Dipak-001/mistril_dataset huggingface dataset:
user: What is (are) Autoimmune Hepatitis ?

assistant: Autoimmune hepatitis is classified into several types. Type 1 autoimmune hepatitis is the most common form in North America. Type 1 can occur at any age; however, it most often starts in adolescence or young adulthood. About 70 percent of people with type 1 autoimmune hepatitis are female.1
                
People with type 1 autoimmune hepatitis commonly have other autoimmune disorders, such as
                
- celiac disease, an autoimmune disease in which people cannot tolerate gluten because it damages the lining of their small intestine and prevents absorption of nutrients  - Crohn's disease, which causes inflammation and irritation of any part of the digestive tract  - Graves' disease, the most common cause of hyperthyroidism in the United States  - Hashimoto's disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, a form of chronic inflammation of the thyroid gland  - proliferative glomerulonephritis, or inflammation of the glomeruli, which are tiny clusters of looping blood vessels in the kidneys  - primary sclerosing cholangitis, which causes irritation, scarring, and narrowing of the bile ducts inside and outside the liver  - rheumatoid arthritis, which causes pain, swelling, stiffness, and loss of function in the joints  - Sjgren's syndrome, which causes dryness in the mouth and eyes  - systemic lupus erythematosus, which causes kidney inflammation called lupus nephritis  - type 1 diabetes, a condition characterized by high blood glucose, also called blood sugar, levels caused by a total lack of insulin  - ulcerative colitis, a chronic disease that causes inflammation and sores, called ulcers, in the inner lining of the large intestine
                
Type 2 autoimmune hepatitis is less common and occurs more often in children than adults.1 People with type 2 can also have any of the above autoimmune disorders.
user: What are the symptoms of Autoimmune Hepatitis ?

assistant: The most common symptoms of autoimmune hepatitis are
                
- fatigue  - joint pain  - nausea  - loss of appetite  - pain or discomfort over the liver  - skin rashes  - dark yellow urine  - light-colored stools  - jaundice, or yellowing of the skin and whites of the eyes
                
Symptoms of autoimmune hepatitis range from mild to severe. Some people may feel as if they have a mild case of the flu. Others may have no symptoms when a health care provider diagnoses the disease; however, they can develop symptoms later.
user: How to diagnose Autoimmune Hepatitis ?

assistant: A health care provider will make a diagnosis of autoimmune hepatitis based on symptoms, a physical exam, blood tests, and a liver biopsy.
                
A health care provider performs a physical exam and reviews the person's health history, including the use of alcohol and medications that can harm the liver. A person usually needs blood tests for an exact diagnosis because a person with autoimmune hepatitis can have the same symptoms as those of other liver diseases or metabolic disorders.
                
Blood tests. A blood test involves drawing blood at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. A person will need blood tests for autoantibodies to help distinguish autoimmune hepatitis from other liver diseases that have similar symptoms, such as viral hepatitis, primary biliary cirrhosis, steatohepatitis, or Wilson disease.
                
Liver biopsy. A liver biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to temporarily stop taking certain medications before the liver biopsy. He or she may also ask the patient to fast for 8 hours before the procedure.
                
During the procedure, the patient lies on a table, right hand resting above the head. A health care provider will apply a local anesthetic to the area where he or she will insert the biopsy needle. If needed, he or she will give sedatives and pain medication. Then, he or she will use a needle to take a small piece of liver tissue, and may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home.
                
A health care provider performs a liver biopsy at a hospital or an outpatient center. The liver sample is sent to a pathology lab where the pathologista doctor who specializes in diagnosing diseaselooks at the tissue with a microscope and sends a report to the patient's health care provider.
                
A health care provider can use liver biopsy to diagnose autoimmune hepatitis and determine if cirrhosis is present. People often have cirrhosis at the time they are diagnosed with autoimmune hepatitis. A health care provider can also use liver biopsy to look for changes in the severity of liver damage prior to ending treatment for autoimmune hepatitis.
user: What is (are) Autoimmune Hepatitis ?

assistant: People with autoimmune hepatitis and cirrhosis are at risk of developing liver cancer. A health care provider will monitor the person with a regular ultrasound examination of the liver. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care provider's office, an outpatient center, or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images; anesthesia is not needed. The images can show the liver's size and the presence of cancerous tumors.
user: What to do for Autoimmune Hepatitis ?

assistant: Researchers have not found that eating, diet, and nutrition play a role in causing or preventing autoimmune hepatitis.
user: What to do for Autoimmune Hepatitis ?

assistant: - Autoimmune hepatitis is a chronicor long lastingdisease in which the body's immune system attacks the liver and causes inflammation and damage.  - Autoimmune hepatitis is a serious condition that may worsen over time if not treated. Autoimmune hepatitis can lead to cirrhosis and liver failure.  - Autoimmune hepatitis is more common in females. The disease can occur at any age and affects all ethnic groups.  - Autoimmune hepatitis is classified as type 1 or type 2.  - A health care provider will make a diagnosis of autoimmune hepatitis based on symptoms, a physical exam, blood tests, and a liver biopsy.  - A person usually needs blood tests for an exact diagnosis because a person with autoimmune hepatitis can have the same symptoms as those of other liver diseases or metabolic disorders.  - Treatment for autoimmune hepatitis includes medication to suppress, or slow down, an overactive immune system.  - Treatment works best when autoimmune hepatitis is diagnosed early.  - People with autoimmune hepatitis generally respond to standard treatment and the disease can be controlled in most cases.  - In some people, autoimmune hepatitis progresses to cirrhosis and end-stage liver failure, and a liver transplant may be necessary.
user: What is (are) Whipple Disease ?

assistant: Whipple disease is a rare bacterial infection that primarily affects the small intestine. The infection may spread to any organ in the body; however, it more commonly affects the
                
- joints  - central nervous system, which includes the brain, the spinal cord, and nerves located throughout the body  - heart  - eyes  - lungs
                
Left untreated, Whipple disease gets worse and is usually life threatening.
user: What is (are) Whipple Disease ?

assistant: The small intestine is part of the upper gastrointestinal (GI) tract and is a tube-shaped organ between the stomach and large intestine. The upper GI tract also includes the mouth, esophagus, stomach, and duodenum, or the first part of the small intestine.
                
Most food digestion and nutrient absorption take place in the small intestine. The small intestine measures about 20 feet long and includes the duodenum, jejunum, and ileum. Villitiny, fingerlike protrusionsline the inside of the small intestine. Villi normally let nutrients from food be absorbed through the walls of the small intestine into the bloodstream.
user: What causes Whipple Disease ?

assistant: Bacteria called Tropheryma whipplei (T. whipplei) cause Whipple disease. T. whipplei infection can cause internal sores, also called lesions, and thickening of tissues in the small intestine. The villi take on an abnormal, clublike appearance and the damaged intestinal lining does not properly absorb nutrients, causing diarrhea and malnutrition. Diarrhea is frequent, loose, and watery bowel movements. Malnutrition is a condition that develops when the body does not get the right amount of vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function. Over time, the infection spreads to other parts of the persons body and will damage other organs.
user: What are the symptoms of Whipple Disease ?

assistant: Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are
                
- diarrhea  - weight loss caused by malabsorption
                
A person may not have diarrhea. Instead, other signs and symptoms of Whipple disease may appear, such as
                
- abnormal yellow and white patches on the lining of the small intestine  - joint pain, with or without inflammation, that may appear off and on for years before other symptoms  - fatty or bloody stools  - abdominal cramps or bloating felt between the chest and groin  - enlarged lymph nodesthe small glands that make infection-fighting white blood cells  - loss of appetite  - fever  - fatigue, or feeling tired  - weakness  - darkening of the skin
                
People with a more advanced stage of Whipple disease may have neurologic symptomsthose related to the central nervous systemsuch as
                
- vision problems.  - memory problems or personality changes.  - facial numbness.  - headaches.  - muscle weakness or twitching.  - difficulty walking.  - hearing loss or ringing in the ears.  - dementiathe name for a group of symptoms caused by disorders that affect the brain. People with dementia may not be able to think well enough to do normal activities such as getting dressed or eating.
                
Less common symptoms of Whipple disease may include
                
- chronic cough.  - chest pain.  - pericarditisinflammation of the membrane surrounding the heart.  - heart failurea long-lasting condition in which the heart cannot pump enough blood to meet the bodys needs. Heart failure does not mean the heart suddenly stops working.
user: What are the complications of Whipple Disease ?

assistant: People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine. As a result of delayed diagnosis or treatment, people may experience the following complications in other areas of the body:
                
- long-lasting nutritional deficiencies  - heart and heart valve damage  - brain damage
                
A person with Whipple disease may experience a relapsea return of symptoms. Relapse can happen years after treatment and requires repeat treatments.
user: What are the treatments for Whipple Disease ?

assistant: The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease. Health care providers choose antibiotics that treat the infection in the small intestine and cross the blood-brain barriera layer of tissue around the brain. Using antibiotics that cross the blood-brain barrier ensures destruction of any bacteria that may have entered the patients brain and central nervous system.
                
The health care provider usually prescribes IV antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two. A nurse or technician places an IV in the patients arm to give the antibiotics. IV antibiotics used to treat Whipple disease may include
                
- ceftriaxone (Rocephin)  - meropenem (Merrem I.V.)  - penicillin G (Pfizerpen)  - streptomycin (Streptomycin)
                
After a patient completes the IV antibiotics, the health care provider will prescribe long-term oral antibiotics. Patients receive long-term treatmentat least 1 to 2 yearsto cure the infection anywhere in the body. Oral antibiotics may include
                
- trimethoprim/sulfamethoxazole (Septra, Bactrim)a combination antibiotic  - doxycycline (Vibramycin)
                
Patients should finish the prescribed course of antibiotics to ensure the medication destroyed all T. whipplei bacteria in the body. Patients who feel better may still have the bacteria in the small intestine or other areas of the body for 1 to 2 years. A health care provider will monitor the patient closely, repeat the blood tests, and repeat the upper GI endoscopy with biopsy during and after treatment to determine whether T. whipplei is still present.
                
People may relapse during or after treatment. A health care provider will prescribe additional or new antibiotics if a relapse occurs. Some people will relapse years after treatment, so it is important for patients to schedule routine follow-ups with the health care provider. Most patients have good outcomes with an early diagnosis and complete treatment.
                
Health care providers treat patients with neurologic symptoms at diagnosis or during relapse more aggressively. Treatment may include
                
- a combination of antibiotics  - hydroxychloroquine (Plaquenil)an antimalarial medication  - weekly injections of interferon gammaa substance made by the body that activates the immune system  - corticosteroidsmedications that decrease inflammation
user: How to prevent Whipple Disease ?

assistant: Experts have not yet found a way to prevent Whipple disease.
user: What to do for Whipple Disease ?

assistant: A person with Whipple disease and malabsorption may need
                
- a diet high in calories and protein  - vitamins  - nutritional supplements
user: What to do for Whipple Disease ?

assistant: - Whipple disease is a rare bacterial infection that primarily affects the small intestine. Left untreated, Whipple disease gets worse and is usually life threatening.  - Bacteria called Tropheryma whipplei (T. whipplei) cause Whipple disease. T. whipplei infection can cause internal sores, also called lesions, and thickening of tissues in the small intestine.  - Anyone can get Whipple disease. However, it is more common in Caucasian men between 40 and 60 years old.  - Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are      - diarrhea    - weight loss caused by malabsorption    - People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine.  - The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease.  - The health care provider usually prescribes intravenous (IV) antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two.  - After a patient completes the IV antibiotics, the health care provider will prescribe long-term oral antibiotics.  - Most patients have good outcomes with an early diagnosis and complete treatment.
user: What is (are) Prolactinoma ?

assistant: A prolactinoma is a benign noncancerous tumor of the pituitary gland that produces a hormone called prolactin. Prolactinomas are the most common type of pituitary tumor. Symptoms of prolactinoma are caused by hyperprolactinemia --- too much prolactin in the blood --- or by pressure of the tumor on surrounding tissues.
                
Prolactin stimulates the breast to produce milk during pregnancy.  After giving birth, a mothers prolactin levels fall unless she breastfeeds her infant. Each time the baby nurses, prolactin levels rise to maintain milk production.
user: What is (are) Prolactinoma ?

assistant: The pituitary gland, sometimes called the master gland, plays a critical role in regulating growth and development, metabolism, and reproduction. It produces prolactin and other key hormones including
                
- growth hormone, which regulates growth  - adrenocorticotropin (ACTH), which stimulates the adrenal glands to produce cortisol, a hormone important in metabolism and the body's response to stress  - thyrotropin, which signals the thyroid gland to produce thyroid hormone, also involved in metabolism and growth  - luteinizing hormone and follicle-stimulating hormone, which regulate ovulation and estrogen and progesterone production in women and sperm formation and testosterone production in men
                
The pituitary gland sits in the middle of the head in a bony box called the sella turcica. The optic nerves sit directly above the pituitary gland. Enlargement of the gland can cause symptoms such as headaches or visual disturbances. Pituitary tumors may also impair production of one or more pituitary hormones, causing reduced pituitary function, also called hypopituitarism.
user: How many people are affected by Prolactinoma ?

assistant: Although small benign pituitary tumors are fairly common in the general population, symptomatic prolactinomas are uncommon. Prolactinomas occur more often in women than men and rarely occur in children.
user: What are the symptoms of Prolactinoma ?

assistant: In women, high levels of prolactin in the blood often cause infertility and changes in menstruation. In some women, periods may stop. In others, periods may become irregular or menstrual flow may change. Women who are not pregnant or nursing may begin producing breast milk. Some women may experience a loss of libido-interest in sex. Intercourse may become painful because of vaginal dryness.
                
In men, the most common symptom of prolactinoma is erectile dysfunction. Because men have no reliable indicator such as changes in menstruation to signal a problem, many men delay going to the doctor until they have headaches or eye problems caused by the enlarged pituitary pressing against nearby optic nerves. They may not recognize a gradual loss of sexual function or libido. Only after treatment do some men realize they had a problem with sexual function.
user: What causes Prolactinoma ?

assistant: The cause of pituitary tumors remains largely unknown. Most pituitary tumors are sporadic, meaning they are not genetically passed from parents to their children.
user: What causes Prolactinoma ?

assistant: In some people, high blood levels of prolactin can be traced to causes other than prolactinoma.
                
Prescription drugs. Prolactin secretion in the pituitary is normally suppressed by the brain chemical dopamine. Drugs that block the effects of dopamine at the pituitary or deplete dopamine stores in the brain may cause the pituitary to secrete prolactin. These drugs include older antipsychotic medications such as trifluoperazine (Stelazine) and haloperidol (Haldol); the newer antipsychotic drugs risperidone (Risperdal) and molindone (Moban); metoclopramide (Reglan), used to treat gastroesophageal reflux and the nausea caused by certain cancer drugs; and less often, verapamil, alpha-methyldopa (Aldochlor, Aldoril), and reserpine (Serpalan, Serpasil), used to control high blood pressure. Some antidepressants may cause hyperprolactinemia, but further research is needed.
                
Other pituitary tumors. Other tumors arising in or near the pituitary may block the flow of dopamine from the brain to the prolactin-secreting cells. Such tumors include those that cause acromegaly, a condition caused by too much growth hormone, and Cushing's syndrome, caused by too much cortisol. Other pituitary tumors that do not result in excess hormone production may also block the flow of dopamine.
                
Hypothyroidism. Increased prolactin levels are often seen in people with hypothyroidism, a condition in which the thyroid does not produce enough thyroid hormone. Doctors routinely test people with hyperprolactinemia for hypothyroidism.
                
Chest involvement. Nipple stimulation also can cause a modest increase in the amount of prolactin in the blood. Similarly, chest wall injury or shingles involving the chest wall may also cause hyperprolactinemia.
user: How to diagnose Prolactinoma ?

assistant: A doctor will test for prolactin blood levels in women with unexplained milk secretion, called galactorrhea, or with irregular menses or infertility and in men with impaired sexual function and, in rare cases, milk secretion. If prolactin levels are high, a doctor will test thyroid function and ask first about other conditions and medications known to raise prolactin secretion. The doctor may also request magnetic resonance imaging (MRI), which is the most sensitive test for detecting pituitary tumors and determining their size. MRI scans may be repeated periodically to assess tumor progression and the effects of therapy. Computerized tomography (CT) scan also gives an image of the pituitary but is less precise than the MRI.
                
The doctor will also look for damage to surrounding tissues and perform tests to assess whether production of other pituitary hormones is normal. Depending on the size of the tumor, the doctor may request an eye exam with measurement of visual fields.
user: Who is at risk for Prolactinoma? ?

assistant: Women whose ovaries produce inadequate estrogen are at increased risk for osteoporosis. Hyperprolactinemia can reduce estrogen production. Although estrogen production may be restored after treatment for hyperprolactinemia, even a year or 2 without estrogen can compromise bone strength. Women should protect themselves from osteoporosis by increasing exercise and calcium intake through diet or supplements and by not smoking. Women treated for hyperprolactinemia may want to have periodic bone density measurements and discuss estrogen replacement therapy or other bone-strengthening medications with their doctor.
user: What is (are) Intestinal Pseudo-obstruction ?

assistant: Intestinal pseudo-obstruction is a rare condition with symptoms that resemble those caused by a blockage, or obstruction, of the intestines, also called the bowel. However, when a health care provider examines the intestines, no blockage exists. Instead, the symptoms are due to nerve or muscle problems that affect the movement of food, fluid, and air through the intestines.
                
The intestines are part of the gastrointestinal (GI) tract and include the small intestine and the large intestine. The small intestine is the organ where most digestion occurs. The small intestine measures about 20 feet and includes the
                
- duodenum, the first part of the small intestine  - jejunum, the middle section of the small intestine  - ileum, the lower end of the small intestine
                
The large intestine absorbs water from stool and changes it from a liquid to a solid form, which passes out of the body during a bowel movement. The large intestine measures about 5 feet and includes the
                
- cecum, the first part of the large intestine, which is connected to the ileum  - colon, the part of the large intestine extending from the cecum to the rectum  - rectum, the lower end of the large intestine leading to the anus