visual problems, see your doctor immediately.
### Instruction:  Disease name:

    Presbyopia

: Prognosis

The condition will continue to get worse, and then stabilize. With proper corrective glasses or contact lenses, you'll still be able to read and do other close-work as well as ever.
### Instruction:  Disease name:

    Presbyopia

: Additional info

American Optometric Association

https://www.aoa.org
 
National Eye Institute

https://www.nei.nih.gov/
### Instruction:  Disease name:

    Priapism

: What Is It?

Priapism is an abnormally prolonged and often painful erection. This erection may not be related to sexual desire or stimulation. It often won't be relieved by orgasm.   Priapism may start after prolonged sexual activity, although this by itself is not believed to cause priapism. Most men seek medical attention within hours to days, but a few people may have a partial erection that persists for weeks.  Priapism can affect males of any age. Most cases occur in boys aged 5 to 10 years or men aged 20 to 50 years. In young boys, the most common cause is sickle cell disease. In adult males, the leading cause is drug treatment of erectile dysfunction, especially injection therapy. Other less common causes include recreational drug use, trauma to the genitals or groin, other medications and spinal cord problems.    In up to one-third of cases, no specific cause can be found.  In a normal erection, the veins that drain blood from the penis narrow and cause blood to back up, which makes the penis stiffen and swell. After the veins relax and open, the penis will not be erect.   In most cases of priapism, these veins do not relax after orgasm, which causes the penis to remain erect. Less commonly, priapism occurs when so much blood flows into the penis that it cannot drain, even though veins that function properly. This increased blood flow is usually caused by a damaged blood vessel.
### Instruction:  Disease name:

    Priapism

: Symptoms

Symptoms of priapism include:
### Instruction:  Disease name:

    Priapism

: Diagnosis

Your doctor will ask about your medical history, and use of medications, drugs and alcohol. He or she will examine you, and will order blood tests. Additional tests may include:
### Instruction:  Disease name:

    Priapism

: Expected Duration

Usually priapism does not improve without medical attention.
### Instruction:  Disease name:

    Priapism

: Prevention

In a few cases, priapism can occur more than once. If this happens, it is important to avoid medications, alcohol or drugs that may trigger these episodes. However, in most men, priapism occurs unexpectedly and cannot be prevented.
### Instruction:  Disease name:

    Priapism

: Treatment

Treatment for priapism depends on the cause. In most cases, a physician will start by numbing the penis, and will then use a needle to remove trapped blood from the swollen penis. Often, the doctor will inject a medication that helps to relax the narrowed veins. Usually, this treatment works promptly.  Men with semi-erect, painless erections, which are less common, are more likely to have too much blood flowing into the penis rather than narrowed veins. This condition often follows trauma to the penis or groin. After the diagnosis is confirmed by ultrasound, many men can be observed without specific treatment.   Priapism caused by high flow rarely causes complications. Priapism often resolves over the next one to three days. You should follow up with your doctor. If the priapism persists, your doctor will likely order an angiogram. Dye that can be detected by x-ray is injected into an artery to locate the site of excess blood flow. A procedure to correct the problem may be recommended.  When sickle cell disease causes priapism, treatment usually starts with fluids given intravenously (into a vein), oxygen and transfusion of non-sickle blood. If this treatment is not effective, aspiration therapy as described above or surgery may be required.
### Instruction:  Disease name:

    Priapism

: When To Call A Professional

You should call a physician if you develop an erection that lasts longer than four to six hours, particularly if this erection is painful and is not caused by sexual stimulation.
### Instruction:  Disease name:

    Priapism

: Prognosis

If priapism is treated early, the outcome is usually excellent. However, if medical attention is delayed, the problem can lead to permanent impotence.
### Instruction:  Disease name:

    Prostate cancer

: What is it?

Prostate cancer results from the uncontrolled growth of abnormal cells in the prostate gland. This gland produces part of the fluid in semen. It is located below the bladder and in front of the rectum, near the base of the penis. Prostate cancer is one of the most commonly diagnosed cancers in American men. Many other men have the disease, but have not been diagnosed. This is because prostate cancer has few symptoms early on. Prostate cancer is common, but it is not always dangerous. This is because it usually grows very slowly. It affects older men; the average age at diagnosis is 70. And it's usually diagnosed before it causes any symptoms. Also, these men often have other illnesses which may be more important to treat than a cancer that doesn't cause symptoms. When cells in the prostate become cancerous (malignant), they clump together, forming small "islands" of cancer in the prostate. In many cases, it takes years, even decades, for this localized cancer to spread beyond the prostate. And many of these cancers may never spread. Researchers do not know the exact cause of prostate cancer. But they have identified several factors that raise a man's risk of the disease. These include: