task102_mediqa_ans_question_answering.json

{
    "Contributors": [
        "MEDIQA-AnS"
    ],
    "Source": [
        "MEDIQA-AnS"
    ],
    "URL": [
        "https://osf.io/fyg46/"
    ],
    "Categories": [
        "Question Answering"
    ],
    "Definition": [
        "Given a question, answer it with comprehensive details."
    ],
    "Reasoning": [],
    "Input_language": [
        "English"
    ],
    "Output_language": [
        "English"
    ],
    "Instruction_language": [
        "English"
    ],
    "Domains": [
        "Medical Knowledge"
    ],
    "Positive Examples": [],
    "Negative Examples": [],
    "Instances": [
        {
            "input": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks",
            "output": "Test that can help diagnose abetalipoproteinemia, also known as Bassen-Kornzweig syndrome, include blood tests to look for vitamin deficiencies, red blood cell malformations, complete blood count (CBC) and cholesterol. Other tests may be needed: electromyography, eye exam, nerve conduction velocity, stool sample analysis and genetic testing.  Treatment for  abetalipoproteinemia  includes large doses of  fat-soluble vitamins (A, D, E, and K) and linoleic acid supplements. Dietary restrictions, including a low-fat diet, are recommended to prevent digestive problems. Specific complications are treated by specialists in gastroenterology , hepatology, ophthalmology , and neurology."
        },
        {
            "input": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?",
            "output": "Asthma symptoms can be managed but not cured.  Asthma can be managed by you and your doctor if you have plans for taking asthma medicines when your condition is stable; know your asthma triggers and how to avoid them; know how to care for asthma when you exercise; and know how to recognize when your asthma is getting worse, and when to call your provider."
        },
        {
            "input": "X-linked congenital stationary night blindness i m suffering from similar or same decease.my mothers father suffered from same & my brother also.we have problem in low light infact cant view in damp conditions during day also have myopia but still not normal myopia cant see little object with clarity.life is looking like imprisonment.is there any chance for our recovery from this x linked decease.will we be able to see like normal ones.plz help. my age 38 y brother 44.address",
            "output": "Autosomal recessive congenital stationary night blindness is a disorder of the retina. People with this condition typically have difficulty seeing in low light. The symptoms are present from birth but tend to remain stable over time."
        },
        {
            "input": "how common is cystic fibrosis",
            "output": "Cystic Fibrosis affects males and females of all racial and ethnic groups. However, it is most prevalent among Latinos and American Indians, especially the Pueblo and Zuni, as well as white people of Northern European ancestry.. Cystic Fibrosis is less common among African Americans and Asian Americans. In all, more than 10 million Americans are carriers of a faulty CF gene."
        },
        {
            "input": "how common is fragile x syndrome",
            "output": "Fragile X syndrome occurs in about 1 in 4,000 males and 1 in 8,000 females. Although Fragile X syndrome is relatively rare, people may have a premutation in the gene responsible for the syndrome without showing symptoms of the syndrome. The premutations of the FMR1 gene are relatively common: A recent study of 6,747 people found that 1 in 151 women and 1 in 468 men had the premutation."
        },
        {
            "input": "how do i prevent myself from having dementia",
            "output": "Some types of dementia cannot be prevented, such as Alzheimer's, though their progression can be slowed. Others can be halted or reversed with appropriate treatment. There are drug-based and treatment-based treatments for dementia. There are drugs that specifically treat Alzheimers disease and other progressive dementias. Medications such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) work by boosting levels of a chemical messenger involved in memory and judgement. These drugs do not halt or reverse the disease, but they can slow its progression. The therapeutic-based approaches include practicing tasks designed to improve memory, attention, and other cognitive abilities. These tasks are not designed to prevent dementia but slow its progression.  An occupational therapist can teach you behaviors to make living with dementia easier. They can help you prevent accidents such as falls, and prepare you for the progression of the disease."
        },
        {
            "input": "how do i stop using rasagiline",
            "output": "If you want to stop taking rasagiline, first talk to your doctor. Your doctor will be able to decrease your dose safely and gradually. This is important because if you stop taking rasagiline, you may experience withdrawal symptoms such as fever, muscle stiffness, lack of coordination, or changes in consciousness. Talk to your doctor if you experience any of these symptoms when your dose of rasagiline is decreased."
        },
        {
            "input": "how do people get diabetes",
            "output": "There are two major types of diabetes, type 1 and type 2, as well as others that cannot be classified into type 1 and 2. Each has different causes and risk factors. In type 1, the body makes little or no insulin. This is because that the cells in the pancreas that make insulin stop working. The exact cause of this is unknown. In type 2 diabetes, the body is resistant to insulin, and doesn't use it efficiently as it should. The causes of other types of diabetes vary."
        },
        {
            "input": "how do we treat the burns caused by radiation?",
            "output": "To treat burns caused by radiation, seek emergency medical treatment. Do not apply ointments to burned areas."
        },
        {
            "input": "how do you administer lanreotide",
            "output": "Lanreotide may be administered under the skin (subcutaneously), into the upper area of the buttock. A nurse or doctor will be able to do this for you, usually done once every 4 weeks for the period of the treatment."
        },
        {
            "input": "how do you catch hepatitis c",
            "output": "Hepatitis C can be spread through contact with blood already infected by the virus. It can be spread through sex sex with an affected individual, or from the mother to her child during birth."
        },
        {
            "input": "how do you check for lupus?",
            "output": "It may take months or years for your doctor to diagnose lupus (system lupus erythematosus). Your doctor may use many tools to make a diagnosis, as there is no single test to diagnose lupus. These include blood and urine tests, physical examinations, imaging tests, skin biopsy, and other observations of signs and symptoms. For example, an examination of a sample of your urine may show increased protein or red blood cell levels, which may have occurred if lupus has affected your kidneys. A chest X-ray may be used to check for fluid or inflammation in your lungs, which can occur if lupus has affected your lungs."
        },
        {
            "input": "how do you diagnose anxiety",
            "output": "Anxiety disorders are generally diagnosed when fear or dread of nonthreatening situations, events, places, or objects become excessive and uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life. Talk to your primary care doctor to find out if your anxiety could be related to your physical health. However, if you have severe anxiety, you may need to see a mental health specialist such as a psychiatrist, psychologist, or other mental health professional. To help diagnose an anxiety disorder, your provider may give you a psychological evaluation. This includes describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. For separation anxiety in children, there are no tests as this is normal behavior. However, if the separation anxiety is severe and persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition. To diagnose social anxiety disorder, your health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends."
        },
        {
            "input": "how do you get a prolapse bladder",
            "output": "Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. When the connections between your pelvic floor muscles and the ligaments weaken, your bladder or other pelvic organs can slip lower than normal and bulge into your vagina. This can happen because of pregnancy, childbirth, being overweight or obese, strain due to heavy lifting or bowel movements, or a chronic cough or bronchitis."
        },
        {
            "input": "how do you get neuromuscular disorders",
            "output": "Myasthenia gravis is a neuromuscular disorder where the body produces antibodies that block muscle cells from receiving neurotransmitters from the nerve cells. The exact cause myasthenia gravis is unknown. In some cases, it has been linked to tumors of the thymus. Myasthenia gravis can affect people at any age, and is most common in young women and older men."
        },
        {
            "input": "how do you get pulmonary hypertension",
            "output": "Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. These changes make it more difficult for your heart to push blood through your pulmonary arteries. This causes the pressure in your arteries to rise. This is called pulmonary hypertension. Pulmonary hypertension can be causes by autoimmune diseases, birth defects of the heart, heart failure, blood clots in the lungs, heart failure or heart valve disease, HIV, lung diseases, or some medicines. For most individuals diagnosed with pulmonary arterial hypertension, there is no known family history. About 20 percent of these cases are caused by mutations in one of the genes associated with the disease; however, for most cases a single causative gene has not been identified."
        },
        {
            "input": "how do you test for cholesterol level in your body",
            "output": "A blood test for cholesterol levels typically reports total cholesterol level, LDL cholesterol, HDL cholesterol, and triglycerides. For the best measurements, don't drink or eat anything other than water for nine to twelve hours before the blood sample is taken."
        },
        {
            "input": "how is a heart attack treated",
            "output": "Treatment of heart attacks depends on the immediacy of the attack. Once you have a heart attack, the main way to prevent heart damage is to quickly restore blood flow. The 911 operator may instruct you to take aspirin, or the emergency medical personnel may provide you with it. This will reduce blood clotting and help maintain blood flow through a narrowed artery. Once you experience a heart attack and have been taken to a hospital, you will be hooked up to a heart monitor so your health care team the check to see how regularly your heart is beating. You will receive oxygen, so your heart doesn't have to work as hard. You may get medicines through an IV to help reduce chest pain, as well as additional medicine to reduce the likelihood of blood clots. If it is an emergency and your blood vessels are not capable of delivering blood to the heart, angioplasty is a surgical procedure that is often the first choice of treatment. This is when narrowed or blocked blood vessels are opened to allow them to flow again. To help prevent a heart attack, you can avoid smoking and secondhand smoke, control your blood pressure and cholesterol levels, and get regular medical checkups. It is also beneficial to exercise regularly, eat a heart-healthy diet, maintain a healthy weight, and reduce stress in your daily life."
        },
        {
            "input": "how is asthma diagnosed",
            "output": "A doctor will conduct a physical exam and potentially lung function tests to diagnose asthma. These tests will determine how much air moves in and out as you breathe. A chest X-ray and CT scan can identify structural issues or diseases that may be causing breathing problems. Allergy tests may also help a doctor diagnose the cause of your asthma. Lung function tests can be used to determine how well the lungs are working. Lung function tests include peak flow readings to measure how quickly you can breathe out, spirometry to measure how much air you breathe out, or nitric oxide measurement, which can indicate inflammation of the bronchial tubes. Pulse oximetry is used during a severe asthma attack to measure the amount of oxygen in your blood."
        },
        {
            "input": "Bad Breath I have very bad breath and at times it can make myself and others sick.  I need some advice as to what I need to do.",
            "output": "Bad breath could be caused by poor oral hygiene, dental and  gastroesophageal diseases, infections, smoking, alcoholism, and certain foods. Practice good oral hygiene to reduce bad breath. To find out if your bad breath is caused by an underlying health condition visit your primary care provider. Treatment of dental disease and mouth rinses and toothpaste that kill bacteria could make your breath fresher. Some home remedies, such as fresh parsley or mint can temporarily fight bad breath.  Follow your doctor's instructions to treat the underlying cause of bad breath."
        },
        {
            "input": "how is edward's syndrome diagnosed",
            "output": "To diagnose Edwards syndrome, also known as Trisomy 18, exams of the pregnant mother and the infant can be done. An exam during pregnancy may show an abnormally large uterus and extra amniotic fluid. A small placenta when the baby is born is another sign of the disorder. Other physical signs include unusual fingerprint patterns of the infant, a short breast bone, a cleft in the iris of the eye, separation of the left and right side of the abdominal muscle, kidney problems, or signs of congenital heart disease. To concretely diagnose the disorder, chromosome studies should be performed, which will show the chromosome abnormality. Genetic testing is recommended for parents with a child with the syndrome who are thinking about having more children."
        },
        {
            "input": "how is generalized anxiety disorder diagnosed",
            "output": "To help diagnose generalized anxiety disorder, your doctor or mental health professional will be able to take a few approaches: They will look for signs that link your anxiety to medications or other medical conditions. A physical exam or lab tests can rule out other conditions that cause similar problems. They can order blood, urine, or other tests, and they will ask questions about your symptoms and medical history. There are also psychological questionnaires that can help to determine a diagnosis, as can the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Association."
        },
        {
            "input": "how is gonorrhea diagnosed",
            "output": "To test for gonorrhea, your doctor will take a sample of cells from your urine, throat, or vagina, if female. This cell sample will indicate if the bacteria is present. There are also home test kits available for women. If you suspect you have gonorrhea, it is very important you get tested. In women, untreated gonorrhea can lead to serious health issues. If you are tested for gonorrhea, you also need to get tested for other STIs, such as chlamydia, syphilis, and HIV."
        },
        {
            "input": "how is hemophilia treated",
            "output": "The main way to treat hemophilia is with replacement therapy. This is where clotting factor VIII (for hemophilia A) or clotting factor IX (for hemophilia B) are dripped or injected intravenously. These infusions help replenish the missing or low clotting factor. You may receive a preventative treatment, or you may receive treatment only to stop bleeding when it occurs. However, the latter treatment may not be able to stop damage before it occurs. Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels."
        },
        {
            "input": "how is klineflyers syndrome screened",
            "output": "Once the characteristic signs and symptoms of Klinefelter syndrome have been observed, testing can be ordered to confirm the diagnosis. The includes a chromosomal analysis, called a karyotype, which shows the arrangement of your chromosomes. It is also possible to diagnose Kinefelter syndrome before birth through chorionic villous sampling or amniocentesis."
        },
        {
            "input": "how is congenital heart disease passed down",
            "output": "Most cases of critical congenital heart disease (CCDH) occur in people with no history of the disorder in their family. However, close relatives of people with congenital heart disease may have an increased risk of having a heart defect. A variety of genetic and environmental factors likely contribute to CCHD. Mutations in individual genes have been associated with CCHD. These mutations reduce the amount of protein produced which in turn impairs the formation of the heart. Potential risk factors include exposure to certain chemicals or drugs, viral infections during pregnancy, or other maternal diseases."
        },
        {
            "input": "how is edward's syndrome diagnosed",
            "output": "An unusually small placenta when the baby is born is a sign of Edward's syndrome. A physical exam of the infant may show unusual fingerprint patterns, and X-rays may reveal a short breastbone. To accurately diagnose Edward's syndrome, chromosome studies should be performed. These may show part of chromosome 18 in other cells or attached to another chromosome. Other signs of Edward's syndrome include a cleft or split in the iris, separation between the left and right side of the abdominal muscle, or a hernia. Symptoms of congenital heart disease are another sign of Edward's syndrome."
        },
        {
            "input": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy.  Do you know anything about it?  Has it had success?  Also wondering about ECT?  Finally, I've been told acupuncture can help for mood disorders.  Is that true for mixed bipolar and generalized anxiety disorder along with meds?  Have you ever heard of this?",
            "output": "Generalized anxiety disorder (GAD) may be helped by talk therapy (psychotherapy), medications, and better care for your body and relationships. Cognitive-behavioral therapy (CBT) is an effective talk therapy. It teaches controlling stress and panic-causing thoughts. The first line of medications to treat GAD are antidepressants, such as selective serotonin reuptake inhibitors and norepinephrine reuptake inhibitors.  It is important to get enough sleep, eat right, keep regular daily schedule, exercise and get out of the house every day, and stay away from alcohol and street drugs. Talking with family or friends and joining group activities when you get nervous could be helpful."
        },
        {
            "input": "how is epidural harmful",
            "output": "Many studies have shown that epidural is a safe way to manage pain during childbirth. However, there are some rare risks. Your blood pressure may drop, and if this occurs, you will receive fluids through an intravenous line to help keep your blood pressure stable. The epidural may change your labor and delivery. For example, if you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Your contractions may slow down for a little while, but your labor will still continue as it should. Other rare side effects include a headache with the epidural, dizziness, or, also rarely, a seizure. Make sure to tell your health provider what medicines you are currently taking, any allergies you may have, and any previous anesthesia you have had before."
        },
        {
            "input": "how is epilepsy diagnosed",
            "output": "To diagnose epilepsy, your doctor will review your symptoms and medical history. Your doctor may also order several tests. This may include a neurological exam, blood tests, an electroencephalogram, a computerized tomography scan, or magnetic resonance imaging. The electroencephalogram is the most common way to diagnose epilepsy. The more accurate your doctor knows about your seizure type and where the seizures begin in your brain, the better your chance for finding an effective treatment."
        },
        {
            "input": "how much ibuprofen is too much",
            "output": "Prescription ibuprofen that comes as a tablet should be taken three or four times per day for arthritis, or every 4 to 6 hours as needed for pain relief. Nonprescription ibuprofen may come in a tablet, liquid, or drops. Adults and children over 12 may take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children less than 12 may usually be given nonprescription ibuprofen every 6 to 8 hours and should not be given more than 4 doses in 24 hours. Do not give ibuprofen to a child under 6 months of age unless you have talked to your provider first."
        },
        {
            "input": "how much oxazepam could cause an overdose?",
            "output": "Oxazepam is used to treat anxiety and symptoms of alcohol withdrawal. If you or some you are with overdoses, call your local emergency number, such as 911, or call your local poison center which can be reached at 1-800-222-1222."
        },
        {
            "input": "how nicotine effects the brain",
            "output": "Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. Nicotine is very addictive when inhaled into the lungs via tobacco smoke. This allows nicotine to get into the brain within seconds of taking a puff. Once in the brain, nicotine increases the release of chemicals which help to regulate mood and behavior. This include dopamine, which is released in the reward center of the brain, causing improvements in mood and behavior. Experiencing these effects is what makes nicotine so addictive.  Nicotine can have many effects on the body: It can decrease appetite, boost mood, increase intestinal activity, increase heart rate, increase blood pressure, and stimulate memory and alertness. Symptoms of withdrawal include craving for nicotine, anxiety, depression, drowsiness, trouble sleeping, feeling tense, headaches, problems concentrating, and increased appetite."
        },
        {
            "input": "how often do you need a pap smear",
            "output": "Cervical cancer usually develops slowly. It starts as precancerous changes called dysplasia, which can be detected by a test called a Pap smear. Dysplasia is fully treatable, and be detected with regular Pap smears, so that precancerous cells can removed before they become cancer. Pap smear screening should start at 21 and continue every three years. Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years. If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years"
        },
        {
            "input": "how smoking tobacco affects the brain",
            "output": "Nicotine has many different effects on the body. It can decrease appetite, create more saliva and phlegm, boost mood, increase intestinal activity, increase blood pressure and heart rate, and stimulate memory and alertness. Nicotine withdrawal symptoms appear within 2 to 3 hours after your last use of tobacco."
        },
        {
            "input": "how smoking tobacco affects the rest of the body",
            "output": "Smoking tobacco can increase you risk for many health problems. These include heart and blood vessel problems, lung problems, and different types of cancer. The health benefits of quitting include decrease in blood pressure and pulse, improved circulation, improved nasal congestion, less fatigue, fewer illnesses, and decreased risk of many types of cancer."
        },
        {
            "input": "how to deal with anxiety",
            "output": "Talking with a therapist about your generalized anxiety disorder will help you learn ways of managing and reducing your anxiety. Talk therapy can help you understand and gain better control of your anxiety. One common form of talk therapy is cognitive-behavioral talk therapy. It can help you understand the relationship between your thoughts, behaviors, and symptoms."
        },
        {
            "input": "Breast cancer at 84.    My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.",
            "output": "After lumpectomy your mother's doctor might prescribe  medicines for a time. She will need to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer."
        },
        {
            "input": "how to loose weight",
            "output": "To lose weight, the number of calories you burn needs to be greater than the number of calories you eat and drink. If you work out a lot, but still still ear more than you burn, you will gain weight. Even if you don't change the amount of calories in your diet, but you do add activity to your daily life, you'll lose weight or gain less weight. Women ages 30 to 50 years need about 1,800 calories to maintain their normal weight. Men ages 30 to 50 years need about 1,800 calories to maintain their normal weight."
        },
        {
            "input": "how to manage prostate cancer",
            "output": "You can talk to your doctor about possible treatments for prostate cancer. Your doctor will consider your age, medical history, side effects of the treatment, the extent of the spread of the cancer, as well as other factors.  There are different types of treatment for patients with prostate cancer. These include surgery, radiation therapy, hormone therapy, chemotherapy, biologic therapy, and bisphosphonate therapy. New types of treatments are tested in clinical trials, which you may want to think about taking part in."
        },
        {
            "input": "how to prevent atherosclerosis",
            "output": "Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment are to lower your risk of blood clots, preventing atherosclerosis-related diseases, reducing risk factors for plaque buildup, and widening or bypassing plaque-clogged arteries."
        },
        {
            "input": "how to prevent conjunctivitis",
            "output": "Good hygiene can help prevent the spread of conjunctivitis. Things you can do include change your pillowcases often, do not share eye makeup, do not share towels or handkerchiefs, handle your contact lenses properly, keep your hands away from the eye, and wash your hands often."
        },
        {
            "input": "how to prevent diabetes",
            "output": "Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, researchers do not know how to prevent type 1 diabetes. There is currently research in preventing type 1 diabetes in women and girls with close relatives with diabetes."
        },
        {
            "input": "how to prevent lung cancer",
            "output": "If you smoke, now is the time to quit. If you are having difficulty quitting, talk to your health care provider. There are many methods to help you quit. Try to avoid secondhand smoke as well. If you smoke or have smoked in the past, talk with your provider about getting screened for lung cancer."
        },
        {
            "input": "how to prevent schizophrenia",
            "output": "Schizophrenia is a complex illness. Mental health experts are not sure what causes it. Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them."
        },
        {
            "input": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?",
            "output": "Peripheral neuropathy pertains to more than 100 types of damage to the nerves that transmit information from the brain and spinal cord to every other part of the body.  Peripheral neuropathy may be inherited or caused by physical injury (trauma) to a nerve, systemic disease, tumors, toxins, infections, autoimmune disorders, nutritional deficiencies, alcoholism, medical procedures, and vascular and metabolic disorders."
        },
        {
            "input": "how to treat a heart attack",
            "output": "To treat a heart attack that has just occurred, blood flow to the heart must be restored quickly. You may be given medication such as aspirin for this purpose. Once you are taken to the hospital, you may be given pain relievers and medicine to reduce the risk of blood clots. In addition to medications, you may undergo one of the following procedures to treat your heart attack.  Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days."
        },
        {
            "input": "what are autoimmune blood disorders",
            "output": "An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders. The blood cells in the body's immune system help protect against harmful substances. These substances contain antigens. The immune system produces antibodies against these antigens that enable it to destroy these harmful substances. When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and antigens. As a result, the body sets off a reaction that destroys normal tissues."
        },
        {
            "input": "what are known causes of bipolar disorder",
            "output": "The exact cause of bipolar disorder is unknown, but several factors may be involved. These include biological differences, such as physical changes in the brain, and genetics, where bipolar disorder is more common in people who have a first degree relative with the condition. Researchers are currently studying genes that may be involved in causing bipolar disorder. Other factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include having a first-degree relative, periods of high stress, or drug or alcohol abuse."
        },
        {
            "input": "what are pancreatic enzymes?",
            "output": "The pancreas is an organ located behind the stomach. It produces chemicals (called enzymes) needed to digest food. It also produces the hormones insulin and glucagon."
        },
        {
            "input": "what are some common symptoms of bulimia",
            "output": "Bulimia signs and symptoms may include being preoccupied with your body shape and weight, living in fear of gaining weight, feeling that you can't control your eating behavior, or eating until the point of discomfort or pain. People with bulimia may eat much more in a binge episode than in a normal meal or snack, and may force themselves to vomit or exercise to keep from gaining weight after bingeing. They may also misuse laxatives, diuretics or enemas after eating, or restrict calories or avoid certain foods between binges. If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings.  If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust."
        },
        {
            "input": "what are some of the treatments available to males with klinefelter's",
            "output": "If you or your son is diagnosed with Klinefelter syndrome, your health care team may include a doctor who specializes in diagnosing and treating disorders involving the body's glands and hormones (endocrinologist), a speech therapist, a pediatrician, a physical therapist, a genetic counselor, a reproductive medicine or infertility specialist, and a counselor or psychologist. Although there's no way to repair the sex chromosome changes due to Klinefelter syndrome, treatments can help minimize its effects. Treatment may include testosterone replacement therapy, breast tissue removal, speech and physical therapy, educational evaluation and support, fertility treatment, and psychological counseling."
        },
        {
            "input": "what are symptoms of a nonfunctioning gallbladder",
            "output": "If your gallbladder is not working normally, common symptoms may include indigestion, bloating, heartburn, gas, nausea, vomiting, and pain after eating, especially in the upper right or middle area of your belly."
        },
        {
            "input": "what are the causes of childhood obesity",
            "output": "There are many factors that contribute to increasing your child's risk of becoming overweight. Regularly eating high calorie foods can cause your child to gain weight. Lack of physical exercise can contribute to childhood obesity. If your child comes from a family of overweight people, he or she may be more likely to put on weight. Personal, parental, and family stress can also increase a child's risk of obesity."
        },
        {
            "input": "what are the causes of pulmonary hypertension",
            "output": "When blood passes through the heart, the lower right chamber pumps blood to your lungs through the pulmonary artery. From your lungs the blood flows to the left side of the heart. With pulmonary hypertension, the cells that line your pulmonary arteries become stiff and thick, making it harder for blood to flow. This raises the blood pressure in the pulmonary arteries. Your risk of developing pulmonary hypertension may be greater for a few reasons. These include if you're a young adult, you're overweight, you have a family history of the disease, you use illegal drugs, you take certain appetite-suppressant medications, you have an existing risk of developing pulmonary hypertension, or you live at a high altitude. The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition."
        },
        {
            "input": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently",
            "output": "Pneumonia is an infectious disease that can be cured. Specific treatments depend on the type and severity of the disease, and your age and overall health. Bacterial pneumonia is treated with antibiotics.   Viral pneumonias may be treated with anti-viral medications at the early stages of the infection. Treatments may also include corticosteroids, increased fluid intake, oxygen and humidified air. If you are unable to stay hydrated or need help with breathing, you might be hospitalized. At home, you could take drugs that control fever and reduce pain and discomfort, such as ibuprofen or acetaminophen, drink plenty of fluids and get a lot of rest. Low doses of cough medicine may be used to calm cough and give you a rest, but it is not clear if over-the-counter cough medicines lessen coughing caused by pneumonia."
        },
        {
            "input": "what are the main causes tooth loss?",
            "output": "A tooth abscess is an infection in the center of the tooth caused by bacteria. The infection results in a buildup of pus and tissue swelling within the tooth, which causes a toothache. If the infection is not treated, it can continue to spread, which can cause loss of the tooth, blood infection, and spread of the infection to other areas of the body."
        },
        {
            "input": "what are the risk factors of type ii diabetes",
            "output": "Certain factors can increase your risk for diabetes. For type 1 diabetes, scientists do not currently know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors are involved. There are many risk factors for type 2 diabetes. Here a few of them: Being over 45 years of age, being overweight, having a first-degree relative with diabetes, or being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. Additionally, other risk factors include giving birth to at least one baby weighing more than 9 pounds, having high blood pressure, having abnormal cholesterol levels, or exercising fewer than three times a week."
        },
        {
            "input": "what are the symptoms for cystic fibrosis",
            "output": "The symptoms of cystic fibrosis vary depending on the severity of the disease. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents may be able to taste the salt when they kiss their children. The other symptoms of cystic fibrosis affect the respiratory system and the digestive system. Adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas, infertility, and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis can cause signs and symptoms such a persistent cough, wheezing, breathlessness, exercise intolerance, repeated lung infections, inflamed nasal passages or a stuffy nose. The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. The result is often foul-smelling, greasy stools, poor weight gain and growth, intestinal blockage, particularly in newborns, and severe constipation."
        },
        {
            "input": "what are the symptoms for prostate cancer",
            "output": "Early prostate cancer may not cause any symptoms. However, if prostate cancer develops and is not treated, symptoms will emerge. These include the need to urinate frequently, difficulty starting urination, inability to urinate, painful urination, painful ejaculation, blood in urine or semen, or stiffness in the lower back, hips, or upper thighs."
        },
        {
            "input": "what are the uses of vitamin e capsules",
            "output": "Vitamin E is an antioxidant, which means that it protects cells in the body from the damaging effects of unstable molecules called free radicals. A shortage (deficiency) of vitamin E can lead to neurological problems, such as difficulty coordinating movements (ataxia) and speech (dysarthria), loss of reflexes in the legs (lower limb areflexia), and a loss of sensation in the extremities (peripheral neuropathy). Ataxia with vitamin E deficiency (AVED) is a progressive disease affecting motor control and movement. Treatment for AVED includes vitamin E supplements, which will prevent AVED from developing if given before symptoms begin and may reverse some neurological symptoms if begun after AVED develops."
        },
        {
            "input": "what are the causes of headaches",
            "output": "Serious causes of headaches are rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and sometimes by taking medicines. The most common type of headache is tension headache, which may be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. Other types of headaches include cluster headache, which is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. Sinus headaches cause pain in the front of the head and face. It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain is worse when you bend forward and when you first wake up in the morning. Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome. Additional, more serious causes of headaches include brain tumor, carbon monoxide poisoning, high blood pressure, or brain swelling."
        },
        {
            "input": "what are the causes of pulmonary hypertension",
            "output": "Pulmonary hypertension is a type of high blood pressure caused by the walls of the pulmonary arteries stiffening and thickening. These changes make it harder for blood to flow, which raises the blood pressure in the pulmonary arteries. This means that the heart has to work harder to pump blood through your lungs, which causes the heart muscle to weaken and fail. Pulmonary hypertension may be caused by autoimmune diseases that damage the lungs, birth defects of the heart, blood clots in the lung, heart failure, heart valve disease, certain medicines, sleep apnea. In rare cases, the cause is unknown."
        },
        {
            "input": "what blood tests confirm celiac disease",
            "output": "Tests on the following biological markers may be performed to diagnose celiac disease: Bone density, cholesterol, complete blood count, comprehensive metabolic panel, folate level, iron level, vitamin B12, vitamin D, and other blood antibody tests. Your provider will order these if celiac disease is suspected. If the tests are positive, upper endoscopy is often performed to sample a piece of tissue (biopsy) from the first part of the small intestine (duodenum)."
        },
        {
            "input": "what can cause hypoglycemia",
            "output": "Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Other possible causes of hypoglycemia include not eating enough food as usual after taking diabetes medication, or exercising more than you usually would. If you don't have diabetes, hypoglycemia can be caused by accidentally taking someone else's oral diabetes medication, excessive alcohol consumption, other medications, or some illnesses such as cancer or kidney disorders."
        },
        {
            "input": "what causes bipolar disorder",
            "output": "The exact cause of bipolar disorder is unknown, but several factors may be involved, such as biological or genetic differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include having a first-degree relative, such as a parent or sibling, with bipolar disorder, periods of high stress, such as the death of a loved one or other traumatic event, or drug or alcohol abuse. Left untreated, bipolar disorder can result in serious personal problems, such as drug and alcohol use, suicide or suicide attempts, legal or financial problems, damaged relationships, or poor work and school performance. If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. These can include anxiety disorders, eating disorders, heart disease, or obesity."
        },
        {
            "input": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, etc.",
            "output": "Treatments for fibromyalgia include medications and self-care to minimize symptoms and improve general health. Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices are over-the-counter pain relievers such as acetaminophen or ibuprofen. Your doctor might suggest a prescription pain reliever or anti-seizure drugs to reduce pain, antidepressants that may help with the pain and fatigue, muscle relaxants to help with sleep.  Different therapies can help reduce the effect that fibromyalgia has on your body and your life.  A physical therapist can teach you exercises that will improve your strength, flexibility and stamina.  An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. Avoid overexertion and emotional stress, get enough sleep and take time to relax, but stay active. Stress management techniques include deep-breathing exercises or meditation, practicing good sleep habits, and regular moderate exercise. Appropriate exercises may include walking, swimming, biking and water aerobics. Stretching, good posture and relaxation exercises also are helpful. Maintain a healthy lifestyle. Eat healthy foods. Limit your caffeine intake. Do something that you find enjoyable and fulfilling every day. Complementary and alternative therapies for pain and stress management include meditation, yoga, tai chi, acupuncture, and massage therapy."
        },
        {
            "input": "what causes fungal pneumonia",
            "output": "Three types of fungi in the soil in some parts of the United States can cause pneumonia.These are coccidioidomycosis, histoplasmosis, and cryptococcus. Coccidioidomycosis is found in Southern California and the desert Southwest. It is the cause of valley fever. Histoplasmosis is found in the Ohio and Mississippi River Valleys. Cryptococcus is found throughout the United States in bird droppings and soil contaminated with bird droppings. Most people exposed to these fungi don't get sick, but some do and require treatment. Serious fungal infections are most common in people who have weak immune systems due to the long-term use of medicines to suppress their immune systems or having HIV/AIDS."
        },
        {
            "input": "what does kidney disease look like",
            "output": "Signs and symptoms of kidney disease may include nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, changes in how much you urinate, decreased mental sharpness, muscle twitches and cramps, swelling of feet and ankles, persistent itching, chest pain, shortness of breath, or high blood pressure. Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. Make an appointment with your doctor if you have any signs or symptoms of kidney disease."
        },
        {
            "input": "what is acute diverticulitis",
            "output": "Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine. Usually diverticula seldom cause problems; however, if one or more of the pouches become inflamed or infected, they can cause sever pain, fever, nausea, and a marked changed in your bowel habits. This is known as diverticulitis. Diverticulitis is usually diagnosed during an acute attack.   Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require surgery."
        },
        {
            "input": "what is binge eating disorder",
            "output": "Binge eating disorder is the most common eating disorder in the United States. People with binge eating disorder often feel out of control and eat a large amount of food at one time (called a binge). Unlike other eating disorders, people who have binge eating disorder do not throw up the food or exercise too much. Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment."
        },
        {
            "input": "what is copd",
            "output": "COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. COPD can cause coughing that produces large amounts of  mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. COPD develops slowly, and most of the time, COPD is diagnosed in middle-aged or older adults. . Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. The disease is not contagious. COPD has no cure yet, and the damage to the lungs is not reversible, but treatments, such as medicines, oxygen therapy, surgery, or a lung transplant, and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. Quitting smoking is the most important step you can take to treat COPD."
        },
        {
            "input": "what is epilepsy",
            "output": "Epilepsy is a  brain disorder in which the activity of brain cells is disturbed,  which, in turn, causes strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness."
        },
        {
            "input": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?",
            "output": "A woman's sexual behavior, such as having sex at an early age and having multiple partners can increase her risk of developing cervical cancer. Other risk factors include not getting the HPV vaccine, having a weakened immune system, and having a mother who took the drug diethylstilbestrol (DES) during pregnancy.  To prevent cervical cancer: talk to your provider about the HPV vaccine, practice safe sex, get Pap smears to detect and treat early changes before they turn into cancer, and quit smoking, if you smoke."
        },
        {
            "input": "what is the cause of congenital heart defects",
            "output": "Causes of congenital heart defects are unknown. The risk factors for these problems that  occur early in the baby's heart development include: having rubella during pregnancy; uncontrolled diabetes;  taking medications known to increase the risk of congenital heart defects, such as thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. Other factors are smoking, drinking alcohol during pregnancy, and genetic syndromes, such as Down syndrome. A genetic counselor can estimate the odds that a child will have a genetic disorder."
        },
        {
            "input": "what is the cause of ocd",
            "output": "The causes of obsessive-compulsive disorder are unknown. The known risk factors of developing obsessive-compulsive disorder  are having parents or other family members with the disorder, traumatic or stressful life events, and having other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders."
        },
        {
            "input": "what is the cause of the coffin lowry syndrome?",
            "output": "Coffin-Lowry syndrome is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1), and is usually more severe in males because males have only one X chromosome. The mutations  in the RPS6KA3 gene result in the production of little or no RPS6KA3 protein. This rare genetic disorder is characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia.  It is unclear how mutations in the DNA structure of the gene and the lack of RPS6KA3 protein lead to the clinical findings."
        },
        {
            "input": "what is the disorder achondroplasia",
            "output": "Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism.   Achondroplasia is caused by mutations in the FGFR3 gene. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from 1 parent, the child will have the disorder.  The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: abnormal hands, bowed legs, decreased muscle tone, disproportionately large head, prominent forehead, shortened arms and legs, short stature, spinal stenosis, and spine curvatures called kyphosis and lordosis. Achondroplasia most often develops spontaneously and prevention is not always possible."
        },
        {
            "input": "what is the treatment for lymphoma",
            "output": "Treatments for lymphoma depend on the type and stage of the disease, your overall health, and your preferences. The treatments range from surveillance for slow growing forms that don't have any symptoms, to drug and radiation treatments to destroy fast-growing cancer cells. Drug treatments include chemotherapy, targeted drugs that focus on specific abnormalities in cancer cells, and immunotherapy.  A bone marrow transplant, also known as a stem cell transplant, involves suppressing your bone marrow with high doses of chemotherapy and radiation, and then infusing healthy bone marrow stem cells into your blood."
        },
        {
            "input": "what medications are prescribed for brucellosis",
            "output": "For brucellosis, you'll need to take antibiotics for at least six weeks, and your symptoms may not go away completely for several months."
        },
        {
            "input": "what test do you do for rheumatoid \"arthritis?\"",
            "output": "Rheumatoid arthritis can be difficult to diagnose in its early stages because the symptoms can be the same as in other kinds of joint disease. There is no one blood test or physical finding to confirm the diagnosis. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, such as MRI and ultrasound tests, and lab tests. During physical exams doctors  may check your reflexes and muscle strength. Blood tests often show elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies."
        },
        {
            "input": "what the treatment for bronchitis",
            "output": "Treatments for acute and chronic bronchitis relieve symptoms and make breathing easier. For acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever. Cases of bronchitis that are caused by viral infections do not need antibiotics. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways. For chronic bronchitis and chronic obstructive pulmonary disease (COPD), you may need bronchodilators and steroids to open your airways and help clear away mucus. Your doctor may also  prescribe oxygen therapy. One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs, such as quitting smoking and avoiding secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution."
        },
        {
            "input": "what treatment do you use to cure chickenpox",
            "output": "Although there are medicines that fight the chickenpox virus, they are not given to healthy children. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given within the first 24 hours of the rash. Treatment for chickenpox involves keeping the person as comfortable as possible, e.g., wearing cool, light, loose bedclothes. Avoid scratching or rubbing the itchy areas, and keep fingernails short. Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. Apply a soothing moisturizer after bathing to soften and cool the skin. Avoid prolonged exposure to excessive heat and humidity. Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl) and hydrocortisone cream on itchy areas. Aspirin and ibuprofen has been associated with complications, but acetaminophen (Tylenol) may be used."
        },
        {
            "input": "who is at higher risk for calcium overdose?",
            "output": "People can take more than the normal or recommended amount of  antacids  or dietary supplements containing  Calcium carbonate by accident or on purpose. Long-term overuse of  antacids  or dietary supplements is more serious than a single overdose, because it can cause kidney damage."
        },
        {
            "input": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165.  How can I lower it?  I eat dinner around 8PM and nothing until the next morning.",
            "output": "Ask your provider how to control symptoms that you are having and make your life better. Your provider will set the target range for your blood sugar, clarify what type of exercise you need and if you need to see a dietitian for discussing healthy eating and weight loss or maintenance goals. Your provider will tell you how often and when you need to check your blood sugar levels, and what to do if they are out of range.  To keep your blood sugar in your target range, follow a meal plan that includes a variety of foods, about the same amount of carbohydrates at each meal and snack, and healthy fats. Carbohydrates in food give you energy, but carbohydrates also raise your blood sugar higher and faster than other kinds of food. The main kinds of carbohydrates are starches, sugars, and fiber. The plate method could help getting all the nutrients you need during meals. This method encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate). If you are overweight, losing 10 pounds can help. You can achieve and maintain your desired weight by eating healthy foods and staying active, for example, walking 30 to 60 minutes of  per day."
        },
        {
            "input": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?",
            "output": "40% of the global population are at risk of dengue fever, which is found in the tropics worldwide, especially in Southeast Asia, the Pacific region, and the Americas, Of the  50 to 100 million cases of dengue fever that occur yearly, 500,000 lead to hospitalizations, and 20,000 to death worldwide. Dengue hemorrhagic fever and dengue shock syndrome occur most often in children under the age of 15 years."
        },
        {
            "input": "why can you not take grapefruit with felodipine",
            "output": "Drinking grapefruit juice while taking Felodipine (Plendil), a medication for high blood pressure might cause your blood pressure to go too low, because grapefruit juice might increase how much Felodipine the body absorbs."
        },
        {
            "input": "can i take keflex to cure staph?",
            "output": "Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs, or vancomycin given intravenously."
        },
        {
            "input": "could tetanus be a cause of death?",
            "output": "Complications of tetanus infection may include death due to respiratory failure, cardiac arrest or pneumonia."
        },
        {
            "input": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.",
            "output": "Severe thalassemia requires frequent blood transfusions which can cause iron overload.  Oral  medications can remove the extra iron. A drug hydroxyurea might reduce pain and the need for blood transfusions.  In some cases, stem cell transplant. also called a bone marrow transplant, can help."
        },
        {
            "input": "My cousin she is leber amaurosis she need help I don't know where to start from",
            "output": "Leber congenital amaurosis is associated with severe visual impairment beginning in infancy, increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The visual impairment tends to be stable, although it may worsen very slowly over time.  Treatments for Leber congenital amaurosis are discussed in the linked resources. Discuss your treatment options with your healthcare provider."
        },
        {
            "input": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent",
            "output": "Symptoms of Stiff-Person Syndrome (SPS) include fluctuating rigidity of the muscles in the body and limbs, and sensitivity to noise, touch and emotional distress that can cause muscle spasms; abnormal postures  that are hunched over and stiff; and being afraid to leave the house because of the street noises that could cause spasms and falls. Twice as many women as men have SPS. It is often associated with diabetes,  thyroiditis, vitiligo, and pernicious anemia. The symptoms can be mistaken for  Parkinson's disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia. Your doctor could order blood tests that measure the level of glutamic acid decarboxylase (GAD) antibodies in the blood to see if you have SPS."
        },
        {
            "input": "Please help me with my brother with locked-in syndrome in  for 3 years.Somebody please help. God bless .",
            "output": "There is no cure for locked-in syndrome. Neromuscular stimulation of muscle reflexes using electrodes may activate some paralyzed muscles.  In rare cases, some patients may regain certain functions, but the chances for motor recovery are very limited. Several devices to help communication are available."
        },
        {
            "input": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations.  I just learned that this condition most likely caused the death of my first child back in 1971.  I was then told it was merely a fluke.  I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health.  Now my son (from a different husband) and his wife are due to have fraternal twins in  2015.  Does the term 'congenital' mean that it could be passed down to another generation?  I do not want to alarm my son and his wife.  I just would like to inform whatever pediatrician is caring for these babies as to my experience.  Unfortunately my son and I are estranged.  And I do not know who is their pediatrician.  My child's CDH was very severe.  I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition.  Please respond to my concerns.",
            "output": "More than 80 percent of congenital diaphragmatic hernia are not associated with a genetic syndrome or chromosomal abnormality. In these cases the causes of the hernia are not known, although environmental factors may play a role. In other individuals the condition is caused by changes in single genes or chromosomal abnormalities that affect several genes. Isolated congenital diaphragmatic hernia is rarely inherited. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may be inherited according to the inheritance pattern for that condition."
        },
        {
            "input": "Colon cancer cure seen on tv.    My father has colon cancer and said he saw a commercial on tv about a cure for colon cancer.  He cannot remember any details about it. I was wondering if you know anything about something like this.  Please let me know.  Thank you,",
            "output": "Your doctor will choose treatments depending on the stage of your cancer. Traditional treatments include surgery, chemotherapy and radiation. .Small early-stage localized cancers may be removed completely during a colonoscopy or laparoscopic surgery. If the cancer has grown into or through your colon, your surgeon may remove the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer.  Chemotherapy, rugs that destroy cancer cells, may be used before or after surgery to reduce the risk of cancer recurrence. Radiation therapy uses powerful energy sources, such as X-rays, to kill cancer cells, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer.  Drugs that target specific malfunctions that allow cancer cells to grow are available to people with advanced colon cancer, including: - Bevacizumab (Avastin) - Cetuximab (Erbitux) - Panitumumab (Vectibix) - Ramucirumab (Cyramza) - Regorafenib (Stivarga) - Ziv-aflibercept (Zaltrap) Targeted drugs can be given along with chemotherapy or alone. Targeted drugs are typically reserved for people with advanced colon cancer. Some patients with advanced colon cancer have a chance to benefit from immunotherapy with antibodies such as pembrolizumab (Keytruda) and nivolumab (Opdivo). Whether a colon cancer has the chance to respond to these immunotherapies can be determined by a specific test of the tumor tissue."
        },
        {
            "input": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more  HELP",
            "output": "Most cases of diarrhea do not require treatment. If diet changes and home remedies do not help within a couple of days,  your doctor might give you antibiotics to treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. Your doctor might recommend drinking water or broth to replace fluids and electrolytes."
        },
        {
            "input": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional.  I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.",
            "output": "Duchenne muscular dystrophy (DMD) is a progressive form of muscular dystrophy that occurs primarily in males, though in rare cases may affect females. Early signs of DMD may include delayed ability to sit, stand, or walk and difficulties learning to speak. Muscle weakness is usually noticeable by 3 or 4 years of age and begins in the hips, pelvic area, upper legs, and shoulders. DMD may also affect learning and memory, as well as communication and certain social emotional skills.  Muscle weakness worsens with age and progresses to the arms, legs and trunk. Most children with DMD use a wheelchair full time by age 13. Heart and respiratory muscle problems begin in the teen years and lead to serious, life threatening complications. DMD is caused by mutations in the DMD gene, which are inherited in an X-linked recessive  pattern. DMD may also occur in people who do not have a family history of the disease.  The sons of women who are carriers of the disease (women with a defective gene, but no symptoms themselves) have a 50% chance of having the disease. The daughters each have a 50% chance of being carriers. Duchenne muscular dystrophy occurs in about 1 out of every 3,600 male infants.  While there is no known cure for DMD, there are treatments that can help control symptoms. and complications caused by severe progressive muscle weakness. An enlarged, weakened heart may be treated with medications, but in severe cases a  heart transplant may be necessary. Assistive devices for breathing difficulties may be needed, especially at night and as the disease progresses. Steroids may improve the strength and function of muscles in people with DMD, including lung function.   Duchenne muscular dystrophy lis a debilitating disease that often leads to death by age 25, typically from lung disorders. Advances in supportive care have resulted in many men living much longer than this."
        },
        {
            "input": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.",
            "output": "Esophageal cancer affects the esophagus, the tube that carries food and liquids from the throat to the stomach. Esophageal cancer is not common in the United States. It occurs most often in men over 50 years old.  The exact cause is not known, but environmental and genetic factors play a role in the development of this condition. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma.  Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol. Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese. Symptoms of esophageal cancer may include painful or difficult swallowing, backward movement of food through the esophagus and possibly mouth, called regurgitation; chest pain; heartburn, weight loss and coughing up or vomiting blood. Your doctor may use the following tests to diagnose esophageal cancer: barium swallow, MRI, CT, endoscopic ultrasound, PET scan, and endoscopy to obtain a tissue sample for biopsy. If  the cancer has not spread outside the esophagus, surgery or radiation therapy will be done. Chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform. If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms.  Beside a change in diet, other treatments may be used to help the patient swallow. Joining a cancer support group can help you not feel alone. Complications may include pneumonia and severe weight loss from not eating enough."
        },
        {
            "input": "Absence seizures Does any damage occurre from these spells. Mental or physical",
            "output": "Absence seizures may affect ability to learn, daily activities, ability to drive, and bathe or swim alone."
        },
        {
            "input": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks",
            "output": "Surgery to repair abdomen wall or weakened diaphragm is the only treatment that can permanently fix a hernia. Sometimes mesh patches are used to close the holes in the abdominal tissues.  If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting.  Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications. Treatments for hiatal hernia include medications, avoiding large or heavy meals, avoiding bending over after a meal, maintaining healthy weight, quitting smoking. and raising the head of the bed.  If medicines and lifestyle measures do not help control symptoms, you may need surgery."
        },
        {
            "input": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.",
            "output": "Lifestyle and dietary changes could relieve IBS symptoms. Exercise and good sleep habits may help. There is no specific diet because IBS varies from person to person.  Look for foods that make the symptoms worse and change your diet to avoid such foods. These may include  fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. Avoiding foods and drinks that stimulate the intestines, eating smaller meals, and increasing fiber in the diet to improve constipation or diarrhea could help. Foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may also help. Add these foods to the diet slowly, increasing by 2-3 grams a day to prevent causing gas and triggering IBS symptoms. Talk to your doctor about medicines that control muscle spasms and relieve your symptoms."
        },
        {
            "input": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder.  We are wondering why?  should we be concerned?",
            "output": "Frozen shoulder may develop without a known cause.  It is more likely to occur in people who have diabetes, thyroid problems, hormonal changes, e.g., during menopause, shoulder disease, had shoulder injury, or are unable to move their arm due to cast or stroke. Most people have a full recovery with full range of motion.  If you don't treat the risk factors and don't use the full range of motion, the frozen shoulder may return."
        },
        {
            "input": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks",
            "output": "Causes of gastroparesis, or  delayed gastric emptying, are unknown in most people. The most common known cause is diabetes. The symptoms of gastrparesis, a disorder that mostly affects women, are nausea, gastroesophageal reflux, a feeling of fullness after eating only a small amount of  food, and vomiting undigested food, sometimes several hours after a meal. Your doctor will diagnose gastroparesis through a physical examination, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal tract, and gastric emptying tests. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy (surgery to place a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum), and parenteral nutrition. Alternative medicine treatments for gastroparesis include: acupuncture and electroacupuncture, Herbal preparations, such as STW 5 (Iberogast) in Germany and Rikkunshito in Japan, as well as cannabis and derivatives that might ease nausea and the digestive symptoms."
        },
        {
            "input": "Genetic mutaion my son born with alopicia totalis and swealling around the eyes , we have done for him Whole Exome Sequencing , they  identified a heterozygous likely pathogenic variant in the SOX18 gene, which supports the clinical diagnosis of hypotrichosis-lymphedema-telangiectasia syndrome , i would like to know if i can trat this or any thing that we can do to help the symptos ,pleae help",
            "output": "The most frequent symptoms of hypotrichosis-lymphedema-telangiectasia syndrome, which occur in 90% of the patients, include:  alopecia, aplasia or hypoplasia of the eyebrow, swelling of the legs, and lymphangioma. About half of the patients have eye abnormalities, cutis marmorata, periorbital edema, vaginal hernia, and venous insufficiency. Less than 8% will experience abnormality of the peritoneum, abnormality of the pleura, hydrops fetalis, nail and  teeth  abnormalities, lack of eyebrows or eyelashes, hydrocele testis, hypotrichosis, nonimmune hydrops fetalis, palmar telangiectasia, and thin skin."
        },
        {
            "input": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis.  I tried to see three different doctors today, but all were booked.  I honestly don't know what to do.  It hurts in my chest, and I can hardly talk.",
            "output": "Your doctor will treat gastritis with medications to reduce the amount of acid in the stomach and treat the underlying cause. Reducing acid helps healing the stomach. Medications that reduce acid include antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan. H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), proton pump inhibitors (PPIs), which  include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), dexlansoprazole (Dexilant), pantoprazole (Protonix), rabeprazole (AcipHex), and esomeprazole (Nexium). PPIs decrease acid production more effectively than H2 blockers. Depending on the cause of gastritis, additional treatments might be needed.Treating H. pylori infection with antibiotics is important, even if a person does not have symptoms from the infection. Avoiding the cause of reactive gastritis such as prolonged used of NSAIDs, can cure it. Researchers have not found that eating, diet, and nutrition play a major role in causing or preventing gastritis. Call your health care provider if symptoms of diverticulitis occur."
        },
        {
            "input": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.",
            "output": "Glaucoma can damage the optic nerve due to increased pressure in the eye. Adults may have open-angle glaucoma, angle-closure glaucoma, also called closed-angle glaucoma or secondary glaucoma.  Open-angle glaucoma occurs due to slow increase in eye pressure over time, and is the most common type of glaucoma. Its cause is unknown, but it tends to run in the families. Closed-angle glaucoma occurs due to a quick, severe rise in eye pressure. Dilating eye drops and certain medicines may trigger an acute glaucoma attack.  Secondary glaucoma occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include: drugs such as corticosteroids, eye diseases such as uveitis, diabetes, eye injury. Most people cannot feel open-angle glaucoma. People may experience blind spots and slow loss of side (peripheral) vision (also called tunnel vision). Symptoms of closed-angle glaucoma may come and go at first, or steadily become worse. You may notice: sudden, severe pain in one eye decreased or cloudy vision, nausea and vomiting, rainbow-like halos around lights, red eye, feeling that an eye is swollen. The only way to diagnose glaucoma is by having a complete eye exam. You will be given a test to check your eye pressure (tonometry.)  Eye pressure can be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include: using a special lens to look at the angle of the eye (gonioscopy), optic nerve imaging, checking your visual acuity, field of vision, retina and how your pupil responds to light (pupillary reflex response), 3-D view of your eye (slit lamp examination). The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have.  If you have open-angle glaucoma, you will probably be given eye drops. You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need laser treatment that uses a painless laser to open the channels for fluid  to flow out.  If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. An acute angle-closure attack is a medical emergency. If you have had acute glaucoma in one eye, your doctor is likely to treat your second eye to prevent an attack in that eye.You can become blind in a few days if you are not treated. You may be given drops, pills, and IV medicine to lower your eye pressure. Some people also need an emergency operation, called an iridotomy.  If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed. Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions.  You cannot prevent open-angle glaucoma, but you can help prevent vision loss. A complete eye exam can help find open-angle glaucoma early, when it is easier to treat. All adults should have a complete eye exam by the age of 40. You should have regular eye exams as recommended by your provider. If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss."
        },
        {
            "input": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.",
            "output": "If hair loss is caused by a health condition or medication, treating the disease or stopping medication could help. Two medications are approved to treat hair loss in men: Minoxidil (Rogaine) and Finasteride (Propecia.) Minoxidil, an over-the-counter liquid or foam that you rub into your scalp twice a day to grow hair and to prevent further hair loss may be used by  women too. For women, if minoxidil (2% solution or 5% foam) is not working, your doctor may recommend spironolactone, cimetidine, birth control pills, or ketoconazole, To retain the benefits, you need to keep applying these medications. Hair transplant involves taking plugs of hair from areas where hair is thicker and placing it in areas that are balding. Surgical procedures to treat baldness are expensive and can be painful. An alternative to medical treatment oan be a wig or a hairpiece, which  may be covered by insurance if your hair loss is due to a medical condition and your doctor prescribes a wig."
        },
        {
            "input": "Achondroplasia research.    Hello, We are students from  and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance.   sincerely,",
            "output": "If both parents have achondroplasia, the chance their child inherits the disease is 75%. These children might live only for a few months."
        },
        {
            "input": "Hello,   I have a scoliosis problem plz help me I want its treatment I can send my x.ray also",
            "output": "If  you are still growing and have mild scoliosis, your doctor will observe and examine you every few months. If the curve is moderate, your doctor may recommend a brace that must be worn  every day for the full number of hours prescribed by the doctor. For a severe curve, your doctor may suggest surgery, which involves fusing vertebrae together or getting a metal rod to keep the spine straight. Ask at least two doctors about risks and benefits of surgery.Chiropractic treatments, electrical stimulation, and nutritional supplements did not help with scoliosis."
        },
        {
            "input": "help with obesity I would like help on my obesity problem and if I can get help",
            "output": "A healthy eating plan and regular physical activity may help you lose weight and keep it off over the long term. If these lifestyle changes are not enough, your doctor may prescribe medications. Some medications may help you feel less hungry or full sooner. Other medications may make it harder for your body to absorb fat from the foods you eat. Weight-loss medications are for people who may have health problems related to overweight or obesity. When combined with changes to behavior, including eating and physical activity habits, prescription medications may help some people lose weight. Patients who do not respond to lifestyle changes and medications, and develop complications, may  be eligible for gastric bypass, gastrectomy. or gastric banding. Talk to your doctor to learn more about the benefits and risks of each type of surgery. Genetic differences may affect how much weight loss patients experience after bariatric surgery."
        },
        {
            "input": "How bad can endometriosis get?",
            "output": "Endometriosis occurs when cells from the lining of the womb (uterus) grow in other areas of the body. The primary symptoms of endometriosis are pain and infertility. Other common symptoms of endometriosis include: painful, even debilitating, menstrual cramps, pain during or after sex, pain in the intestine or lower abdomen, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods, premenstrual spotting or bleeding between periods, painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy.  In about quarter of women diagnosed with endometriosis, endometriosis patches go away on their own.  Endometriosis pain may get milder after pregnancy or menopause.  In some cases, inflammation and chemicals produced by the endometriosis patches can cause the pelvic organs to stick together, causing scar tissue. This makes the uterus, ovaries, and fallopian tubes, as well as the bladder and rectum, appear as one large organ. Over time, some endometriosis areas may form nodules or bumps as they create lesions on the surface of pelvic organs or can become cysts (fluid-filled sacs) on the ovaries. Some endometriosis lesions have nerves in them.  Women with endometriosis are at a slightly higher risk of ovarian cancer. Rarely, they may also have breast cancer or non-Hodgkin's lymphoma. Pain from endometriosis can be severe, interfering with day-to-day activities. If the systems persist, discuss treatment options with your doctor."
        },
        {
            "input": "I am 23yr boy,i have knock knees i want treatment. Please help me.",
            "output": "Surgery may be considered for knock knees that are severe and continue beyond late childhood. The results of the surgery are good in most cases. Rare complications include difficulty walking and self-esteem changes related to appearance of the knees. Untreated knock knees can lead to early arthritis of the knee."
        },
        {
            "input": "I have a fractured nose i need it fixed. its been broke for 3 years now",
            "output": "If you have a minor fracture that hasn't caused your nose to become crooked or otherwise misshapen, you may not need professional medical treatment.   If your injury is severe enough to warrant surgical treatment, the surgeon should address both your bone and cartilage injuries. The  plastic surgery procedure to correct your nose after injury is called rhinoplasty. It can reduce or increase the size of the nose, change the shape of the tip or the nasal bridge, change the angle between the nose and the upper lip, and narrow the nostrils."
        },
        {
            "input": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do?  Thanks",
            "output": "If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery, which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Several lifestyle changes may help promote healing of an anal fissure and prevent recurrences. Adding about 25 to 30 grams of fiber a day to your diet helps keeping stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. Your doctor may also recommend taking fiber supplement. Increase fiber intake gradually, to avoid gas and bloating. Drink adequate fluids to prevent constipation. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. Your doctor may recommend ointments or creams to help soothe the affected skin, such as numbing cream, petroleum jelly, zinc oxide, 1% hydrocortisone cream, and Preparation H. A warm water bath  2 to 3 times a day may help healing  and cleansing. The water should cover only the hips and buttocks.Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear."
        },
        {
            "input": "I have been suffering from lichen planus since last four years. Some time it reduces the red sign and sometime it increases  and I cannot take spicy food or hot food.   Could you please suggest the remedies. I had consulted the dermatologist also .He gave me some ointment named as clone taxol for applying towards the read area.   Awaiting your valuable advise I this behalf.   With kind regards.   Sent from my iPad",
            "output": "Treatments for Lichen planus may include: antihistamines (in severe cases) that calm down the immune system; lidocaine mouthwashes for mouth sores, to numb the area and make eating more comfortable; topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses; corticosteroid shots into a sore, vitamin A as a cream or taken by mouth; dressings placed over your skin with medicines to keep you from scratching, and ultraviolet light therapy."
        },
        {
            "input": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help",
            "output": "Don't try to treat an ingrown nail at home and see your doctor right away, if you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail To treat an ingrown nail at home, soak the foot in warm water 3 to 4 times a day. After soaking, keep the toe dry, gently massage over the inflamed skin, place a small piece of cotton or dental floss under the nail. Wet the cotton or floss with water or antiseptic. When trimming your toenails, briefly soak your foot in warm water to soften the nails, use a clean, sharp trimmer, trim toenails straight across the top. Do not taper or round the corners or trim too short.\u00a0 Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem. If this doesn't work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist). If the ingrown nail doesn't heal or keeps coming back, your provider may remove part of the nail: This procedure is called a partial nail avulsion.  If the toe is infected, your doctor may prescribe antibiotics. After the procedure, follow the instructions for helping your nail heal."
        },
        {
            "input": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??",
            "output": "Adrenoleukodystrophy (ALD) belongs to genetic disorders called leukodystrophies. These disease cause damage to  myelin that covers nerve cells. The damage is caused by a buildup of very long chain fatty acids (VLCFA) in the brain and adrenal cortex.  Both men and women may get the disease. Since the disease is linked to X chromosome and men have only one of those, they are affected more severely. Almost all people with ALD have adrenal insufficiency (Addison's disease.)  The neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form starts between ages 4 and 10, usually, with behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Children may also experience visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, progressive dementia, long term coma and death within 10 years. There are no specific treatments for adrenoleukodystrophy.  Special diets could protect the body from VLCFA buildup. Adrenocortical insufficiency caused by the damage to the adrenal glands is treated with steroids. Bone marrow transplantation (BMT) might help."
        },
        {
            "input": "Iron Overdose Um...i took 25 iron pills...what do i do...this was last night",
            "output": "For overdoses,  call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States."
        },
        {
            "input": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.",
            "output": "Kartagener syndrome can be caused by changes (mutations) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. Kartagener syndrome is also characterized by situs inversus totalis (mirror-image reversal of internal organs). The signs and symptoms vary but may include frequent lung, sinus and middle ear infections beginning in early childhood; and infertility.   In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems.  Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. Kartagener syndrome is inherited in an autosomal recessive manner. This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. Kartagener syndrome is typically suspected based on the signs and symptoms. A diagnosis can be confirmed by examining a small sample of tissue from an area of the body known to have cilia such as the sinus cavities or the airway. Abnormalities in the structure of cilia can be observed under an electron microscope. Genetic testing can also be used to confirm the diagnosis.. There is currently no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections.  In people with severe lung disease, lung transplantation may be an option.  The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. With appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided."
        },
        {
            "input": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know",
            "output": "SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine. in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition."
        },
        {
            "input": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.",
            "output": "Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected.  Studies of these families suggest that there may be a genetic component to the condition in some cases. Some of these cases appear to be due to single gene mutations that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely are associated with the effects of multiple genes in combination with lifestyle and environmental factors. Most cases of Lewy body dementia are not thought to be inherited. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms."
        },
        {
            "input": "I have a list of questions about Tay sachs disease and clubfoot   1. what is TSD/Clubfoot, and how does it effect a baby  2. what causes both? can it be prevented, treated, or cured  3. How common is TSD? how common is Clubfoot  4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost?  If you can answer these few questions I would be thankful, please get back as soon as you can.",
            "output": "Tay-Sachs disease can be identified by a blood test. Both parents of a child that inherits this metabolic disease must have the mutated gene. There is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatments include proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection.  Gene therapy or enzyme replacement therapy research may eventually lead to a cure or treatment to slow the progression of Tay-Sachs disease."
        },
        {
            "input": "My daughter has menkes syndrome and would like to know how to go about. Thx",
            "output": "Menkes syndrome is a disorder that affects copper levels in the body. The symptoms include kinky hair, failure to thrive, deterioration of the nervous system, weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood. Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results. Most people with this condition die within the first few years of life."
        },
        {
            "input": "Please let me know where I can get literature on Cardiac amyloidosis.  My uncle died yesterday from this disorder.  Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.",
            "output": "Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40.  The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of inflammation. Some people may have no symptoms. When present, symptoms may include excessive urination at night, fatigue, reduced exercise ability, heart palpitations, shortness of breath with activity, swelling of the abdomen, legs, ankles, or other part of the body, and trouble breathing while lying down. To treat cardiac amyloidosis, you may need to make changes to your diet, including limiting salt and fluids, and take water pills (diuretics) to help your body get rid of excess fluid.  Other treatments may include chemotherapy, implantable cardioverter-defibrillator (AICD), pacemaker, for problems with heart signals, and anti-inflammatory medicine, such as prednisone.  A heart transplant may be considered for people with very poor heart function. People with hereditary amyloidosis may need a liver transplant.  People with cardiac amyloidosis may be extra sensitive to side effects of  medicines  for atrial fibrillation, such as digoxin, calcium-channel blockers, and beta-blockers. Complications of cardiac amyloidosis include atrial fibrillation or ventricular arrhythmias, congestive heart failure, fluid buildup in the abdomen (ascites), increased sensitivity to digoxin, low blood pressure and dizziness from excessive urination (due to medication), sick sinus syndrome, and arrhythmias."
        },
        {
            "input": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.",
            "output": "Anal fissures, small tears in the tissues that line the anus, could be caused by hard stools, chronic diarrhea   and inflammation of the anorectal area, and some less common problems. Factors that increase the risk of developing an anal feature include: decreased blood flow to the rectal area due to aging; straining during bowel movements, e.g., due to constipation; chronic inflammation of the intestinal tract; and anal intercourse. Anal fissures are likely to heal within weeks if you keep your stool soft, e.g., by increasing fiber and fluids in your diet, and relax the sphincter by soaking in warm water for 10-20 minutes after bowel movements. If the fissures persist, your doctor may recommend medications to relax the sphincter, such as nitroglycerin applied externally (Rectiv), Botulinum toxin type A (Botox) injection, or oral blood pressure medications, such as nifedipine (Procardia) or diltiazem (Cardizem) . Topical anesthetics, e.g.,  lidocaine hydrochloride (Xylocaine) may relieve pain. For chronic fissures, surgery might be more effective. The procedure called lateral internal sphincterotomy (LIS) involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing."
        },
        {
            "input": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is  16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us",
            "output": "There is currently no cure for Milroy disease. Conservative management is usually successful in most people. Management of lymphedema should be guided by a lymphedema therapist. Some improvement is possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. Decongestive physiotherapy, which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, is the standard of care for primary lymphedema.  People with recurrent cellulitis may benefit from prophylactic antibiotics  Surgical intervention is considered a last option when other medical management fails.  When possible, people with Milroy disease should avoid wounds to swollen areas (because of their reduced resistance to infection,) long periods of immobility, prolonged standing, elevation of the affected limb, and calcium channel-blocking drugs that can cause increased leg swelling in some people. The symptoms and severity of Milroy disease can vary among affected people, however, it rarely causes significant complications. Swelling can be disabling and disfiguring, it sometimes progresses, but in some cases can improve (particularly in early years).  Complications of lymphedema include recurrent bouts of cellulitis and/or lymphangitis, bacterial and fungal infections, deep venous thrombosis, functional impairment, cosmetic embarrassment, and amputation. Complications following surgery are common."
        },
        {
            "input": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks",
            "output": "Ellis-van Creveld syndrome is an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects. There is no cure for Ellis-van Creveld syndrome. The treatments for complications  depend on which body system is affected and the severity of the problem."
        },
        {
            "input": "What is Nephrotic Syndrome.  What are its causes and cures?",
            "output": "Nephrotic syndrome is caused by different disorders that damage the kidneys., in adults, most commonly by glomerulonephritis.  This damage leads to the release of too much protein in the urine. Other conditions that damage kidneys include cancer, diabetes, systemic lupus erythematosus, multiple myeloma, amyloidosis, immune disorders, and infections. Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females. To control nephrotic syndrome, the disorder that is causing it must be treated. Potentially life=long treatments may be needed to keep blood pressure at or below 130/80 mm Hg to delay kidney damage, most often using angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. To reduce the immune system response, corticosteroids and other  suppressants could be used. To reduce the risk of heart and blood vessel problems, high cholesterol needs to be reduced and blood thinners might be prescribed. A low-fat, low-cholesterol, low-protein diet may need to be supplemented with statins. To reduce  swelling in the hands and legs, you may need a low-salt diet  and diuretics."
        },
        {
            "input": "When and how do you know when you have congenital night blindness?",
            "output": "People with congenital stationary night blindness  typically experience night blindness and other vision problems, including loss of sharpness (reduced visual acuity), severe nearsightedness (myopia), nystagmus , and strabismus . Color vision is typically not affected. These vision problems are usually evident at birth, and tend to be stable (stationary) over time."
        },
        {
            "input": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.",
            "output": "Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). Iff you had an exposure, call your local emergency number (such as 911.) Call the US national toll-free Poison Help hotline (1-800-222-1222) if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.  Oleander poisoning can cause irregular or slow heartbeat, low blood pressure, weakness, blurred vision, vision disturbances, including halos, diarrhea, loss of appetite, nausea and vomiting, stomach pain, confusion, disorientation, dizziness, drowsiness, fainting, headache, lethargy, hives, and rash. Depression, loss of appetite, and halos are most often seen in chronic overdose cases. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely."
        },
        {
            "input": "Is optic atrophy ginetic and what cause it?",
            "output": "There are many causes of optic nerve atrophy. The most common problem,  most often in older adults, is poor blood flow.(ischemic optic neuropathy.) The optic nerve can also be damaged by shock, toxins, radiation, and trauma. Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system such as brain tumor, cranial arteritis, multiple sclerosis, and stroke. There are also rare forms of hereditary optic nerve atrophy that affect children and young adults. Optic atrophy 1 is usually caused by  mutations in the OPA1 gene , although some individuals with optic atrophy 1 do not have identified mutations in this gene, in which case the cause of the condition is unknown. This condition is inherited in an  autosomal dominant pattern but some cases result from a new mutation in the gene and occur in people with no history of the disorder in their family. To prevent some cases of  optic nerve atrophy, older adults should have their provider carefully manage their blood pressure. Avoid injuries to the face. Schedule a routine annual eye exam to check for glaucoma. Avoid drinks, such as home-brewed alcohol, that contain methanol, which can cause optic nerve atrophy in both eyes."
        },
        {
            "input": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?",
            "output": "Anyone can get arthritis, but it occurs more often in women and is most common in older people. Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60.  The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood.  Many people have episodes of symptoms followed by periods with no symptoms for the rest of their lives. Some people have continuous health problems related to the disease."
        },
        {
            "input": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?",
            "output": "Angelman syndrome is rarely inherited from a parent. Mostly, random genetic changes in the parents' reproductive cells cause this disorder."
        },
        {
            "input": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?",
            "output": "The cause of PCOS is unknown, but probably involves a combination of genetic and environmental factors"
        },
        {
            "input": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?",
            "output": "Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Symptoms of polymicrogyria vary depending on how much of the brain and which areas of the brain are affected and whether or not it is part of a larger syndrome . Affected people may experience recurrent epileptic seizures; delayed development; crossed eyes; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms, which affect both sides of the brain, cause more severe neurological problems."
        },
        {
            "input": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.",
            "output": "There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy. Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy. Other factors that can increase a woman's risk include chronic high blood pressure or kidney disease before pregnancy, obesity, age  over 40, being pregnant with more than one fetus, African American ethnicity, family history of preeclampsia. Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines, diabetes, rheumatoid arthritis, lupus, scleroderma, urinary tract infections, gum disease, polycystic ovary syndrome, multiple sclerosis, gestational diabetes, and sickle cell disease. Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization. If you are at very high risk of preeclampsia, your doctor may recommend that you start taking low-dose aspirin after at least 12 weeks of pregnancy. Visit your health care provider for a preconception visit to discuss what you can do to lower your risk. Your health care provider may recommend ways to control your blood pressure, if needed, by limiting your salt intake, exercising regularly, and losing weight if you are overweight. If you take medication to control your blood pressure, ask your health care provider if you should change it. Some medications should not be used during pregnancy. Get regular prenatal care, including regular blood pressure checks, urine tests for protein, as well as regular weight checks. Avoid alcohol and tobacco. Talk with your health care provider about any drugs or supplements that you take or are thinking of taking, including vitamins and herbs. Follow your provider's recommendations about prescription and other medications."
        },
        {
            "input": "Project. Hi my name is  and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?",
            "output": "Leukemia treatments are based on the patient\u0092s age and overall health, the type of leukemia, and whether it has spread to other parts of the body. Common treatments used to fight leukemia include chemotherapy, radiation therapy, biological therapy that helps the immune system recognize and attack leukemia cells, and targeted therapy that attacks specific vulnerabilities within cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia."
        },
        {
            "input": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.",
            "output": "Psoriasis treatments reduce inflammation and clear the skin. Treatments can be divided into three main types: topical treatments, light therapy and systemic medications. Topical psoriasis treatments for mild to moderate psoriasis include corticosteroids as a short-term treatment during flares; creams or solutions containing vitamin D; anthralin to slow skin cell growth. Anthralin (Dritho-Scalp) can also remove scales and make skin smoother. But anthralin can irritate skin, and it stains almost anything it touches. It's usually applied for a short time and then washed off. Topical retinoids are vitamin A derivatives that may decrease inflammation, but also increase sensitivity to sunlight, which requires applying sunscreen before going outdoors. Calcineurin inhibitors tacrolimus (Prograf) and pimecrolimus (Elidel) reduce inflammation and plaque buildup.  Salicylic acid promotes sloughing of dead skin cells and reduces scaling. Sometimes it's combined with other medications, such as topical corticosteroids or coal tar, to increase its effectiveness. Salicylic acid is available in medicated shampoos and scalp solutions to treat scalp psoriasis. Coal tar reduces scaling, itching and inflammation. It is available in over-the-counter shampoos, creams and oils.  Coal tar can irritate the skin, has a strong odor and stains clothing and bedding.  Light therapy (phototherapy) uses natural sunlight or artificial ultraviolet light A (UVA) or ultraviolet B (UVB) light.  Some doctors combine UVB treatment and coal tar treatment, which is known as Goeckerman treatment.  Psoralen plus ultraviolet A (PUVA) involves taking a light-sensitizing medication (psoralen) before exposure to UVA light.   For severe psoriasis or psoriasis resistant to other types of treatment, your doctor may prescribe oral or injected drugs. This is known as systemic treatment. Because of severe side effects, some of these medications are used for only brief periods and may be alternated with other forms of treatment. These drugs include retinoids; methotrexate (Rheumatrex) that helps psoriasis by decreasing the production of skin cells and suppressing inflammation; cyclosporine (Gengraf, Neoral) that suppresses the immune system and is similar to methotrexate in effectiveness, but can only be taken short-term.  Drugs that alter the immune system (biologics) include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), apremilast (Otezla), secukinumab (Cosentyx) and ixekizumab (Taltz). Most of these drugs are given by injection (apremilast is oral) and are usually used for people who have failed to respond to traditional therapy or who have associated psoriatic arthritis. Biologics must be used with caution because they have strong effects on the immune system and may permit life-threatening infections.  Thioguanine (Tabloid) and hydroxyurea (Droxia, Hydrea) are medications that can be used when other drugs can't be given.  A number of alternative therapies to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs, are deemed generally safe, and they may be helpful to some people in reducing signs and symptoms, such as itching and scaling.  Alternative therapies include aloe vera that may reduce redness, scaling, itching and inflammation; fish oil to reduce inflammation. Taking 3 grams or less of fish oil daily is generally recognized as safe, and you may find it beneficial. Oregon grape (barberry) may reduce inflammation and ease psoriasis symptoms.  Other measures that may help include daily baths to remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats. Soak about 10 minutes then gently pat dry skin. Use moisturizer. Expose your skin to small amounts of sunlight. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis. Avoid drinking alcohol.  If you do drink, keep it moderate."
        },
        {
            "input": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?",
            "output": "Currently there is no cure for Multiple Sclerosis. Many\u00a0individuals do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.\u00a0 However, three forms of beta interferon (Avonex, Betaseron, and Rebif) are approved for treatment of relapsing-remitting MS.\u00a0 Ocrelizumab (brand name Ocrevus) is approved for adults with relapsing forms of MS and primary progressive MS. Beta interferon has been shown to reduce the number of exacerbations, the severity and duration of the attacks,  and may slow the progression of physical disability. A synthetic form of myelin basic protein, called copolymer I (Copaxone), is approved for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. \u00a0Other approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate. \u00a0An immunosuppressant treatment, Novantrone\u00a0(mitoxantrone), is\u00a0approved for the treatment of advanced or chronic MS. \u00a0Dalfampridine (Ampyra) may improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS. This drug should be used under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians. \u00a0Steroids can reduce the duration and severity of attacks in some patients.\u00a0 Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile.\u00a0 Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.\u00a0 If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help.\u00a0 Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used.  The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.\u00a0 MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment."
        },
        {
            "input": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision",
            "output": "Placing radioactive seeds inside the prostate gland (brachytherapy) is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers.  A surgeon inserts small needles through the skin beneath the scrotum to inject small seeds that you do not feel. The seeds are left in place permanently. Side effects may include pain, swelling, or bruising in the penis or scrotum; red-brown urine or semen; impotence; incontinence, urinary retention, diarrhea."
        }
    ]
}