Dipak-001/mistril_dataset huggingface dataset:
user: How to diagnose IgA Nephropathy ?

assistant: A health care provider diagnoses kidney disease with
                
- a medical and family history  - a physical exam  - urine tests   - a blood test
                
Medical and Family History
                
Taking a medical and family history may help a health care provider diagnose kidney disease.
                
Physical Exam
                
A physical exam may help diagnose kidney disease. During a physical exam, a health care provider usually
                
- measures the patients blood pressure  - examines the patients body for swelling
                
Urine Tests
                
Dipstick test for albumin and blood. A dipstick test performed on a urine sample can detect the presence of albumin and blood. The patient provides a urine sample in a special container in a health care providers office or a commercial facility. A nurse or technician can test the sample in the same location, or he or she can send it to a lab for analysis. The test involves placing a strip of chemically treated paper, called a dipstick, into the patients urine sample. Patches on the dipstick change color when albumin or blood is present in urine.
                
Urine albumin-to-creatinine ratio. A health care provider uses this measurement, which compares the amount of albumin with the amount of creatinine in a urine sample, to estimate 24-hour albumin excretion. A patient may have chronic kidney disease if the urine albumin-to-creatinine ratio is greater than 30 milligrams (mg) of albumin for each gram (g) of creatinine (30 mg/g). This measurement is also called UACR.
                
Blood Test
                
A blood test involves having blood drawn at a health care providers office or a commercial facility and sending the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood a patients kidneys filter each minutea measurement called the estimated glomerular filtration rate (eGFR). Depending on the results, the test can indicate the following:
                
- eGFR of 60 or above is in the normal range  - eGFR below 60 may indicate kidney disease  - eGFR of 15 or below may indicate kidney failure
user: How to diagnose IgA Nephropathy ?

assistant: Currently, health care providers do not use blood or urine tests as reliable ways to diagnose IgA nephropathy; therefore, the diagnosis of IgA nephropathy requires a kidney biopsy.
                
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A health care provider performs a kidney biopsy in a hospital or an outpatient center with light sedation and a local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the kidney. A pathologista doctor who specializes in examining tissues to diagnose diseasesexamines the kidney tissue with a microscope. Only a biopsy can show the IgA deposits in the glomeruli. The biopsy can also show how much kidney damage has already occurred. The biopsy results can help the health care provider determine the best course of treatment.
user: What are the treatments for IgA Nephropathy ?

assistant: Researchers have not yet found a specific cure for IgA nephropathy. Once the kidneys are scarred, they cannot be repaired. Therefore, the ultimate goal of IgA nephropathy treatment is to prevent or delay end-stage kidney disease. A health care provider may prescribe medications to
                
- control a persons blood pressure and slow the progression of kidney disease  - remove extra fluid from a persons blood  - control a persons immune system  - lower a persons blood cholesterol levels
                
Control Blood Pressure and Slow Progression of Kidney Disease
                
People with IgA nephropathy that is causing high blood pressure may need to take medications that lower blood pressure and can also significantly slow the progression of kidney disease. Two types of blood pressure-lowering medicationsangiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. A person may also need beta-blockers, calcium channel blockers, and other blood pressure medications.
                
Remove Extra Fluid
                
A health care provider may prescribe a diuretic, a medication that helps the kidneys remove extra fluid from the blood. Removing the extra fluid can improve the control of blood pressure. Taking a diuretic along with an ACE inhibitor or an ARB often increases the effectiveness of these medications.
                
Control the Immune System
                
Health care providers sometimes use medications to control a persons immune system. Since inflammation is the immune systems normal response, controlling the immune system can decrease inflammation. Health care providers may prescribe the following medications:
                
- corticosteroids, such as prednisone  - cyclophosphamide
                
Lower Blood Cholesterol Levels
                
People with IgA nephropathy may develop high blood cholesterol levels. Cholesterol is a type of fat found in the bodys cells, in blood, and in many foods. People who take medications for high blood cholesterol levels can lower their blood cholesterol levels. A health care provider may prescribe one of several cholesterol-lowering medications called statins.
user: How to prevent IgA Nephropathy ?

assistant: Researchers have not found a way to prevent IgA nephropathy. People with a family history of IgA nephropathy should talk with their health care provider to find out what steps they can take to keep their kidneys healthy, such as controlling their blood pressure and keeping their blood cholesterol at healthy levels.
user: What to do for IgA Nephropathy ?

assistant: Researchers have not found that eating, diet, and nutrition play a role in causing or preventing IgA nephropathy. Health care providers may recommend that people with kidney disease, such as IgA nephropathy, make dietary changes such as
                
- limiting dietary sodium, often from salt, to help reduce edema and lower blood pressure  - decreasing liquid intake to help reduce edema and lower blood pressure  - eating a diet low in saturated fat and cholesterol to help control high levels of lipids, or fats, in the blood
                
Health care providers may also recommend that people with kidney disease eat moderate or reduced amounts of protein, although the benefit of reducing protein in a persons diet is still being researched. Proteins break down into waste products the kidneys must filter from the blood. Eating more protein than the body needs may burden the kidneys and cause kidney function to decline faster. However, protein intake that is too low may lead to malnutrition, a condition that occurs when the body does not get enough nutrients. People with kidney disease on a restricted protein diet should receive blood tests that can show nutrient levels.
                
Some researchers have shown that fish oil supplements containing omega-3 fatty acids may slow kidney damage in some people with kidney disease by lowering blood pressure. Omega-3 fatty acids may help reduce inflammation and slow kidney damage due to IgA nephropathy. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/supplements.
                
People with IgA nephropathy should talk with a health care provider about dietary changes to best manage their individual needs.
user: What to do for IgA Nephropathy ?

assistant: - Immunoglobulin A (IgA) nephropathy, also known as Bergers disease, is a kidney disease that occurs when IgA deposits build up in the kidneys, causing inflammation that damages kidney tissues.  - Scientists think that IgA nephropathy is an autoimmune kidney disease, meaning that the disease is due to the bodys immune system attacking tissues in the kidney.  - IgA nephropathy is one of the most common kidney diseases, other than those caused by diabetes or high blood pressure.  - In its early stages, IgA nephropathy may have no symptoms; it can be silent for years or even decades.  - Once symptoms appear, the most common one is hematuria, or blood in the urine.  - Another symptom of IgA nephropathy is albuminuriawhen a persons urine contains an increased amount of albumin, a protein typically found in the blood, or large amounts of protein in the urine.  - Currently, health care providers do not use blood or urine tests as reliable ways to diagnose IgA nephropathy; therefore, the diagnosis of IgA nephropathy requires a kidney biopsy.  - Researchers have not yet found a specific cure for IgA nephropathy.
user: What is (are) Hemorrhoids ?

assistant: Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. The rectum is the last part of the large intestine leading to the anus. The anus is the opening at the end of the digestive tract where bowel contents leave the body.
                
External hemorrhoids are located under the skin around the anus. Internal hemorrhoids develop in the lower rectum. Internal hemorrhoids may protrude, or prolapse, through the anus. Most prolapsed hemorrhoids shrink back inside the rectum on their own. Severely prolapsed hemorrhoids may protrude permanently and require treatment.
user: What are the symptoms of Hemorrhoids ?

assistant: The most common symptom of internal hemorrhoids is bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement. Internal hemorrhoids that are not prolapsed are usually not painful. Prolapsed hemorrhoids often cause pain, discomfort, and anal itching.
                
Blood clots may form in external hemorrhoids. A blood clot in a vein is called a thrombosis. Thrombosed external hemorrhoids cause bleeding, painful swelling, or a hard lump around the anus. When the blood clot dissolves, extra skin is left behind. This skin can become irritated or itch.
                
Excessive straining, rubbing, or cleaning around the anus may make symptoms, such as itching and irritation, worse.
                
Hemorrhoids are not dangerous or life threatening. Symptoms usually go away within a few days, and some people with hemorrhoids never have symptoms.
user: How many people are affected by Hemorrhoids ?

assistant: About 75 percent of people will have hemorrhoids at some point in their lives.1 Hemorrhoids are most common among adults ages 45 to 65.2 Hemorrhoids are also common in pregnant women.
user: What causes Hemorrhoids ?

assistant: Swelling in the anal or rectal veins causes hemorrhoids. Several factors may cause this swelling, including
                
- chronic constipation or diarrhea  - straining during bowel movements  - sitting on the toilet for long periods of time  - a lack of fiber in the diet
                
Another cause of hemorrhoids is the weakening of the connective tissue in the rectum and anus that occurs with age.
                
Pregnancy can cause hemorrhoids by increasing pressure in the abdomen, which may enlarge the veins in the lower rectum and anus. For most women, hemorrhoids caused by pregnancy disappear after childbirth.
user: How to diagnose Hemorrhoids ?

assistant: The doctor will examine the anus and rectum to determine whether a person has hemorrhoids. Hemorrhoid symptoms are similar to the symptoms of other anorectal problems, such as fissures, abscesses, warts, and polyps.
                
The doctor will perform a physical exam to look for visible hemorrhoids. A digital rectal exam with a gloved, lubricated finger and an anoscopea hollow, lighted tubemay be performed to view the rectum.
                
A thorough evaluation and proper diagnosis by a doctor is important any time a person notices bleeding from the rectum or blood in the stool. Bleeding may be a symptom of other digestive diseases, including colorectal cancer.
                
Additional exams may be done to rule out other causes of bleeding, especially in people age 40 or older:
                
- Colonoscopy. A flexible, lighted tube called a colonoscope is inserted through the anus, the rectum, and the upper part of the large intestine, called the colon. The colonoscope transmits images of the inside of the rectum and the entire colon.  - Sigmoidoscopy. This procedure is similar to colonoscopy, but it uses a shorter tube called a sigmoidoscope and transmits images of the rectum and the sigmoid colon, the lower portion of the colon that empties into the rectum.  - Barium enema x ray. A contrast material called barium is inserted into the colon to make the colon more visible in x ray pictures.
user: What are the treatments for Hemorrhoids ?

assistant: At-home Treatments
                
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining.
                
Fiber is a substance found in plants. The human body cannot digest fiber, but fiber helps improve digestion and prevent constipation. Good sources of dietary fiber are fruits, vegetables, and whole grains. On average, Americans eat about 15 grams of fiber each day.3 The American Dietetic Association recommends 25 grams of fiber per day for women and 38 grams of fiber per day for men.3
                
Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
                
Other changes that may help relieve hemorrhoid symptoms include
                
- drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day  - sitting in a tub of warm water for 10 minutes several times a day  - exercising to prevent constipation  - not straining during bowel movements
                
Over-the-counter creams and suppositories may temporarily relieve the pain and itching of hemorrhoids. These treatments should only be used for a short time because long-term use can damage the skin.
                
Medical Treatment
                
If at-home treatments do not relieve symptoms, medical treatments may be needed. Outpatient treatments can be performed in a doctor's office or a hospital. Outpatient treatments for internal hemorrhoids include the following:
                
- Rubber band ligation. The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink. This procedure should be performed only by a doctor.  - Sclerotherapy. The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid.  - Infrared coagulation. The doctor uses heat to shrink the hemorrhoid tissue.
                
Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed.
user: What to do for Hemorrhoids ?

assistant: - Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum.  - Hemorrhoids are not dangerous or life threatening, and symptoms usually go away within a few days.  - A thorough evaluation and proper diagnosis by a doctor is important any time a person notices bleeding from the rectum or blood in the stool.  - Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms.  - If at-home treatments do not relieve symptoms, medical treatments may be needed.
user: What is (are) Anemia of Inflammation and Chronic Disease ?

assistant: Anemia is a condition in which a person has a lower than normal number of red blood cells or the amount of hemoglobin in the red blood cells drops below normal, which prevents the bodys cells from getting enough oxygen. Hemoglobin is an iron-rich protein that gives blood its red color and lets red blood cells transport oxygen from the lungs to the bodys tissues. Therefore, low numbers of red blood cells or low levels of hemoglobin also cause low blood iron levels.
                
People with anemia may feel tired because their blood does not supply enough oxygen to the bodys organs and tissues. If anemia becomes severe and prolonged, the lack of oxygen in the blood can lead to shortness of breath or exercise intolerancea condition in which a person becomes easily fatigued during or after physical activityand eventually can cause the heart and other organs to fail.
user: What is (are) Anemia of Inflammation and Chronic Disease ?

assistant: Anemia of inflammation and chronic disease is a type of anemia that commonly occurs with chronic, or long term, illnesses or infections. Cancer and inflammatory disorders, in which abnormal activation of the immune system occurs, can also cause AI/ACD.
                
AI/ACD is easily confused with iron-deficiency anemia because in both forms of anemia levels of iron circulating in the blood are low. Iron in the body is found both circulating in the blood and stored in body tissues. Circulating iron is necessary for red blood cell production. Low blood iron levels occur in iron-deficiency anemia because levels of the iron stored in the bodys tissues are depleted. In AI/ACD, however, iron stores are normal or high. Low blood iron levels occur in AI/ACD, despite normal iron stores, because inflammatory and chronic diseases interfere with the bodys ability to use stored iron and absorb iron from the diet. AI/ACD is the second most common form of anemia, after iron-deficiency anemia.1
user: Who is at risk for Anemia of Inflammation and Chronic Disease? ?

assistant: While AI/ACD can affect people at any age, older adults are especially at risk because they have the highest rates of chronic disease. AI/ACD is also common among hospitalized patients, particularly those with chronic illnesses.
                
More than 130 million Americans live with at least one chronic illness.2 Addressing the causes of anemia in people with chronic disease can help improve their health and quality of life.
user: What are the symptoms of Anemia of Inflammation and Chronic Disease ?

assistant: Anemia of inflammation and chronic disease typically develops slowly and, because it is usually mild, may cause few or no symptoms. Symptoms of anemia may also be masked by the symptoms of the underlying disease. Sometimes, AI/ACD can cause or contribute to
                
- fatigue  - weakness  - pale skin  - a fast heartbeat  - shortness of breath  - exercise intolerance
user: How to diagnose Anemia of Inflammation and Chronic Disease ?

assistant: To diagnose AI/ACD, a health care provider orders a blood test called a complete blood count (CBC). A blood test involves drawing a persons blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. The CBC includes a measurement of a persons hematocrit, the percentage of the blood that consists of red blood cells. The CBC also measures the amount of hemoglobin in the blood and can show whether a person has a lower than normal number of red blood cells.
                
In addition to measuring hematocrit and hemoglobin, the CBC includes two other measurements to show whether a person has enough iron:
                
- The ferritin level indicates the amount of iron stored in the body. A ferritin score below 200 nanograms per liter is a sign that a person may have an iron deficiency.  - The transferrin saturation (TSAT) is a score that indicates how much iron is available, or circulating, to make red blood cells. A TSAT score below 20 percent is another sign of iron deficiency.3
                
A CBC result that shows low iron levels in the blood yet normal measures of iron stores in the body is a hallmark of AI/ACD.
user: What are the treatments for Anemia of Inflammation and Chronic Disease ?

assistant: Anemia of inflammation and chronic disease often is not treated separately from the condition with which it occurs. In general, health care providers focus on treating the underlying illness. If this treatment is successful, the anemia usually resolves. For example, antibiotics prescribed for infection and anti-inflammatory medications prescribed for rheumatoid arthritis or IBD can cause AI/ACD to disappear. However, AI/ACD is increasingly being viewed as a medical condition that merits direct treatment.
                
For people with cancer or kidney disease who have low levels of EPO, a synthetic form of EPO may be prescribed. A health care provider usually injects EPO subcutaneouslyunder the skintwo or three times a week. A person may be taught how to inject the EPO at home. People on hemodialysis who cannot tolerate EPO shots may receive EPO intravenously during hemodialysis.
                
If iron deficiency has a role in causing AI/ACD, a person may need iron supplements to raise hematocrit to a target level. Iron supplements can be taken by pill, subcutaneously, or intravenously during hemodialysis.
                
People with kidney disease and AI/ACD may also be advised to take vitamin B12 and folic acid supplements. A person should talk with a health care provider before taking any supplements.
                
More information is provided in the NIDDK health topic, Anemia in Kidney Disease and Dialysis.
user: What to do for Anemia of Inflammation and Chronic Disease ?

assistant: People with anemia caused by iron, vitamin B12, or folic acid deficiencies are usually advised to include sources of these nutrients in their diets.
                
Dietary sources of iron include
                
- beans  - breakfast cereals  - chicken  - enriched bread  - spinach  - turkey
                
Dietary sources of vitamin B12 include
                
- beef liver  - breakfast cereals  - chicken  - clams  - fish  - turkey
                
Dietary sources of folic acid include
                
- beans  - breakfast cereals  - chicken  - enriched bread  - rice  - turkey
user: What to do for Anemia of Inflammation and Chronic Disease ?

assistant: - Anemia is a condition in which a person has a lower than normal number of red blood cells or the amount of hemoglobin in the red blood cells drops below normal, which prevents the bodys cells from getting enough oxygen.  - Anemia of inflammation and chronic disease (AI/ACD) is a type of anemia that commonly occurs with chronic illnesses, infections, cancer, or inflammatory disorders.  - AI/ACD typically develops slowly and, because it is usually mild, may cause few or no symptoms. Sometimes, AI/ACD can cause or contribute to fatigue, weakness, pale skin, a fast heartbeat, shortness of breath, and exercise intolerance.  - To diagnose AI/ACD, a health care provider orders a blood test called a complete blood count (CBC).  - AI/ACD often is not treated separately from the condition with which it occurs. In general, health care providers focus on treating the underlying illness.