Dipak-001/mistril_dataset huggingface dataset:
user: How to diagnose Celiac Disease ?

assistant: In some cases, a health care provider will order genetic blood tests to confirm or rule out a diagnosis of celiac disease. Most people with celiac disease have gene pairs that contain at least one of the human leukocyte antigen (HLA) gene variants.4 However, these variants are also common in people without celiac disease, so their presence alone cannot diagnose celiac disease.
                
If a biopsy and other blood tests do not give a clear diagnosis of celiac disease, a health care provider may test a patient for HLA gene variants. If the gene variants are not present, celiac disease is unlikely.
user: What to do for Celiac Disease ?

assistant: - Celiac disease is an immune disorder in which people cannot tolerate gluten because it damages the lining of their small intestine and prevents absorption of nutrients.  - When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villithe tiny, fingerlike projections on the inner lining of the small intestine.  - A person may experience digestive signs and symptoms, or symptoms in other parts of the body.  - Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases and conditions.  - Dermatitis herpetiformis is a chronic, itchy, blistering skin rashusually on the elbows, knees, buttocks, back, or scalpthat affects about 5 to 10 percent of people with celiac disease.  - Signs and symptoms of celiac disease vary from person to person because of numerous factors.  - Some people with celiac disease have no signs or symptoms; however, they can still develop complications of the disease over time. Long-term complications include malnutrition, liver diseases, intestinal cancer, and lymphoma.  - A health care provider diagnoses celiac disease with a medical and family history, a physical exam, blood tests, an intestinal biopsy, and a skin biopsy.  - Since celiac disease sometimes runs in families, blood relatives of people with celiac disease should talk with their health care provider about their chances of getting the disease.  - Most people with celiac disease have a significant improvement in symptoms when they follow a gluten-free diet.  - Health care providers typically refer people to a dietitian who specializes in treating people with the disease.  - The dietitian will give the person instructions for how to read food and product labels and identify ingredients that contain gluten.  - Medications, supplements, and other products may also contain a hidden source of gluten.  - People with celiac disease can eat a wellbalanced diet with a variety of foods.
user: How to diagnose Treatment Methods for Kidney Failure: Hemodialysis ?

assistant: About once a month, your dialysis care team will test your blood by using one of two formulasURR or Kt/Vto see whether your treatments are removing enough wastes. Both tests look at one specific waste product, called blood urea nitrogen (BUN), as an indicator for the overall level of waste products in your system. For more information about these measurements, see the NIDDK fact sheet Hemodialysis Dose and Adequacy.
user: What is (are) Hashimoto's Disease ?

assistant: Hashimotos disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an autoimmune disease. An autoimmune disease is a disorder in which the bodys immune system attacks the bodys own cells and organs. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances.
                
In Hashimotos disease, the immune system attacks the thyroid gland, causing inflammation and interfering with its ability to produce thyroid hormones. Large numbers of white blood cells called lymphocytes accumulate in the thyroid. Lymphocytes make the antibodies that start the autoimmune process.
                
Hashimotos disease often leads to reduced thyroid function, or hypothyroidism. Hypothyroidism is a disorder that occurs when the thyroid doesnt make enough thyroid hormone for the bodys needs. Thyroid hormones regulate metabolismthe way the body uses energyand affect nearly every organ in the body. Without enough thyroid hormone, many of the bodys functions slow down. Hashimotos disease is the most common cause of hypothyroidism in the United States.1
                
More information is provided in the NIDDK health topic, Hypothyroidism.
user: What is (are) Hashimoto's Disease ?

assistant: The thyroid is a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on either side of the windpipe.
                
The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce and store hormones and release them into the bloodstream. The hormones then travel through the body and direct the activity of the bodys cells.
                
The thyroid makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is the active hormone and is made from T4. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.
                
Thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain, regulates thyroid hormone production. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary decreases TSH production.
user: What are the symptoms of Hashimoto's Disease ?

assistant: Many people with Hashimotos disease have no symptoms at first. As the disease slowly progresses, the thyroid usually enlarges and may cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in the throat, though it is usually not painful. After many years, or even decades, damage to the thyroid causes it to shrink and the goiter to disappear.
                
Not everyone with Hashimotos disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinicalmild and without symptoms, especially early in its course. With progression to hypothyroidism, people may have one or more of the following symptoms:
                
- fatigue  - weight gain  - cold intolerance  - joint and muscle pain  - constipation, or fewer than three bowel movements a week  - dry, thinning hair  - heavy or irregular menstrual periods and problems becoming pregnant  - depression  - memory problems  - a slowed heart rate
user: What are the treatments for Hashimoto's Disease ?

assistant: Treatment generally depends on whether the thyroid is damaged enough to cause hypothyroidism. In the absence of hypothyroidism, some health care providers treat Hashimotos disease to reduce the size of the goiter. Others choose not to treat the disease and simply monitor their patients for disease progression.
                
Hashimotos disease, with or without hypothyroidism, is treated with synthetic thyroxine, which is man-made T4. Health care providers prefer to use synthetic T4, such as Synthroid, rather than synthetic T3, because T4 stays in the body longer, ensuring a steady supply of thyroid hormone throughout the day. The thyroid preparations made with animal thyroid are not considered as consistent as synthetic thyroid (Levothyroxine) and rarely prescribed today.
                
Health care providers routinely test the blood of patients taking synthetic thyroid hormone and adjust the dose as necessary, typically based on the result of the TSH test. Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed.
user: What to do for Hashimoto's Disease ?

assistant: Iodine is an essential mineral for the thyroid. However, people with Hashimotos disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hypothyroidism. Read more in Iodine in diet at www.nlm.nih.gov/medlineplus/ency/article/002421.htm.
                
Women need more iodine when they are pregnantabout 220 micrograms a daybecause the baby gets iodine from the mothers diet. Women who are breastfeeding need about 290 micrograms a day. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Pregnant women should choose iodized saltsalt supplemented with iodineover plain salt and take prenatal vitamins containing iodine to ensure this need is met.
                
To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health.
user: What to do for Hashimoto's Disease ?

assistant: - Hashimotos disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an autoimmune disease.  - Hashimotos disease often leads to reduced thyroid function, or hypothyroidism. Hypothyroidism is a disorder that occurs when the thyroid doesnt make enough thyroid hormone for the bodys needs.  - Hashimotos disease is the most common cause of hypothyroidism in the United States. Many people with Hashimotos disease have no symptoms at first. As the disease slowly progresses, the thyroid usually enlarges and may cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in the throat, though it is usually not painful.  - Not everyone with Hashimotos disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinicalmild and without symptoms, especially early in its course.  - Hashimotos disease is much more common in women than men. Although the disease often occurs in adolescent or young women, it more commonly appears between 30 and 50 years of age.  - Hashimotos disease, with or without hypothyroidism, is treated with synthetic thyroxine, which is man-made T4.  - Women with Hashimotos disease should discuss their condition with their health care provider before becoming pregnant.  - Pregnant women should choose iodized saltsalt supplemented with iodineover plain salt and take prenatal vitamins containing iodine.  - People should discuss their use of dietary supplements, such as iodine, with their health care provider.
user: What is (are) Kidney Stones in Children ?

assistant: A kidney stone is a solid piece of material that forms in a kidney when substances that are normally found in the urine become highly concentrated. A stone may stay in the kidney or travel down the urinary tract. Kidney stones vary in size. A small stone may pass out of the body causing little or no pain. A larger stone may get stuck along the urinary tract and can block the flow of urine, causing severe pain or blood that can be seen in the urine.
user: What is (are) Kidney Stones in Children ?

assistant: The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean-shaped organs, each about the size of a fist and located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine an adult produces each day. Children produce less urine each day; the amount produced depends on their age. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.
user: What causes Kidney Stones in Children ?

assistant: Kidney stones can form when substances in the urinesuch as calcium, magnesium, oxalate, and phosphorousbecome highly concentrated due to one or more causes:
                
- Defects in the urinary tract may block the flow of urine and create pools of urine. In stagnant urine, stone-forming substances tend to settle together into stones. Up to one-third of children who have stones have an anatomic abnormality in their urinary tract.  - Kidney stones may have a genetic cause. In other words, the tendency to form stones can run in families due to inherited factors.  - An unhealthy lifestyle may make children more likely to have kidney stones. For example, drinking too little water or drinking the wrong types of fluids, such as soft drinks or drinks with caffeine, may cause substances in the urine to become too concentrated. Similarly, too much sodium, or salt, in the diet may contribute to more chemicals in the urine, causing an increase in stone formation. Some doctors believe increases in obesity rates, less active lifestyles, and diets higher in salt may be causing more children to have kidney stones.  - Sometimes, a urinary tract infection can cause kidney stones to form. Some types of bacteria in the urinary tract break down ureaa waste product removed from the blood by the kidneysinto substances that form stones.  - Some children have metabolic disorders that lead to kidney stones. Metabolism is the way the body uses digested food for energy, including the process of breaking down food, using foods nutrients in the body, and removing the wastes that remain. The most common metabolic disorder that causes kidney stones in children is hypercalciuria, which causes extra calcium to collect in the urine. Other more rare metabolic conditions involve problems breaking down oxalate, a substance made in the body and found in some foods. These conditions include hyperoxaluria, too much oxalate in the urine, and oxalosis, characterized by deposits of oxalate and calcium in the bodys tissues. Another rare metabolic condition called cystinuria can cause kidney stones. Cystinuria is an excess of the amino acid cystine in the urine. Amino acids are the building blocks of proteins.
user: What are the symptoms of Kidney Stones in Children ?

assistant: Children with kidney stones may have pain while urinating, see blood in the urine, or feel a sharp pain in the back or lower abdomen. The pain may last for a short or long time. Children may experience nausea and vomiting with the pain. However, children who have small stones that pass easily through the urinary tract may not have symptoms at all.
user: What is (are) Kidney Stones in Children ?

assistant: Four major types of kidney stones occur in children:
                
- Calcium stones are the most common type of kidney stone and occur in two major forms: calcium oxalate and calcium phosphate. Calcium oxalate stones are more common. Calcium oxalate stone formation has various causes, which may include high calcium excretion, high oxalate excretion, or acidic urine. Calcium phosphate stones are caused by alkaline urine.  - Uric acid stones form when the urine is persistently acidic. A diet rich in purinessubstances found in animal proteins such as meats, fish, and shellfishmay cause uric acid. If uric acid becomes concentrated in the urine, it can settle and form a stone by itself or along with calcium.  - Struvite stones result from kidney infections. Eliminating infected stones from the urinary tract and staying infectionfree can prevent more struvite stones.  - Cystine stones result from a genetic disorder that causes cystine to leak through the kidneys and into the urine in high concentration, forming crystals that tend to accumulate into stones.
user: How to diagnose Kidney Stones in Children ?

assistant: The process of diagnosing any illness begins with consideration of the symptoms. Pain or bloody urine may be the first symptom. Urine, blood, and imaging tests will help determine whether symptoms are caused by a stone. Urine tests can be used to check for infection and for substances that form stones. Blood tests can be used to check for biochemical problems that can lead to kidney stones. Various imaging techniques can be used to locate the stone:
                
- Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show the location of any stones. This test does not expose children to radiation, unlike some other imaging tests. Although other tests are more useful in detecting very small stones or stones in the lower portion of the ureter, ultrasound is considered by many health care providers to be the best screening test to look for stones.  - Computerized tomography (CT) scans use a combination of x rays and computer technology to create threedimensional (3-D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the child to lie on a table that slides into a tunnel-shaped device where the x rays are taken. The procedure is performed in an outpatient center or hospital by an x-ray technician, and the images are interpreted by a radiologist; anesthesia is not needed. CT scans may be required to get an accurate stone count when children are being considered for urologic surgery. Because CT scans expose children to a moderate amount of radiation, health care providers try to reduce radiation exposure in children by avoiding repeated CT scans, restricting the area scanned as much as possible, and using the lowest radiation dose that will provide the needed diagnostic information.  - X-ray machines use radiation to create images of the childs urinary tract. The images can be taken at an outpatient center or hospital by an x-ray technician, and the images are interpreted by a radiologist; anesthesia is not needed. The x rays are used to locate many kinds of stones. A conventional x ray is generally less informative than an ultrasound or CT scan, but it is less expensive and can be done more quickly than other imaging procedures.
user: What are the treatments for Kidney Stones in Children ?

assistant: The treatment for a kidney stone usually depends on its size and what it is made of, as well as whether it is causing symptoms of pain or obstructing the urinary tract. Small stones usually pass through the urinary tract without treatment. Still, children will often require pain control and encouragement to drink lots of fluids to help move the stone along. Pain control may consist of oral or intravenous (IV) medication, depending on the duration and severity of the pain. IV fluids may be needed if the child becomes dehydrated from vomiting or an inability to drink. A child with a larger stone, or one that blocks urine flow and causes great pain, may need to be hospitalized for more urgent treatment. Hospital treatments may include the following:
user: How to prevent Kidney Stones in Children ?

assistant: To prevent kidney stones, health care providers and their patients must understand what is causing the stones to form. Especially in children with suspected metabolic abnormalities or with recurrent stones, a 24-hour urine collection is obtained to measure daily urine volume and to determine if any underlying mineral abnormality is making a child more likely to form stones. Based on the analysis of the collected urine, the treatment can be individualized to address a metabolic problem.
                
In all circumstances, children should drink plenty of fluids to keep the urine diluted and flush away substances that could form kidney stones. Urine should be almost clear.
user: What to do for Kidney Stones in Children ?

assistant: Families may benefit from meeting with a dietitian to learn how dietary management can help in preventing stones. Depending on the underlying cause of the stone formation, medications may be necessary to prevent recurrent stones. Dietary changes and medications may be required for a long term or, quite often, for life. Some common changes include the following:
                
- Children who tend to make calcium oxalate stones or have hypercalciuria should eat a regular amount of dietary calcium and limit salt intake. A thiazide diuretic medication may be given to some children to reduce the amount of calcium leaking into the urine.  - Children who have large amounts of oxalate in the urine may need to limit foods high in oxalate, such as chocolate, peanut butter, and dark-colored soft drinks.  - Children who form uric acid or cystine stones may need extra potassium citrate or potassium carbonate in the form of a pill or liquid medication. Avoiding foods high in purinessuch as meat, fish, and shellfishmay also help prevent uric acid stones.
user: What to do for Kidney Stones in Children ?

assistant: - A kidney stone is a solid piece of material that forms in a kidney when some substances that are normally found in the urine become highly concentrated.  - Kidney stones occur in infants, children, and teenagers from all races and ethnicities.  - Kidney stones in children are diagnosed using a combination of urine, blood, and imaging tests.  - The treatment for a kidney stone usually depends on its size and composition as well as whether it is causing symptoms of pain or obstructing the urinary tract.  - Small stones usually pass through the urinary tract without treatment. Still, children will often require pain control and encouragement to drink lots of fluids to help move the stone along.  - Children with larger stones, or stones that block urine flow and cause great pain, may need to be hospitalized for more urgent treatment.  - Hospital treatments may include shock wave lithotripsy (SWL), removal of the stone with a ureteroscope, lithotripsy with a ureteroscope, or percutaneous nephrolithotomy.   - To prevent recurrent kidney stones, health care providers and their patients must understand what is causing the stones to form.  - In all circumstances, children should drink plenty of fluids to keep the urine diluted and flush away substances that could form kidney stones. Urine should be almost clear.
user: What is (are) Autoimmune Hepatitis ?

assistant: Autoimmune hepatitis is a chronicor long lastingdisease in which the body's immune system attacks the normal components, or cells, of the liver and causes inflammation and liver damage. The immune system normally protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances.
                
Autoimmune hepatitis is a serious condition that may worsen over time if not treated. Autoimmune hepatitis can lead to cirrhosis and liver failure. Cirrhosis occurs when scar tissue replaces healthy liver tissue and blocks the normal flow of blood through the liver. Liver failure occurs when the liver stops working properly.
user: What is (are) Autoimmune Hepatitis ?

assistant: Autoimmune diseases are disorders in which the body's immune system attacks the body's own cells and organs with proteins called autoantibodies; this process is called autoimmunity.
                
The body's immune system normally makes large numbers of proteins called antibodies to help the body fight off infections. In some cases, however, the body makes autoantibodies. Certain environmental triggers can lead to autoimmunity. Environmental triggers are things originating outside the body, such as bacteria, viruses, toxins, and medications.
user: What causes Autoimmune Hepatitis ?

assistant: A combination of autoimmunity, environmental triggers, and a genetic predisposition can lead to autoimmune hepatitis.