Dipak-001/mistril_dataset huggingface dataset:
user: How to diagnose Mineral and Bone Disorder in Chronic Kidney Disease ?

assistant: A health care provider diagnoses mineral and bone disorder in CKD with
                
- a family and medical history  - a physical exam  - a blood test  - a bone biopsy  - an x-ray
                
Family and Medical History
                
Taking a medical and family history is one of the first things a health care provider may do to help diagnose mineral and bone disorder in CKD. He or she will ask the patient or caretaker questions about when the patient was first diagnosed with CKD and whether any family members have also had mineral and bone disorder with or without CKD.
                
Physical Exam
                
A physical exam may help diagnose mineral and bone disorder in CKD. During a physical exam, a health care provider usually examines a patients body for changes in bone structure.
                
Blood Test
                
A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. The blood test shows levels of calcium, phosphorus, parathyroid hormone, and sometimes vitamin D.
                
Bone Biopsy
                
A bone biopsy is a procedure that removes a piece of bone tissue for examination with a microscope. A health care provider performs the biopsy in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the hip bone. A pathologista doctor who specializes in diagnosing diseasesexamines the bone tissue in a lab. The test can show whether a persons bone cells are building normal bone.
                
X-ray
                
An x-ray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. A radiographer performs the x-ray at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. Patients do not need anesthesia. The patient will lie on a table or stand during the x-ray. The technician will position the x-ray machine over the bone area. The patient will hold his or her breath as the x-ray machine takes the picture so that the picture will not be blurry. The radiographer may ask the patient to change position for additional pictures. An x-ray can show extra calcium in blood vessels.
                
Each of these tests can help the health care provider determine whether CKD or some other condition is causing the mineral and bone disorder and decide on a course of treatment.
user: What to do for Mineral and Bone Disorder in Chronic Kidney Disease ?

assistant: - Mineral and bone disorder in chronic kidney disease (CKD) occurs when damaged kidneys and abnormal hormone levels cause calcium and phosphorus levels in a persons blood to be out of balance. Mineral and bone disorder commonly occurs in people with CKD and affects most people with kidney failure receiving dialysis.  - Chronic kidney disease is kidney damage that occurs slowly over many years, often due to diabetes or high blood pressure. Once damaged, the kidneys cant filter blood as they should.  - Hormones and minerals are important because they help bones stay strong. If a persons hormones and minerals are out of balance, his or her bones can become weak and malformed.   - Parathyroid hormone plays an important role in controlling calcium levels in the blood. When kidneys do not function properly, extra parathyroid hormone is released in the blood to move calcium from inside the bones into the blood.  - Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body. The kidneys stop activating calcitriol and do not remove the phosphorus in the blood properly.  - The complications of mineral and bone disorder in CKD include slowed bone growth and deformities, and heart and blood vessel problems.   - Treating mineral and bone disorder in CKD includes preventing damage to bones by controlling parathyroid hormone levels through changes in eating, diet, and nutrition; medications and supplements; and dialysis.   - Reducing dietary intake of phosphorus is one of the most important steps in preventing bone disease.  - If diet, medications, and dialysis cant control parathyroid hormone levels, a surgeon can remove one or more of the parathyroid glands.
user: What is (are) Urinary Incontinence in Children ?

assistant: Urinary incontinence is the loss of bladder control, which results in the accidental loss of urine. A child with UI may not stay dry during the day or night. Some UI is caused by a health problem such as
                
- a urinary tract infection (UTI)  - diabetes, a condition where blood glucose, also called blood sugar, is too high  - kidney problems  - nerve problems  - constipation, a condition in which a child has fewer than two bowel movements a week and stools can be hard, dry, small, and difficult to pass  - obstructive sleep apnea (OSA), a condition in which breathing is interrupted during sleep, often because of inflamed or enlarged tonsils  - a structural problem in the urinary tract
                
Most of the time, the exact cause of UI is not known, but it is often the result of more than one factor.
                
Although UI affects many children, it usually disappears naturally over time. UI after age 3the age when most children achieve daytime drynessmay cause great distress and embarrassment. Many children experience occasional UI, and treatment is available for most children who have a hard time controlling their bladder. Thus, caregivers of children who wet the bed or have accidents during the day should approach this problem with understanding and patience.
                
The age at which children achieve dryness varies. Wetting in younger children is common and not considered UI, so daytime UI is not usually diagnosed until age 5 or 6, and nighttime UI is not usually diagnosed until age 7.
                
Enuresis   Urinary incontinence is also called enuresis. Types of enuresis include the following:   - Primary enuresis is wetting in a child who has never been consistently dry.   - Secondary enuresis is wetting that begins after at least 6 months of dryness.   - Nocturnal enuresis is wetting that usually occurs during sleep, also called nighttime UI.   - Diurnal enuresis is wetting when awake, also called daytime UI.
user: How many people are affected by Urinary Incontinence in Children ?

assistant: By 5 years of age, more than 90 percent of children can control urination during the day. Nighttime wetting is more common than daytime wetting in children, affecting 30 percent of 4-year-olds. The condition resolves itself in about 15 percent of children each year; about 10 percent of 7-year-olds, 3 percent of 12-year-olds, and 1 percent of 18-year-olds continue to experience nighttime wetting.1
user: What causes Urinary Incontinence in Children ?

assistant: Daytime UI can be caused by a UTI or structural problems in the urinary tract. Daytime UI that is not associated with UTI or structural problems is less common and tends to disappear much earlier than nighttime UI. Overactive bladder and infrequent or incomplete voiding, or urination, are common causes of daytime UI.
                
Overactive Bladder
                
Overactive bladder is a condition in which a child experiences at least two of the following conditions:
                
- urinary urgencyinability to delay urination  - urge urinary incontinenceurinary leakage when the bladder contracts unexpectedly  - urinary frequencyurination eight or more times a day or more than twice at night
                
Infrequent or Incomplete Voiding
                
Infrequent voiding is when children voluntarily hold urine for prolonged periods of time. For example, children may not want to use the toilets at school or may not want to interrupt enjoyable activities, so they ignore the bodys signal of a full bladder. In these cases, the bladder can overfill and leak urine. In addition, these children often develop UTIs, leading to an irritated or overactive bladder.
                
Factors that may combine with infrequent voiding to produce daytime UI include
                
- small bladder capacity  - structural problems  - anxiety-causing events  - pressure from constipation  - drinks or foods that contain caffeine
                
Sometimes, overly demanding toilet training may make children unable to relax the sphincters enough to completely empty the bladder. Incomplete voiding may also lead to UTIs.
user: What are the treatments for Urinary Incontinence in Children ?

assistant: Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications.
                
Growth and Development
                
As children mature
                
- bladder capacity increases  - natural body alarms become activated  - an overactive bladder settles down  - production of ADH becomes normal  - response to the bodys signal that it is time to void improves
                
Bladder Training and Related Strategies
                
Bladder training consists of exercises to strengthen the bladder muscles to better control urination. Gradually lengthening the time between trips to the bathroom can also help by stretching the bladder so it can hold more urine. Additional techniques that may help control daytime UI include
                
- urinating on a scheduletimed voidingsuch as every 2 hours  - avoiding food or drinks with caffeine  - following suggestions for healthy urination, such as relaxing muscles and taking enough time to allow the bladder to empty completely
                
Waking children up to urinate can help decrease nighttime UI. Ensuring children drink enough fluids throughout the day so they do not drink a lot of fluids close to bedtime may also help. A health care provider can give guidance about how much a child needs to drink each day, as the amount depends on a childs age, physical activity, and other factors.
                
Moisture Alarms
                
At night, moisture alarms can wake children when they begin to urinate. These devices use a water-sensitive pad connected to an alarm that sounds when moisture is first detected. A small pad can clip to the pajamas, or a larger pad can be placed on the bed. For the alarm to be effective, children must awaken as soon as the alarm goes off, stop the urine stream, and go to the bathroom. Children using moisture alarms may need to have someone sleep in the same room to help wake them up.
                
Medications
                
Nighttime UI may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin (DDAVP), which is available in pill form, nasal spray, and nose drops. DDAVP is approved for use in children. Another medication, called imipramine (Tofranil), is also used to treat nighttime UI, though the way this medication prevents bedwetting is not known. Although both of these medications may help children achieve short-term success, relapse is common once the medication is withdrawn.
                
UI resulting from an overactive bladder may be treated with oxybutynin (Ditropan), a medication that helps calm the bladder muscle and control muscle spasms.
user: What to do for Urinary Incontinence in Children ?

assistant: Eating, diet, and nutrition have not been shown to play a role in causing or preventing UI in children, though ensuring sufficient fluid intake throughout the day and avoiding caffeine intake may be helpful.
user: What to do for Urinary Incontinence in Children ?

assistant: - Urinary incontinence (UI) is the loss of bladder control, which results in the accidental loss of urine. A child with UI may not stay dry during the day or night. Although UI affects many children, it usually disappears naturally over time.  - By 5 years of age, more than 98 percent of children can control urination during the day. Nighttime wetting is more common than daytime wetting in children, affecting 30 percent of 4-year-olds.  - The exact cause of most cases of nighttime UI is not known. Though a few cases are caused by structural problems in the urinary tract, most cases result from more than one factor including slower physical development, an overproduction of urine at night, and the inability to recognize bladder filling when asleep.  - Nighttime UI has also been associated with attention deficit hyperactivity disorder (ADHD), obstructive sleep apnea (OSA), and anxiety. Certain genes have been found to contribute to UI.  - Daytime UI that is not associated with urinary tract infection (UTI) or structural problems in the urinary tract may be due to an overactive bladder or infrequent or incomplete voiding problems.  - Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications.
user: What is (are) Hemochromatosis ?

assistant: Hemochromatosis is the most common form of iron overload disease. Too much iron in the body causes hemochromatosis. Iron is important because it is part of hemoglobin, a molecule in the blood that transports oxygen from the lungs to all body tissues. However, too much iron in the body leads to iron overloada buildup of extra iron that, without treatment, can damage organs such as the liver, heart, and pancreas; endocrine glands; and joints.
                
The three types of hemochromatosis are primary hemochromatosis, also called hereditary hemochromatosis; secondary hemochromatosis; and neonatal hemochromatosis.
user: What are the symptoms of Hemochromatosis ?

assistant: A person with hemochromatosis may notice one or more of the following symptoms:
                
- joint pain  - fatigue, or feeling tired  - unexplained weight loss  - abnormal bronze or gray skin color  - abdominal pain  - loss of sex drive
                
Not everyone with hemochromatosis will develop these symptoms.
user: What are the complications of Hemochromatosis ?

assistant: Without treatment, iron may build up in the organs and cause complications, including
                
- cirrhosis, or scarring of liver tissue  - diabetes  - irregular heart rhythms or weakening of the heart muscle  - arthritis  - erectile dysfunction
                
The complication most often associated with hemochromatosis is liver damage. Iron buildup in the liver causes cirrhosis, which increases the chance of developing liver cancer.
                
For some people, complications may be the first sign of hemochromatosis. However, not everyone with hemochromatosis will develop complications.
user: What are the treatments for Hemochromatosis ?

assistant: Health care providers treat hemochromatosis by drawing blood. This process is called phlebotomy. Phlebotomy rids the body of extra iron. This treatment is simple, inexpensive, and safe.
                
Based on the severity of the iron overload, a patient will have phlebotomy to remove a pint of blood once or twice a week for several months to a year, and occasionally longer. Health care providers will test serum ferritin levels periodically to monitor iron levels. The goal is to bring serum ferritin levels to the low end of the average range and keep them there. Depending on the lab, the level is 25 to 50 g/L.
                
After phlebotomy reduces serum ferritin levels to the desired level, patients may need maintenance phlebotomy treatment every few months. Some patients may need phlebotomies more often. Serum ferritin tests every 6 months or once a year will help determine how often a patient should have blood drawn. Many blood donation centers provide free phlebotomy treatment for people with hemochromatosis.
                
Treating hemochromatosis before organs are damaged can prevent complications such as cirrhosis, heart problems, arthritis, and diabetes. Treatment cannot cure these conditions in patients who already have them at diagnosis. However, treatment will help most of these conditions improve. The treatments effectiveness depends on the degree of organ damage. For example, treating hemochromatosis can stop the progression of liver damage in its early stages and lead to a normal life expectancy. However, if a patient develops cirrhosis, his or her chance of developing liver cancer increases, even with phlebotomy treatment. Arthritis usually does not improve even after phlebotomy removes extra iron.
user: What to do for Hemochromatosis ?

assistant: Iron is an essential nutrient found in many foods. Healthy people usually absorb less than 10 percent of iron in the food they eat.6 People with hemochromatosis absorb up to 30 percent of that iron.6 People with hemochromatosis can help prevent iron overload by
                
- eating only moderate amounts of iron-rich foods, such as red meat and organ meat  - avoiding supplements that contain iron  - avoiding supplements that contain vitamin C, which increases iron absorption
                
People with hemochromatosis can take steps to help prevent liver damage, including
                
- limiting the amount of alcoholic beverages they drink because alcohol increases their chance of cirrhosis and liver cancer  - avoiding alcoholic beverages entirely if they already have cirrhosis
user: What to do for Hemochromatosis ?

assistant: - Hemochromatosis is the most common form of iron overload disease. Too much iron in the body causes hemochromatosis.  - Inherited genetic defects cause primary hemochromatosis.  - Primary hemochromatosis mainly affects Caucasians of Northern European descent.  - A person with hemochromatosis may notice one or more of the following symptoms: joint pain; fatigue, or feeling tired; unexplained weight loss; abnormal bronze or gray skin color; abdominal pain; and loss of sex drive. Not everyone with hemochromatosis will develop these symptoms.  - Without treatment, iron may build up in the organs and cause complications, including cirrhosis, diabetes, irregular heart rhythms or weakening of the heart muscle, arthritis, and erectile dysfunction.  - If a health care provider diagnoses and treats the iron overload caused by hemochromatosis before organ damage has occurred, a person can live a normal, healthy life.  - Experts recommend testing for hemochromatosis in people who have symptoms, complications, or a family history of the disease.  - Health care providers treat hemochromatosis by drawing blood. This process is called phlebotomy.
user: What is (are) Causes of Diabetes ?

assistant: Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.
                
Diabetes is a disorder of metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose, a form of sugar that enters the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both.
                
Insulin is made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.
                
If beta cells dont produce enough insulin, or the body doesnt respond to the insulin that is present, glucose builds up in the blood instead of being absorbed by cells in the body, leading to prediabetes or diabetes. Prediabetes is a condition in which blood glucose levels or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough to be diagnosed as diabetes. In diabetes, the bodys cells are starved of energy despite high blood glucose levels.
                
Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other complications of diabetes may include increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy problems. No one is certain what starts the processes that cause diabetes, but scientists believe genes and environmental factors interact to cause diabetes in most cases.
                
The two main types of diabetes are type 1 diabetes and type 2 diabetes. A third type, gestational diabetes, develops only during pregnancy. Other types of diabetes are caused by defects in specific genes, diseases of the pancreas, certain drugs or chemicals, infections, and other conditions. Some people show signs of both type 1 and type 2 diabetes.
user: What causes Causes of Diabetes ?

assistant: Insulin Resistance and Beta Cell Dysfunction
                
Hormones produced by the placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If the pancreas cant produce enough insulin due to beta cell dysfunction, gestational diabetes occurs.
                
As with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk.
                
Family History
                
Having a family history of diabetes is also a risk factor for gestational diabetes, suggesting that genes play a role in its development. Genetics may also explain why the disorder occurs more frequently in African Americans, American Indians, and Hispanics/Latinos. Many gene variants or combinations of variants may increase a womans risk for developing gestational diabetes. Studies have found several gene variants associated with gestational diabetes, but these variants account for only a small fraction of women with gestational diabetes.
                
Future Risk of Type 2 Diabetes
                
Because a womans hormones usually return to normal levels soon after giving birth, gestational diabetes disappears in most women after delivery. However, women who have gestational diabetes are more likely to develop gestational diabetes with future pregnancies and develop type 2 diabetes.3 Women with gestational diabetes should be tested for persistent diabetes 6 to 12 weeks after delivery and at least every 3 years thereafter.
                
Also, exposure to high glucose levels during gestation increases a childs risk for becoming overweight or obese and for developing type 2 diabetes later on. The result may be a cycle of diabetes affecting multiple generations in a family. For both mother and child, maintaining a healthy body weight and being physically active may help prevent type 2 diabetes.