Cirrhosis is the final stage of liver injury and degeneration. It occurs in 15 % of heavy drinkers. Other causes of liver cirrhosis are drug or chemical poisoning, hepatitis B virus, cystic fibrosis, etc. Cirrhosis is characterized by liver necrosis meaning the normal liver tissue is gradually destroyed and replaced by inactive fibrous connective tissue (scar tissue).
NUTRITIONAL MANAGEMENT:
Energy Requirements: Due to extreme weight loss in cirrhosis, energy requirements are increased. A diet with 25-35 Kcal/Kg IBW (Ideal Body Weight) per day is recommended. Small and frequent meals should be given.
Carbohydrate Requirements: The carbohydrate content of the diet should be high in order to provide sufficient calories so that protein is not utilized for energy. Also, the liver may store glycogen. Liver function improves when an adequate store of glycogen is present in hepatocytes (liver cells). Simple carbohydrates should be given, i.e., sugars, fruits juices, Sago, Arrowroot products, etc. About 65-70 % of total calories should be provided by carbohydrates.
Protein Requirements: A liberal protein intake is essential for the repair of hepatic cells. The serum albumin which is exclusively synthesized by the liver cells falls down in cirrhosis as a result of which there is water retention. So, in order to maintain serum levels of albumin, it is necessary to take protein. In case of absence of Hepatic Coma (a condition in which ammonia levels increases leading to brain tissue damage), 1.2 -1.5 gms per kg present body weight can be given. Both animal and plant protein can be given. Vegetable and dairy proteins are better tolerated because of their lower content of Aromatic Amino Acids (Methionine and Glutamine) and higher content of Branched chain Amino Acids (Valine, Leucine, and Isoleucine). If protein requirements cannot be met by diet alone, then protein supplements can also be given. However, if cirrhosis progresses to Hepatic Coma, then protein has to be totally restricted.
Fat Requirements: Cirrhosis is marked by impaired fat metabolism and absorption. Triglycerides which contain Medium Chain Fatty Acids (8-10 CARBON FATTY ACIDS) like Ghee, Butter, etc. can be given. These triglycerides do not require bile for their digestion and absorption. This will help to prevent steatorrhea (fatty stools). As the condition improves, large chain triglycerides can be given to avoid deficiency of essential fatty acids.
Vitamin Requirements: All of the vitamin should be supplied in abundance to fortify the liver against stress and to repair the damage. Since the liver is involved in the synthesis of active forms of any B-complex vitamin and due to lack of proper function, it is advisable to give B-complex vitamin supplements. In the presence of steatorrhea, water soluble forms of vitamin A, D, E, and K should be given. In severe cirrhosis with problems of vitamin storage, metabolism, and transport intramuscular injections of Vitamin A, D, E, and K may be necessary.
Mineral Requirements: Iron intake should be increased to prevent anemia because the liver is unable to store iron in the form of Ferritin. Iron supplements can be given. However, simultaneous increase of vitamin C is also required. Calcium intake should also be increased. Iron intake can be increased by following measures:
* Increase the intake of Green leafy vegetables like Spinach, Mint, Methi, Amaranth etc.
* Also, increase the intake of vitamin C. So, consume lots of fresh fruits like Guava, Sweet Lime, Oranges, Aavla, etc.
* Consume raw freshly sprouted pulses. It can be consumed with salads too.
* Consume Ragi (Nachni), soya bean flours. They can be mixed with wheat flour and chapatis can be made out of it.
* Consume Rice flakes (Poha) as they are good source of iron.
* Use jaggery instead of sugar, as jaggery is a good source of iron.
* Soak 2-3 dates in water at night and then in the morning, consume it with milk or with water.
Sodium and Potassium Requirements: Sodium restriction is prescribed if edema (fluid retention in body) is present. Sodium is restricted to 2 gm per day. At the same time, potassium intake is increased. Some potassium-rich foods are coconut water, water obtained after boiling Moong Dal, Amla, Guava, Sapota, Papaya, Sweet lime, Peaches, Phalsa, Plums, and Gourd vegetables like Lauki, Karela, Turai, etc.
In order to make food palatable even with less salt one should make use of pepper powder, lemon juice, etc. Also, avoid food items like Jam, Canned fruits, Sauces, Pickles, Papads, Salted biscuits, Salted dry fruits, Cheese, Butter, Potato chips, and fruits like Lichi, Pineapple. Due to restriction of salt, the food becomes less palatable and therefore the patient becomes irritable. However, we can make food palatable if we follow the following tips:
* Make the food look attractive, so garnish well. Can use coriander leaves, tomato slices, onions, etc. Use Ratanjot for natural red color. Ratanjot is a herb which gives bright red color. Make vagaar with Ratanjot, it will give bright red color to food. Can add Ratanjot in Dal, sabzi, pulav, etc.
* Always serve food hot. When food is consumed hot, one does not feel that there is less salt in food. So, serve soups, dal, sabzi hot and ask the patient to consume it hot only.
* Squeeze lemon juice from top just before serving food. This will curb the need of salt in food.
* Add jeera powder and/or black pepper and/or mango powder to food. This will make food tasty even with less salt.
* Serve food in attractive vessels.
Fluid Requirement: In case of edema, fluid restriction is necessary. Total fluid intake equals to urinary output + 500 ml per day .
Alcohol Intake: Alcohol intake should be completely restricted. Even a single drop can be deadly.
Monday, December 8, 2008
Friday, November 28, 2008
TIPS FOR INCREASING NUTRITIVE VALUE OF FOOD
1) Always consume fresh fruits & vegetables only .
2) First wash & than cut the vegetables or fruits , never wash the food item after cutting .
4) Always cut vegetables in to larger pieces to avoid more nutrient loss during cooking . This is because lesser the surface area exposed to heat lesser will be the nutrient loss .
6) When cooking vegetables in Kadai always cover it with lid .
8) Never discard the water obtained after boiling vegetables as that water is rich in nutrients ( USE THAT WATER TO PREPARE DAL OR KNEED DOUGH )
10) If vegetables are to be boiled than first boil the water & than immerse the vegetable in order to reduce the exposure time of nutrients to heat & there by reduce the nutrient destruction by heat .
Sunday, November 23, 2008
LATHYRISM
Lathyrism is a disease caused by excessive consumption of KESARI DAL . LATHYRISM gets it name from the scientific name of kesari dal which is LATHYRUS SATIVUS .Kesari dal is consumed in excess in many parts of Madhya Pradesh , Bihar & Uttar Pradesh . It is staple food in the above mentioned areas because it grows easily with minimum effort & it is comparatively cheaper than other pulses.
Excessive consumption of Kesari dal causes crippling paralysis of both the lower limbs( lathyrism ) mainly in boys & men of the age group 5-45 yers. It has been estimated that if 40 % or more of the diet consists of Kesari dal LATHYRISM manifest itself in 2-4 months . The disease starts with stiffness of the knee joint & legs with pain around the knee & ankle joints . In about 10-30 days after the onset of the symptoms paralysis of lower limbs set in
According to scientists B.O.A.A. a toxic amino acid present in the pulse is responsible for LATHYRISM . This amino acid is not found in other pulses . Till date there is no cure for Lathyrism however lathyrism can be prevented by undertaking following measures.
1) CONSUMING KESARI DAL ONLY AFTER STEEPING FOR 2-3 IN HOT WATER OR PARBOILING & DRAINING AWAY TE WATER. IN PARBOILING THE DAL IS SOAKED IN 70o C WATER FOR 3-4 HOURS & THAN STEAMING IT FOR 3-5 MINUTES . THE WATER IS THAN DISCARDED . BY THIS PROCEDURE B.O.A.A IS REMOVED .
2) NOT CONSUMING THE DAL IN LARGE QUANTITIES AT ANY TIME.
Excessive consumption of Kesari dal causes crippling paralysis of both the lower limbs( lathyrism ) mainly in boys & men of the age group 5-45 yers. It has been estimated that if 40 % or more of the diet consists of Kesari dal LATHYRISM manifest itself in 2-4 months . The disease starts with stiffness of the knee joint & legs with pain around the knee & ankle joints . In about 10-30 days after the onset of the symptoms paralysis of lower limbs set in
According to scientists B.O.A.A. a toxic amino acid present in the pulse is responsible for LATHYRISM . This amino acid is not found in other pulses . Till date there is no cure for Lathyrism however lathyrism can be prevented by undertaking following measures.
1) CONSUMING KESARI DAL ONLY AFTER STEEPING FOR 2-3 IN HOT WATER OR PARBOILING & DRAINING AWAY TE WATER. IN PARBOILING THE DAL IS SOAKED IN 70o C WATER FOR 3-4 HOURS & THAN STEAMING IT FOR 3-5 MINUTES . THE WATER IS THAN DISCARDED . BY THIS PROCEDURE B.O.A.A IS REMOVED .
2) NOT CONSUMING THE DAL IN LARGE QUANTITIES AT ANY TIME.
GINGIVITIS
Gingivitis means inflammation of the gums. It is a manifested as change in color, enlargement, bleeding, puffiness, ulceration.
CAUSES FOR GINGIVITIS:
1)The most common cause is the accumulation of TARTAR (Calculus) is the scaly yellowish or brownish hard chalk like substance that forms at the gum margins around the teeth. This tartar irritates & pushes the gums away from the teeth & causes gingivitis. Tartar contains calcium, magnesium, bacteria & fungus. As a result there is bad smell in mouth. .Hence Tartar should be removed often by the procedure called SCALING by the dentist.
2) Poor oral hygiene is also responsible for gingivitis. Owing to improper or inadequate brushing the teeth, gums become soft & lose their resistance to infection.
3) Those who have the habit of breathing through the mouth keep the lips apart when the air strikes on the gums. The dryness & the absence of the toning effect of Saliva give rise to chronic gingivitis.
4) Pregnancy alters the hormonal balance of women & their gums are prone to enlargement & bleeding which is aggravated by the presence of tartar.
5) A number of skin diseases & general diseases including Syphilis & TB manifest themselves in the inflammation of the gums.
6) Anti –Epileptic drugs causes enlargement of the gingival.
7) Leukemia reflects itself prominently in the mouth. Sometimes the bleeding, enlarged gingival is the first evidence of cancer.
8) Vitamin C deficiency predisposes to reddened, bleeding, enlarged & spongy gums.
NON MEDICAL TREATMENT:
1) Proper oral hygiene.
2) Consume lot of fresh fruits & vegetable especially Vitamin C rich fruits like Guava , plum , peaches , oranges , Aavla , sprouted cereals & grains .
3) Drink plenty of water & do not breathe through mouth.
CAUSES FOR GINGIVITIS:
1)The most common cause is the accumulation of TARTAR (Calculus) is the scaly yellowish or brownish hard chalk like substance that forms at the gum margins around the teeth. This tartar irritates & pushes the gums away from the teeth & causes gingivitis. Tartar contains calcium, magnesium, bacteria & fungus. As a result there is bad smell in mouth. .Hence Tartar should be removed often by the procedure called SCALING by the dentist.
2) Poor oral hygiene is also responsible for gingivitis. Owing to improper or inadequate brushing the teeth, gums become soft & lose their resistance to infection.
3) Those who have the habit of breathing through the mouth keep the lips apart when the air strikes on the gums. The dryness & the absence of the toning effect of Saliva give rise to chronic gingivitis.
4) Pregnancy alters the hormonal balance of women & their gums are prone to enlargement & bleeding which is aggravated by the presence of tartar.
5) A number of skin diseases & general diseases including Syphilis & TB manifest themselves in the inflammation of the gums.
6) Anti –Epileptic drugs causes enlargement of the gingival.
7) Leukemia reflects itself prominently in the mouth. Sometimes the bleeding, enlarged gingival is the first evidence of cancer.
8) Vitamin C deficiency predisposes to reddened, bleeding, enlarged & spongy gums.
NON MEDICAL TREATMENT:
1) Proper oral hygiene.
2) Consume lot of fresh fruits & vegetable especially Vitamin C rich fruits like Guava , plum , peaches , oranges , Aavla , sprouted cereals & grains .
3) Drink plenty of water & do not breathe through mouth.
Tuesday, October 14, 2008
GOITER & GOITROGENS IN FOOD
Iodine is an essential micro nutrient for all animal species & iodine deficiency is among the most prevalent nutritional problem in many developing countries.
In 1928 Chesney & his colleagues at Johns Hopkin Hospital made the chance observation that rabbits rose in the laboratory for the study of Syphilis & fed largely on Cabbage developed Goiter .This observation was followed up by Charles Hercus & his colleague in New Zealand .They established the goitrogenic properties of Cabbage, Turnip & particularly the seeds of Cabbage, Mustard & Rye. A large number of food stuffs possess anti-thyroid agents collectively designated as Goitrogens.
Depending upon the level of interference the goitrogens have been categorized into three classes.
CLASS 1 GOITROGENS:
Are those which inhibit the Iodine uptake by Thyroid gland.These are Thiocynate, Isothiocynate & cyanogenic glucosides.
CLASS 2 GOITROGENS:
Are those which affect the stages of Organification & coupling in the process of Thyroxin synthesis.These are Thiourea & Flavonoides.
CLASS 3 GOITROGENS:
Are those which interfere at the stage of Proteolysis-a step necessary for utilization of Thyroxine.These are Iodine itself when it is in excess & lithium.
In Sudan endemic Goiter & Iodine deficiency disorders are serious health problems.In these areas Iodine deficiency was identified as the principal etiologic factor. However consumption of Pearl Millet ( Bajra) was suggested as an instrumental factor in the etiology of Endemic Goiter in Western Sudan. Pearl millet or Bajra is the main source of food energy for the rural people in many areas of semiarid tropics. Studies showed that the goitrogenic substance was present in both bran & endosperm portions of the grain & was not destroyed by grain fermentation however autoclaving reduced the goitrogeic properties of Pearl Millet.The Goitrogenic substances present in Pearl Millet are Glycosyl Vitexin, Glycosyl Orientin & Vitexin.
Sorghum ( Jowar ) like Pearl Millet ( Bajra ) also contains goitrogenic substance .The goitrogen in Sorghum is known as Dhurin. Cassava is cultivated extensively in developing countries & represents an essential dietary source of energy for more than 200 million people in the tropics.Casava has been demonstrated in the etiology of endemic Goiter & endemic Cretinism in Zaire.Casava contained Linamarin which is groitrogenic substance.The proper processing of Cassava-drying , soaking in water , rinsing or baking effectively reduces Cassava’s Linamarin content. Vegetables from Cruciferae family like Cabbage , Broccoli , Turnip etc also contain goitrogens.However with heating they get destroyed. Soya bean even the processed ones have anti thyroid properties. Genistein & Daizein are much touted for their health benefits but what is unpublicized is they are anti-thyroid agents.Therefore individuals who consume Soyabean products habitually may encounter thyroid disturbances.
Thus foods containing goitrogens should not be eaten regularly or in large amounts without adequate processing .However the same foods can be used in the treatment of hyperthyroidism.
In 1928 Chesney & his colleagues at Johns Hopkin Hospital made the chance observation that rabbits rose in the laboratory for the study of Syphilis & fed largely on Cabbage developed Goiter .This observation was followed up by Charles Hercus & his colleague in New Zealand .They established the goitrogenic properties of Cabbage, Turnip & particularly the seeds of Cabbage, Mustard & Rye. A large number of food stuffs possess anti-thyroid agents collectively designated as Goitrogens.
Depending upon the level of interference the goitrogens have been categorized into three classes.
CLASS 1 GOITROGENS:
Are those which inhibit the Iodine uptake by Thyroid gland.These are Thiocynate, Isothiocynate & cyanogenic glucosides.
CLASS 2 GOITROGENS:
Are those which affect the stages of Organification & coupling in the process of Thyroxin synthesis.These are Thiourea & Flavonoides.
CLASS 3 GOITROGENS:
Are those which interfere at the stage of Proteolysis-a step necessary for utilization of Thyroxine.These are Iodine itself when it is in excess & lithium.
In Sudan endemic Goiter & Iodine deficiency disorders are serious health problems.In these areas Iodine deficiency was identified as the principal etiologic factor. However consumption of Pearl Millet ( Bajra) was suggested as an instrumental factor in the etiology of Endemic Goiter in Western Sudan. Pearl millet or Bajra is the main source of food energy for the rural people in many areas of semiarid tropics. Studies showed that the goitrogenic substance was present in both bran & endosperm portions of the grain & was not destroyed by grain fermentation however autoclaving reduced the goitrogeic properties of Pearl Millet.The Goitrogenic substances present in Pearl Millet are Glycosyl Vitexin, Glycosyl Orientin & Vitexin.
Sorghum ( Jowar ) like Pearl Millet ( Bajra ) also contains goitrogenic substance .The goitrogen in Sorghum is known as Dhurin. Cassava is cultivated extensively in developing countries & represents an essential dietary source of energy for more than 200 million people in the tropics.Casava has been demonstrated in the etiology of endemic Goiter & endemic Cretinism in Zaire.Casava contained Linamarin which is groitrogenic substance.The proper processing of Cassava-drying , soaking in water , rinsing or baking effectively reduces Cassava’s Linamarin content. Vegetables from Cruciferae family like Cabbage , Broccoli , Turnip etc also contain goitrogens.However with heating they get destroyed. Soya bean even the processed ones have anti thyroid properties. Genistein & Daizein are much touted for their health benefits but what is unpublicized is they are anti-thyroid agents.Therefore individuals who consume Soyabean products habitually may encounter thyroid disturbances.
Thus foods containing goitrogens should not be eaten regularly or in large amounts without adequate processing .However the same foods can be used in the treatment of hyperthyroidism.
Sunday, October 12, 2008
BLOOD PRESSURE & HYPERTENSION
Classification of Blood Pressure for adults :
CATEGORY SYSTOLIC / DIASTOLIC
Optimal < 120 mmHg / <80 mmHg
Normal <130 mmHg / < 85 mmHg
High Normal 130-139 mmHg / 85-89mmHg
(are at a risk )
Mild Hypertension 140-159 mmHg / 90-99 mmHg
Moderate Hypertension 160-179 mmHg / 100-109 mmHg
Severe Hypertension 180-209 mmHg / 110-119 mmHg
Very Severe Hypertension >210 mmHg / >120 mmHg
CATEGORY SYSTOLIC / DIASTOLIC
Optimal < 120 mmHg / <80 mmHg
Normal <130 mmHg / < 85 mmHg
High Normal 130-139 mmHg / 85-89mmHg
(are at a risk )
Mild Hypertension 140-159 mmHg / 90-99 mmHg
Moderate Hypertension 160-179 mmHg / 100-109 mmHg
Severe Hypertension 180-209 mmHg / 110-119 mmHg
Very Severe Hypertension >210 mmHg / >120 mmHg
Wednesday, October 1, 2008
CAUSES OF DENTAL CARIES
TEETH ARE LIKE WIVES WHEN THEY ARE THEIR WE FIGHT WITH THEM & WHEN WE LOSE THEM WE CRY. THIS IS AN OLD SAYING. A major reason due to which we lose teeth is dental caries. In order to protect them from decay we should first know what causes decay.
1) ACID REFLUX DISORDERS :
Both gastric reflux & self induced vomiting observed in eating disorders commonly irritate oral tissue & destroy dental enamel. The extent of oral tissue damage depends on the frequency of the purging & cariogenicity of the diet. The most obvious symptom of bulimia is loss of tooth enamel because of frequent self induced vomiting.
2) LACK OF SALIVARY FLOW :
Saliva has anti bacterial & neutralizing properties. These two properties are of significance as caries is a disease where bacteria &acids are involved. The average amount of salivary secretions in 24 hours is roughly estimates as 1& ½ lts .The flow is not steady in an individual as rate of secretion is influenced by various factors. The condition of dryness of mouth called XEROSTOMIA may be caused by number of diseases that interrupt the secretary nerve pathway. A regular flow of saliva aids in bringing down the caries rate. Individuals who have to undergo radiation of the parotid salivary gland of left side develop more caries on the left side because of decreases salivary flow in left side.
3) MEDICATIONS USED:
Several categories of medications can affect the integrity of the oral mucosa, taste, sensation & salivary production. Care should be taken to assess the effects of medications in the oral cavity & how these effects can be minimized by alterations in diet or during therapy. The following medications affect teeth
- Anti anxiety agents
- Anti depressants
- Anti histamines
- Anti hypertensives
- Diuretics
- Sedatives
- Tranquilizers
4) NUTRITIONAL DEFICIENCY:
Nutrition plays a significant part in the caries incidence. Deficiency of Vitamin A, C, D & proteins in infants & children result in their teeth being more vulnerable to decay than those of others. Lady Mallenby, the famous British dental researcher who studied the nutritional aspect of dental caries for over 30 years demonstrated that adequate supplements of Vitamins, Calcium & Phosphorus to diets brought an appreciable drop in caries incidence.
5) SOFT FOOD :
Today's finely powdered flour without a trace of husk harms the teeth of people as food made from refines flour needs no chewing & it rapidly forms into a sticky mass that adheres to the teeth .
1) ACID REFLUX DISORDERS :
Both gastric reflux & self induced vomiting observed in eating disorders commonly irritate oral tissue & destroy dental enamel. The extent of oral tissue damage depends on the frequency of the purging & cariogenicity of the diet. The most obvious symptom of bulimia is loss of tooth enamel because of frequent self induced vomiting.
2) LACK OF SALIVARY FLOW :
Saliva has anti bacterial & neutralizing properties. These two properties are of significance as caries is a disease where bacteria &acids are involved. The average amount of salivary secretions in 24 hours is roughly estimates as 1& ½ lts .The flow is not steady in an individual as rate of secretion is influenced by various factors. The condition of dryness of mouth called XEROSTOMIA may be caused by number of diseases that interrupt the secretary nerve pathway. A regular flow of saliva aids in bringing down the caries rate. Individuals who have to undergo radiation of the parotid salivary gland of left side develop more caries on the left side because of decreases salivary flow in left side.
3) MEDICATIONS USED:
Several categories of medications can affect the integrity of the oral mucosa, taste, sensation & salivary production. Care should be taken to assess the effects of medications in the oral cavity & how these effects can be minimized by alterations in diet or during therapy. The following medications affect teeth
- Anti anxiety agents
- Anti depressants
- Anti histamines
- Anti hypertensives
- Diuretics
- Sedatives
- Tranquilizers
4) NUTRITIONAL DEFICIENCY:
Nutrition plays a significant part in the caries incidence. Deficiency of Vitamin A, C, D & proteins in infants & children result in their teeth being more vulnerable to decay than those of others. Lady Mallenby, the famous British dental researcher who studied the nutritional aspect of dental caries for over 30 years demonstrated that adequate supplements of Vitamins, Calcium & Phosphorus to diets brought an appreciable drop in caries incidence.
5) SOFT FOOD :
Today's finely powdered flour without a trace of husk harms the teeth of people as food made from refines flour needs no chewing & it rapidly forms into a sticky mass that adheres to the teeth .
Tuesday, September 30, 2008
OSTEOPOROSIS
Osteoporosis is typically defined as reduction in bone mineral mass that results in decreased bone strength & increased susceptibility to fracture with only mild or moderate trauma.It is a major health problem through out the world owing to the morbidity, mortality & cost of care which are consequence of the fractures.Osteoporosis is classified as Primary & Secondary Osteoporosis.
Primary Osteoporosis is further classified as Post menopausal & Age Related Osteoporosis.
Secondary Osteoporosis is caused due to long term Glucocorticoid treatment. Glucocorticoids are a class of drugs used to treat a range of chronic inflammatory diseases such as Inflammatory Bowel Disease, Asthma , other respiratory disorders & to suppress the rejection of transplanted organs. Adverse effects associated with the use of Glucocorticoids are decreased intestinal absorption & increased urinary excretion of Calcium, inhibition of Osteoblast function and increased bone resorption.Each of these mechanism result in accelerated bone loss & increase risk of fracture.Osteoporosis occurs in more than half of patients who receive long term Glucocoricoid treatment. Secondary Osteoporosis is also caused by elevated levels of thyroid hormone whether due to thyrotoxicosis or excess replacement therapy in Hypothyroidism.The thyroid hormone acts on Osteoclasts indirectly through the Osteoblasts therefore bone resorption exceeds bone formation thus resulting in Bone loss.
Age related Osteoporosis is seen in both males & females. Bone density decreases with age due to decline in physical activity & decreased Calcium intake. Evidence suggests that initiating exercise in older people who were initially sedentary individuals has increased their bone density & slowed bone loss.
Till now it is clear to you that not only Post menopausal women suffers from Osteoporosis but also men & women who have received Glucocorticoid treatment for a very long time or have elevated levels of Thyroid hormone or are not exercising suffer from Osteoporosis. Alcoholics are also at a risk of developing Osteoporosis. Since Ethanol damages the liver thereby the synthesis of 25(OH) Colicalciferol ( a form of Vitamin D) is reduced.Vitamin D is necessary for absorption of Calcium. Also excess of Ethanol causes low Testosterone levels & decreased Testosterone levels leads to Osteoporosis.
Thus the belief of many people that only elderly women are victims of Osteoporosis is in correct.
Primary Osteoporosis is further classified as Post menopausal & Age Related Osteoporosis.
Secondary Osteoporosis is caused due to long term Glucocorticoid treatment. Glucocorticoids are a class of drugs used to treat a range of chronic inflammatory diseases such as Inflammatory Bowel Disease, Asthma , other respiratory disorders & to suppress the rejection of transplanted organs. Adverse effects associated with the use of Glucocorticoids are decreased intestinal absorption & increased urinary excretion of Calcium, inhibition of Osteoblast function and increased bone resorption.Each of these mechanism result in accelerated bone loss & increase risk of fracture.Osteoporosis occurs in more than half of patients who receive long term Glucocoricoid treatment. Secondary Osteoporosis is also caused by elevated levels of thyroid hormone whether due to thyrotoxicosis or excess replacement therapy in Hypothyroidism.The thyroid hormone acts on Osteoclasts indirectly through the Osteoblasts therefore bone resorption exceeds bone formation thus resulting in Bone loss.
Age related Osteoporosis is seen in both males & females. Bone density decreases with age due to decline in physical activity & decreased Calcium intake. Evidence suggests that initiating exercise in older people who were initially sedentary individuals has increased their bone density & slowed bone loss.
Till now it is clear to you that not only Post menopausal women suffers from Osteoporosis but also men & women who have received Glucocorticoid treatment for a very long time or have elevated levels of Thyroid hormone or are not exercising suffer from Osteoporosis. Alcoholics are also at a risk of developing Osteoporosis. Since Ethanol damages the liver thereby the synthesis of 25(OH) Colicalciferol ( a form of Vitamin D) is reduced.Vitamin D is necessary for absorption of Calcium. Also excess of Ethanol causes low Testosterone levels & decreased Testosterone levels leads to Osteoporosis.
Thus the belief of many people that only elderly women are victims of Osteoporosis is in correct.
SOME INSTRUCTIONS FOR DIABETICS
Diabetic individual should not only take care of their diet but also should follow the below mentioned instructions.
1) Diabetic individuals should avoid injuries to their skin .Therefore should take care while shaving. If there is a skin injury than the wound should be immediately cleaned & disinfected.
2) If there is an injury do not apply strong medicine like tincture of iodine , carbolic acid, salicylic acid .on the wound instead apply mild antiseptics like mercurochrome , acriflavine or furazolidine.
3) A diabetic should always avoid injury to his feet. They should keep their feet clean for this wash the feet at least twice with warm water & also check the feet for any cut or rashes.
4) Should take lot of care while cutting his nails of feet.
5) Should never cut corns on his soles himself. For this he/ she should visit a physician.
6) A diabetic should never move bare-footed.
7) Should never wear underwear that is tight around the thighs.
8) Diabetic individuals should not sit cross-legged (with one knee lying above the other) for very long time.
9) Avoid nylon socks instead wear cotton socks. Nylon socks impede blood circulation.
Sunday, September 28, 2008
HALITOSIS
Halitosis means bad breathe. It is due to various causes
A ) Dieting : Dieters may develop unpleasant breathe due to restriction of Carbohydrates. By restricting Carbohydrate the body utilize fat for energy purpose when fat are utilized in the body ketone bodies (Acetone , Acetoacetate , Beta hydroxy butyrate ) are formed .Acetone is expelled through lungs.
B ) Diabetes : Diabetics also develop unpleasant breath due to the above reason.
C ) Xerostomia : Halitosis is also caused by Xerostomia. Xerostomia refers to dryness of mouth resulting from diminished secretion of saliva.
D ) Food : Vegetables like Garlic , onion also cause objectionable breathe.
E ) Periodontal Disease : Disease of gums are also responsible for Halitosis.
F ) Indigestion & Constipation : are another cause of bad breathe
Flossing , Brushing & use of mouth fresheners will mask Halitosis for a short while. One may not get rid of Halitosis unless the underlying cause is treated.
A ) Dieting : Dieters may develop unpleasant breathe due to restriction of Carbohydrates. By restricting Carbohydrate the body utilize fat for energy purpose when fat are utilized in the body ketone bodies (Acetone , Acetoacetate , Beta hydroxy butyrate ) are formed .Acetone is expelled through lungs.
B ) Diabetes : Diabetics also develop unpleasant breath due to the above reason.
C ) Xerostomia : Halitosis is also caused by Xerostomia. Xerostomia refers to dryness of mouth resulting from diminished secretion of saliva.
D ) Food : Vegetables like Garlic , onion also cause objectionable breathe.
E ) Periodontal Disease : Disease of gums are also responsible for Halitosis.
F ) Indigestion & Constipation : are another cause of bad breathe
Flossing , Brushing & use of mouth fresheners will mask Halitosis for a short while. One may not get rid of Halitosis unless the underlying cause is treated.
NON-MEDICAL TREATMENT OF OSTEOPOROSIS
Osteoporosis is a condition in which the bone mass reduces. As a result of which fracture of bone occurs even with mild trauma. Here are some non medical measures to prevent reduction in bone mass .
A ) CALCIUM INTAKE :
Osteoporosis can be prevented by achieving maximum bone mass during growth & maintaining proper calcium intake throughout life.
Rich Food Sources Of Calcium
FOOD ITEM & CALCIUM CONTENT
Ragi( Nachni ) - 344 mg/100 gms
Channa - 202
Matki - 202
Rajmah - 260
Soya bean - 240
Amaranth Leafy Veg -530
Arbi Ke patte - 460
( black variety )
Lotus stem dry - Veg. 405
Apricot dry - 110
Dates dried - 120
Milk buffalo's- 210
Curds cow's milk - 149
Cheese - 790
Paneer -cow's milk - 208
Paneer-buffalo's milk 480
Mutton muscles - 150
All fishes & dry fruits are rich sources of calcium
B ) SODIUM INTAKE :
In order to prevent resorption of bone one should not take Sodium in excess amounts. Sodium causes an increase in renal Calcium excretion. For each 500 mg increase in Sodium excretion there is approximately a 10 mg increase in the amount of Calcium lost in urine.The major source of Sodium in our diet is the Common salt. Also preserved food items like jam, pickles papads , canned fruits contain high amounts of Sodium.Therefore elderly people who may not be suffering from Hypertension should still consume less Sodium.
C ) INTAKE OF CAFFEINE :
Caffeine ingestion causes a short term increase in urinary calcium loss.Such a temporary increase may have a minor effect on net calcium balance.However older individuals with low calcium intake will be affected greatly.Therefore intake of Coffee should be reduced .
D ) PROTEIN INTAKE :
Elderly people should avoid taking excess of protein because excess of protein is not stored in body .It is metabolized & excreted therefore with increase in urinary loss of protein there is increase in urinary Calcium loss.
E ) ALCOHOL INTAKE :
Restrict the intake of alcohol. Since ethanol damages the liver as a result synthesis of Vitamin D is affected. Vitamin D is required for the absorption of Calcium from the intestine .
A ) CALCIUM INTAKE :
Osteoporosis can be prevented by achieving maximum bone mass during growth & maintaining proper calcium intake throughout life.
Rich Food Sources Of Calcium
FOOD ITEM & CALCIUM CONTENT
Ragi( Nachni ) - 344 mg/100 gms
Channa - 202
Matki - 202
Rajmah - 260
Soya bean - 240
Amaranth Leafy Veg -530
Arbi Ke patte - 460
( black variety )
Lotus stem dry - Veg. 405
Apricot dry - 110
Dates dried - 120
Milk buffalo's- 210
Curds cow's milk - 149
Cheese - 790
Paneer -cow's milk - 208
Paneer-buffalo's milk 480
Mutton muscles - 150
All fishes & dry fruits are rich sources of calcium
B ) SODIUM INTAKE :
In order to prevent resorption of bone one should not take Sodium in excess amounts. Sodium causes an increase in renal Calcium excretion. For each 500 mg increase in Sodium excretion there is approximately a 10 mg increase in the amount of Calcium lost in urine.The major source of Sodium in our diet is the Common salt. Also preserved food items like jam, pickles papads , canned fruits contain high amounts of Sodium.Therefore elderly people who may not be suffering from Hypertension should still consume less Sodium.
C ) INTAKE OF CAFFEINE :
Caffeine ingestion causes a short term increase in urinary calcium loss.Such a temporary increase may have a minor effect on net calcium balance.However older individuals with low calcium intake will be affected greatly.Therefore intake of Coffee should be reduced .
D ) PROTEIN INTAKE :
Elderly people should avoid taking excess of protein because excess of protein is not stored in body .It is metabolized & excreted therefore with increase in urinary loss of protein there is increase in urinary Calcium loss.
E ) ALCOHOL INTAKE :
Restrict the intake of alcohol. Since ethanol damages the liver as a result synthesis of Vitamin D is affected. Vitamin D is required for the absorption of Calcium from the intestine .
NON-MEDICAL TREATMENT OF HYPERTENSION
Hypertension means high blood pressure.There are various causes of Hypertension. Below are some non medical measures to cure Hypertension.
A ) SODIUM RESTRICTION :
Normally 10-15 gms of salt is consumed daily .Individuals suffering from Hypertension should consume 2-3 gms of salt daily. In order to make food palatable even with less salt one should make use of pepper powder , lemon juice etc . Also avoid food items like Jam , Canned fruits, Sauces, Pickles , Papads , Salted biscuits , Salted dry fruits, Cheese , Butter , Potato chips & fruits like Lichi , Pineapple
Due to restriction of salt, the food becomes less palatable & therefore the patient becomes irritable. However we can make food palatable if we follow the following tips .
1) Make the food look attractive . So garnish well . Can use coriander leaves , tomato slices , onions etc. Use Ratanjot for natural red colour . Ratajot is a herb which gives bright red colour . Make vagaar with Ratanjot , It will give bright red colour to food. Can add Ratanjot in Dal , sabzi , pulav etc.
2) Always serve food hot . When food is consumed hot one does not feel that there is less salt in food.. So serve soups , dal , sabzi hot & ask the patient to consume it hot only .
3) Squeeze lemon juice from top just before serving food . This will curb the need of salt inn food.
4) Add jeera powder or / & black pepper or / & mango powder to food . This will make food tasty even with less salt .
5) Serve food in attractive vessels .
B ) INCREASE THE INTAKE OF POTASSIUM RICH FOODS :
Some Potassium rich foods are Coconut water, Water obtained after boiling Moong Dal, Amla, Guava , Sapota, Papaya, Sweet lime , Peaches , Phalsa , Plums & Gourd vegetables like Lauki , Karela , Turai etc.
C ) WEIGHT REDUCTION :
Weight is directly correlated with blood pressure. Therefore with increase in weight BP increases. So reducing weight at times help to reduce Blood Pressure .
D ) EXERCISES :
Exercises reduce Blood Pressure is a proven fact .It should be noted that only ISOTONIC EXERCISES are beneficial. Such exercises include walking , jogging , swimming , cycling. ISOMETRIC EXERCISES like weight- lifting are not beneficial in reducing Blood Pressure.
E ) EK KALI KA JAMMU KA GARLIC :
The ek kali ka Jammu ka garlic has been found useful in lowering Blood Pressure . One should consume daily one ek kali ka garlic empty stomach with warm water.
F ) RESTRICT INTAKE OF ALCOHOL :
G ) QUIT SMOKING :
A ) SODIUM RESTRICTION :
Normally 10-15 gms of salt is consumed daily .Individuals suffering from Hypertension should consume 2-3 gms of salt daily. In order to make food palatable even with less salt one should make use of pepper powder , lemon juice etc . Also avoid food items like Jam , Canned fruits, Sauces, Pickles , Papads , Salted biscuits , Salted dry fruits, Cheese , Butter , Potato chips & fruits like Lichi , Pineapple
Due to restriction of salt, the food becomes less palatable & therefore the patient becomes irritable. However we can make food palatable if we follow the following tips .
1) Make the food look attractive . So garnish well . Can use coriander leaves , tomato slices , onions etc. Use Ratanjot for natural red colour . Ratajot is a herb which gives bright red colour . Make vagaar with Ratanjot , It will give bright red colour to food. Can add Ratanjot in Dal , sabzi , pulav etc.
2) Always serve food hot . When food is consumed hot one does not feel that there is less salt in food.. So serve soups , dal , sabzi hot & ask the patient to consume it hot only .
3) Squeeze lemon juice from top just before serving food . This will curb the need of salt inn food.
4) Add jeera powder or / & black pepper or / & mango powder to food . This will make food tasty even with less salt .
5) Serve food in attractive vessels .
B ) INCREASE THE INTAKE OF POTASSIUM RICH FOODS :
Some Potassium rich foods are Coconut water, Water obtained after boiling Moong Dal, Amla, Guava , Sapota, Papaya, Sweet lime , Peaches , Phalsa , Plums & Gourd vegetables like Lauki , Karela , Turai etc.
C ) WEIGHT REDUCTION :
Weight is directly correlated with blood pressure. Therefore with increase in weight BP increases. So reducing weight at times help to reduce Blood Pressure .
D ) EXERCISES :
Exercises reduce Blood Pressure is a proven fact .It should be noted that only ISOTONIC EXERCISES are beneficial. Such exercises include walking , jogging , swimming , cycling. ISOMETRIC EXERCISES like weight- lifting are not beneficial in reducing Blood Pressure.
E ) EK KALI KA JAMMU KA GARLIC :
The ek kali ka Jammu ka garlic has been found useful in lowering Blood Pressure . One should consume daily one ek kali ka garlic empty stomach with warm water.
F ) RESTRICT INTAKE OF ALCOHOL :
G ) QUIT SMOKING :
NON-MEDICAL TREATMENT OF OBESITY
Obesity is a major health problem in India & abroad. The main reasons are faulty diet & changed life style. It has been found that Obesity is the root of most of the other ailments. Today various drugs are available which instantly reduce weight & even there are surgical processes like liposuction which remove the fat from the desired area of a person's body. Since these medicines are very expensive & have site effects too it is better if we modify our food habits & life style pattern to reduce weight.
A) In order to reduce weight one should be self motivated
.
B) Before starting with weight reduction program, one should know the exact cause of his or her weight increase. Weight gain can be due to faulty food habit, hormonal imbalance eg) HYPOTHYROIDISM, due to medicines, lack of exercise or may due to Menopause in women.
C) Dietary modification alone does not help to reduce weight one needs to exercise also.
D) Dieting does not mean starving . People often think that by starving they will lose weight. It is true that by starving one will lose weight but it is not an ideal approach for weight reduction as one may lose his or her muscle mass along with fat by starving .
E). The Obese or Overweight individual should include following food items in his or diet.
- Whole Wheat & its products.
- Brown Rice & its products.
- Whole pulses
- Fruits like Papaya, water melon, Guava, Apple, Pineapple, Pomegranate.
- Skim Cow's milk
- Green Leafy Vegetables
- Soups without Cream or butter
- Salads without Salad Dressings
F) The Obese or Overweight individual should avoid following food items in his or diet .
- Refined Wheat Flour & its products.
- Fruits like Banana, Sapota, Grapes, Lichi, Cherry, Plums, and Mango.
- Fruit juices & coconut water
- Dry fruits like Almonds, dates, Cashew nuts.
- Cheese, Butter, Paneer, ghee
- Any sweets
- Jam, Jelly, Pickles.
- Potatoes , Sweet Potatoes , Colocasia ( ARBI )
- Red Meat , Egg Yolk
- Soft & Hard Drinks
G) Include boiled , baked foods products instead of fried ones.
H) A person who is following a weight reduction program should take 6 meals in a day. These are
- BREAK FAST ........around 8.00 TO 8.30 am
- MID MORNING........ “10.30 TO 11.00 am
- LUNCH .................. “1.00 TO 1.30 pm
- TEA ...................... “4.00 TO 4.30 pm
- DINNER ................ “8.30 TO 9.00 pm
- BED TIME ............. “10.00 TO 10.30 pm
.
I) The person should not skip any meal because he or she may eat more in the next meal
J) Avoid watching TV, reading books or telephonic conversation while eating food. As all these activities make the individual eat more.
K) Consume salads or soup 15-20 minutes prior to the main meal. As this will help the person to eat less
L) Chew the food well before swallowing.
M) Along with dietary modifications & exercise a slight change in draping style also helps in weight reduction by changing the Psychology of person. Some Sartorial tips for obese man & woman are as follows.
- Obese or Over weight individuals should avoid loose fitting clothes
- Obese man should wear Vertical stripped Shirts & T-shirts . Vertical stripped shirts will make them look tall & slim
- They should avoid floral or big prints on their shirts.
- Should wear full trousers.
- Should avoid Double breast coats.
- Obese or Over weight women should not wear short dresses.
- Should wear Chudidaars instead odd salvars
- Should wear saris made of Silk or Chiffon which will help them to look slimmer.
- Should avoid big prints on their dresses.
N) Last but not least a very simple but effective technique which helps in weight reduction by motivating the individual . The individual should hang on the walls of the room where he or she spends most of the time, his or her photographs in which he or she used to look slim, smart, young & beautiful.
O) Once an individual reduces weight & achieves ideal body weight for his or her age & height. He or she should continue to follow balance diet & should exercise regularly, other wise the person will regain weight.
A) In order to reduce weight one should be self motivated
.
B) Before starting with weight reduction program, one should know the exact cause of his or her weight increase. Weight gain can be due to faulty food habit, hormonal imbalance eg) HYPOTHYROIDISM, due to medicines, lack of exercise or may due to Menopause in women.
C) Dietary modification alone does not help to reduce weight one needs to exercise also.
D) Dieting does not mean starving . People often think that by starving they will lose weight. It is true that by starving one will lose weight but it is not an ideal approach for weight reduction as one may lose his or her muscle mass along with fat by starving .
E). The Obese or Overweight individual should include following food items in his or diet.
- Whole Wheat & its products.
- Brown Rice & its products.
- Whole pulses
- Fruits like Papaya, water melon, Guava, Apple, Pineapple, Pomegranate.
- Skim Cow's milk
- Green Leafy Vegetables
- Soups without Cream or butter
- Salads without Salad Dressings
F) The Obese or Overweight individual should avoid following food items in his or diet .
- Refined Wheat Flour & its products.
- Fruits like Banana, Sapota, Grapes, Lichi, Cherry, Plums, and Mango.
- Fruit juices & coconut water
- Dry fruits like Almonds, dates, Cashew nuts.
- Cheese, Butter, Paneer, ghee
- Any sweets
- Jam, Jelly, Pickles.
- Potatoes , Sweet Potatoes , Colocasia ( ARBI )
- Red Meat , Egg Yolk
- Soft & Hard Drinks
G) Include boiled , baked foods products instead of fried ones.
H) A person who is following a weight reduction program should take 6 meals in a day. These are
- BREAK FAST ........around 8.00 TO 8.30 am
- MID MORNING........ “10.30 TO 11.00 am
- LUNCH .................. “1.00 TO 1.30 pm
- TEA ...................... “4.00 TO 4.30 pm
- DINNER ................ “8.30 TO 9.00 pm
- BED TIME ............. “10.00 TO 10.30 pm
.
I) The person should not skip any meal because he or she may eat more in the next meal
J) Avoid watching TV, reading books or telephonic conversation while eating food. As all these activities make the individual eat more.
K) Consume salads or soup 15-20 minutes prior to the main meal. As this will help the person to eat less
L) Chew the food well before swallowing.
M) Along with dietary modifications & exercise a slight change in draping style also helps in weight reduction by changing the Psychology of person. Some Sartorial tips for obese man & woman are as follows.
- Obese or Over weight individuals should avoid loose fitting clothes
- Obese man should wear Vertical stripped Shirts & T-shirts . Vertical stripped shirts will make them look tall & slim
- They should avoid floral or big prints on their shirts.
- Should wear full trousers.
- Should avoid Double breast coats.
- Obese or Over weight women should not wear short dresses.
- Should wear Chudidaars instead odd salvars
- Should wear saris made of Silk or Chiffon which will help them to look slimmer.
- Should avoid big prints on their dresses.
N) Last but not least a very simple but effective technique which helps in weight reduction by motivating the individual . The individual should hang on the walls of the room where he or she spends most of the time, his or her photographs in which he or she used to look slim, smart, young & beautiful.
O) Once an individual reduces weight & achieves ideal body weight for his or her age & height. He or she should continue to follow balance diet & should exercise regularly, other wise the person will regain weight.
NON-MEDICAL TREATMENT OF IRON DEFICIENCY ANEMIA
Anemia is a condition where in there is low levels of Hb in blood . As a result of which the individual appears pale , lacks good appetite,gets easily tired & also frequently complaints of headache & nausea. Anemia is caused due to excessive loss of blood , heredity , lack of iron in diet , lack of vitamin C in diet , long term use of malaria drugs etc. Non medical treatment of Anemia is as follows.
A) Increase the intake of Green leafy vegetables like Spinach , Mint , Methi , Amranth etc.
B) Also increase the intake of Vitamin C . So consume lots of fresh fruits like Guava , Sweet lime , Oranges , Aavla etc
C) Consume raw freshly sprouted pulses . It can consumed with salads too.
D) Consume Ragi ( Nachni ) , Soya bean flours . They can be mixed with wheat flour & chapatis can be made out of it.
E) Consume Rice flakes ( Poha ) as they are good source of Iron.
F) Use gur instead of sugar . As gur is a good source of Iron.
G) Soak 2-3 dates in water in night & than in morning consume it with milk or with water.
H) Red meat is also good but it will also increase the weight.
A) Increase the intake of Green leafy vegetables like Spinach , Mint , Methi , Amranth etc.
B) Also increase the intake of Vitamin C . So consume lots of fresh fruits like Guava , Sweet lime , Oranges , Aavla etc
C) Consume raw freshly sprouted pulses . It can consumed with salads too.
D) Consume Ragi ( Nachni ) , Soya bean flours . They can be mixed with wheat flour & chapatis can be made out of it.
E) Consume Rice flakes ( Poha ) as they are good source of Iron.
F) Use gur instead of sugar . As gur is a good source of Iron.
G) Soak 2-3 dates in water in night & than in morning consume it with milk or with water.
H) Red meat is also good but it will also increase the weight.
NON-MEDICAL TRATMENT OF ESOPHAGITIS
Esophagitis refers to the inflammation of esophageal mucosa.Common symptom is heart burn. Esophagitis is classified as Acute & Chronic Esophagitis. Now depending upon the fact that you are suffering from Chronic or Acute here is the treatment
1 ) ACUTE ESOPHAGITIS : Is caused by ingestion of irritating agent like alcohol , spicy food & also by intubation.The condition may persist for 1-2 days.
A ) Dietary treatment include consumption of liquids.The individual is asked to be on a liquid diet for a day or two.
B ) Also citrus fruits like orange , sweet lime & spices like pepper , chilli powder should be avoided.
C ) Tomato Juice or soup should be avoided.
D) Milk & Curd should be taken.
2 ) CHRONIC ESOPHAGITIS : Chronic esophagitis is a result of recurrent gastroesophageal reflux due to hiatal hernia or reduced lower esophageal pressure ( LES) or by recurrent vomiting.Condition persists for a long period .
A ) Dietary treatment include avoidance of Citrus fruits & vegetables
B) Also avoidance of alcohol, chocolates, coffee, spicy food & fried foods.
C) Other measures include reduction of weight .
D) Avoidance of tight fitting clothes especially after meals.
E ) Avoidance of lying down on bed immediately after eating meals and quiting smoking.
1 ) ACUTE ESOPHAGITIS : Is caused by ingestion of irritating agent like alcohol , spicy food & also by intubation.The condition may persist for 1-2 days.
A ) Dietary treatment include consumption of liquids.The individual is asked to be on a liquid diet for a day or two.
B ) Also citrus fruits like orange , sweet lime & spices like pepper , chilli powder should be avoided.
C ) Tomato Juice or soup should be avoided.
D) Milk & Curd should be taken.
2 ) CHRONIC ESOPHAGITIS : Chronic esophagitis is a result of recurrent gastroesophageal reflux due to hiatal hernia or reduced lower esophageal pressure ( LES) or by recurrent vomiting.Condition persists for a long period .
A ) Dietary treatment include avoidance of Citrus fruits & vegetables
B) Also avoidance of alcohol, chocolates, coffee, spicy food & fried foods.
C) Other measures include reduction of weight .
D) Avoidance of tight fitting clothes especially after meals.
E ) Avoidance of lying down on bed immediately after eating meals and quiting smoking.
BABY BOTTLE TOOTH DECAY
Baby Bottle Tooth Decay ( B B T D ) is the term adopted in 1986 by the Healthy Mothers Healthy Babies Oral Health Coalition to describe the decay of primary maxillary incisors that occurs due to prolonged bottle feeding in young children.
BBTD is commonly found in children who are given a bottle of milk or sugared liquid to nurse during the day or when the baby is put to bed.The position of the tongue is such that it causes the liquid to be in constant contact with the maxillary incisors thus encouraging bacterial growth. Generally the incisors of the upper jaw get affected but if proper measures are not taken than whole upper jaw gets affected.
BBTD occurs extensively in the American, Indian & Alaska native
communities.The high incidence of of BBTD in Alaskan children is due to continued use of bottle.
BBTD is commonly found in children who are given a bottle of milk or sugared liquid to nurse during the day or when the baby is put to bed.The position of the tongue is such that it causes the liquid to be in constant contact with the maxillary incisors thus encouraging bacterial growth. Generally the incisors of the upper jaw get affected but if proper measures are not taken than whole upper jaw gets affected.
BBTD occurs extensively in the American, Indian & Alaska native
communities.The high incidence of of BBTD in Alaskan children is due to continued use of bottle.
SYMPTOMS OF DIABETES
1) Polydipsia : Polydipsia refers to excessive thirst. This symptom occurs because there is excessive loss of fluid through urine.
2) Polyuria : Polyuria refers to frequent urination.This symptoms occurs because as the sugar is excreted through urine a large quantity of water is also excreted along with the sugar . Therefore a diabetic frequently passes urine.
3) Polyphagia: Polyphagia refers to excessive hunger.In diabetes the various body cells starve since the glucose cannot enter the cell without insulin .To overcome this cellular starvation the body gives rise to abnormal & excessive hunger.
4) Loss of weight : When the cells cannot utilize glucose , the body disintegrates stored fats to provide the cells with the necessary nourishment.Therefore the person looses weight.
5) Weakness, fatigue & body ache : The body also utilize stored muscle protein to nourish the starving cells .This is cause of weakness.
6) Mental Fatigue & lack of concentration : Brain cells mainly utilize glucose for energy .Since glucose cannot enter the cells without insulin the brain cell starve leading to mental fatigue.
7) Wound infection & delayed healing : Diabetic individuals have blood which is rich in glucose but the supply of blood to the skin is poor also there is reduced sensation as a result of which the individual is not aware of injury.All this results in development of wounds which take very long to heal.
2) Polyuria : Polyuria refers to frequent urination.This symptoms occurs because as the sugar is excreted through urine a large quantity of water is also excreted along with the sugar . Therefore a diabetic frequently passes urine.
3) Polyphagia: Polyphagia refers to excessive hunger.In diabetes the various body cells starve since the glucose cannot enter the cell without insulin .To overcome this cellular starvation the body gives rise to abnormal & excessive hunger.
4) Loss of weight : When the cells cannot utilize glucose , the body disintegrates stored fats to provide the cells with the necessary nourishment.Therefore the person looses weight.
5) Weakness, fatigue & body ache : The body also utilize stored muscle protein to nourish the starving cells .This is cause of weakness.
6) Mental Fatigue & lack of concentration : Brain cells mainly utilize glucose for energy .Since glucose cannot enter the cells without insulin the brain cell starve leading to mental fatigue.
7) Wound infection & delayed healing : Diabetic individuals have blood which is rich in glucose but the supply of blood to the skin is poor also there is reduced sensation as a result of which the individual is not aware of injury.All this results in development of wounds which take very long to heal.
Tuesday, September 16, 2008
IBW- IDEAL BODY WEIGHT
Today most of us are weight conscious . Many people get tensed even if they gain one pound extra . So for all health & weight conscious people I am sharing some formulas which are used by Dieticianas to calculate the Ideal body weight & other related aspects.
IDEAL BODY WEIGHT( I B W ) :
Ideal body weight is that weight which is associated with least mortality. Ideal body is calculated by using various formulas.One of the simplest formula is BROCA'S INDEX.
BROCA'S INDEX :
1) I B W of a man in Kgs :
HEIGHT OF A MAN IN CMS MINUS 100
Therefore I B W of 6 feet tall man will be =182.8-100 = 82.8 Kgs
2) I B W of a woman in kgs :
HEIGHT OF A WOMAN IN CMS MINUS 100 + SUBTRACT 10% FROM IT.
Therefore IBW of 6 feet tall woman will be = 182.8-100 = 82.8 - 8.2 =74.6 Kgs.
REMEMBER:
1) 1 FEET = 12 INCHES
2) 1 INCH = 2.54 CMS.
3) This formula is used only to calculate IBW of individuals above 18.
WAIST TO HIP RATIO ( WHR)
1) WHR for man :
WAIST IN INCHES DIVIDED BY CIRCUMFERENCE OF HIP
WHR greater than 0.95 is harmful.
2) WHR for woman :
WAIST IN INCHES DIVIDED BY CIRCUMFERENCE OF HIP
WHR greater than 0.8 is harmful.
BODY MASS INDEX ( BMI )
BMI IS CALCULATED AS ,
WEIGHT IN KGS OF A PERSON
---------------------------------------------------------------
SQUARE OF HEIGHT OF THE PERSON IN METERS
Therefore BMI OF 6 Feet man weighing 90 kgs is
= 90 / 1.828 X 1.828 =26.9
REMEMBER :
1) BMI ranging from 20-25 indicates the individual is normal.
2) BMI ranging from 25-27 indicates.................... over weight
3) BMI ranging from 27-29.9 indicates............................obese
4) BMI ranging from 30-40 indicates..............Grade 2 obesity.
5) BMI above 40...................................................Grade 3 obesity
IDEAL BODY WEIGHT( I B W ) :
Ideal body weight is that weight which is associated with least mortality. Ideal body is calculated by using various formulas.One of the simplest formula is BROCA'S INDEX.
BROCA'S INDEX :
1) I B W of a man in Kgs :
HEIGHT OF A MAN IN CMS MINUS 100
Therefore I B W of 6 feet tall man will be =182.8-100 = 82.8 Kgs
2) I B W of a woman in kgs :
HEIGHT OF A WOMAN IN CMS MINUS 100 + SUBTRACT 10% FROM IT.
Therefore IBW of 6 feet tall woman will be = 182.8-100 = 82.8 - 8.2 =74.6 Kgs.
REMEMBER:
1) 1 FEET = 12 INCHES
2) 1 INCH = 2.54 CMS.
3) This formula is used only to calculate IBW of individuals above 18.
WAIST TO HIP RATIO ( WHR)
1) WHR for man :
WAIST IN INCHES DIVIDED BY CIRCUMFERENCE OF HIP
WHR greater than 0.95 is harmful.
2) WHR for woman :
WAIST IN INCHES DIVIDED BY CIRCUMFERENCE OF HIP
WHR greater than 0.8 is harmful.
BODY MASS INDEX ( BMI )
BMI IS CALCULATED AS ,
WEIGHT IN KGS OF A PERSON
---------------------------------------------------------------
SQUARE OF HEIGHT OF THE PERSON IN METERS
Therefore BMI OF 6 Feet man weighing 90 kgs is
= 90 / 1.828 X 1.828 =26.9
REMEMBER :
1) BMI ranging from 20-25 indicates the individual is normal.
2) BMI ranging from 25-27 indicates.................... over weight
3) BMI ranging from 27-29.9 indicates............................obese
4) BMI ranging from 30-40 indicates..............Grade 2 obesity.
5) BMI above 40...................................................Grade 3 obesity
GM DIET FOR VEGETERIANS
GM ( General Motor's ) Diet is a well known diet program designed to detoxify body & also for weight reduction . GM Diet is a 7 days diet program & it should be follow once in a month or in two months. GM diet is very effective if it is followed sincerely than the individual can loose up to 2-3 Kgs in a week . However after following GM diet one must take care of the diet because the person can regain weight within 2-3 days. However obese individuals who are suffering from Diabetes , Hypertension or other heart problems should not go for GM Diet . Since the actual GM diet chart ask the person to consume Beef many individuals do not follow GM Diet . Therefore as a Dietican I have modified the GM Diet . Below I have given a 7 days diet chart .
1st DAY DIET PLAN
1 ) BREAK-FAST: ( 8.30 AM -9.00 AM )
1 APPLE + 1-2 GLASS OF WATER
2 ) MIDMORNING: (10-30 AM -11.00 PM )
1 BOWL OF RAW PAPAYA+ 1-2 GLASS OF WATER
3 ) LUNCH: (1.00 pm-1.30)
1 BOWL OF WATER MELLON OR MUSK MELLON+ 1to 1 & 1/2glass H2O
4 )TEA: (4.00pm-4.30)
1 ORANGE OR 1 1 SWEET LIME OR 1 CHIKU+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: ( 6.00 pm -6.30 pm)
1 GLASS OF COCONUT WATER.
6 ) DINNER : ( 8.30PM -9.00 PM )
1 APPLE + 1-2 GLASS OF WATER
***** NOTE ONLY FRUITS ARE CONSUMED ON THE FIRST DAY OF GM DIET . BANANA SHOULD BE AVOIDED.
2ND DAY DIET PLAN
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 BOILED POTATO + 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
1 BOWL OF RAW CABBAGE + 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
1 TOMATO+ 1 CUCUMBER+ 1/2 BOILED BEET + 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 TOMATOES + 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF VEG JUICE(PALAK+ TOMATO).
6 ) DINNER:(9.30pm-10.00)
BOILED LAUKI(DUDHI)can add salt & other spices + H2O
******NOTE ON THE SECOND DAY OF GM DIET ONLY VEGETABLES ARE CONSUMED
3Rd DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 RAW APPLE + 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
1 BOWL OF PAPAYA+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
1 TOMATO+ 1 CUCUMBER+ 1/2 BOILED BEET + 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
1 SWEET LIME OR ORANGE+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF VEG JUICE(PALAK+ TOMATO) OR 1 CHIKU.
6 ) DINNER: (9.30pm-10.00)
BOILED LAUKI(DUDHI)can add salt & other spices + H2O
******NOTE ON THE 3 RD DAY OF GM DIET FRUITS & VEGETALES ARE ONLY CONSUMED
4TH DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1/2 GLASS SKIM MILK 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
1 BANANA+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
1 GLASS SKIM MILK WITHOUT SUGAR + 1to 1 & 1/2glass H2O
4)TEA:(4.00pm-4.30)
1 BANANA + 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 BANANA.
6 ) DINNER: (9.30pm-10.00)
I/2 GLASS SKIM MILK WITHOUT SUGAR
******NOTE ON THE 4TH DAY ONLY SKIM MILK & BANANA ARE CONSUMED. SUGAR SHOULD BE AVOIDED
5Th DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 KATORI PRESSURE COOKED BROWN RICE+ 1 to 1 & 1/2 glass of water.
2) MIDMORNING: (10.30 am-11.00)
2 TOMATOES+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
I KATORI BROWN RICE COOKED IN TOMATO GRAVY+ 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 TOMATOES CAN ADD SALT & JEERA+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF WATER WITH LEMON & SALT.
6 ) DINNER: (9.30pm-10.00)
BOILED BROWN RICEcan add salt & other spices + H2O
*****NOTE ON THE 5TH DAY OF GM DIET BROEN RICE & TOMATOES ARE ONLY CONSUMED
6Th DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 KATORI PRESSURE COOKED BROWN RICE+ 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
2 TOMATOES+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
I KATORI BROWN RICE COOKED WITH OTHER VEGs+ 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 CUCUMBERS CAN ADD SALT & JEERA+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF WATER WITH LEMON & SALT.
6 ) DINNER:(9.30pm-10.00)
BOILED BEET + CUCUMBER + CARROT + TOMATOES + RAW CABBAGE can add salt & other spices + H2O
******NOTE ON THE 6TH DAY OF GM DIET BROWN RICE , TOMATOES & OTHER VEGETABLES ARE ONLY CONSUMED
7Th DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 KATORI PRESSURE COOKED BROWN RICE+ 1 to 1 & 1/2 glass of water.
2)MIDMORNING: (10.30 am-11.00)
2 TOMATOES+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
I KATORI BROWN RICE COOKED WITH OTHER VEGS+ 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 CUCUMBERS CAN ADD SALT & JEERA+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF SWEET LIME JUICE WITHOUT STRAINING & SUGAR.
6 ) DINNER: (9.30pm-10.00)
BOILED BEET + CUCUMBER + CARROT + TOMATOES + RAW CABBAGE can add salt & other spices + H2O
*****NOTE ON THE 7 TH DAY BROWN RICE , VEGETABLES & FRUIT JUICES ARE ONLY CONSUMED.
1st DAY DIET PLAN
1 ) BREAK-FAST: ( 8.30 AM -9.00 AM )
1 APPLE + 1-2 GLASS OF WATER
2 ) MIDMORNING: (10-30 AM -11.00 PM )
1 BOWL OF RAW PAPAYA+ 1-2 GLASS OF WATER
3 ) LUNCH: (1.00 pm-1.30)
1 BOWL OF WATER MELLON OR MUSK MELLON+ 1to 1 & 1/2glass H2O
4 )TEA: (4.00pm-4.30)
1 ORANGE OR 1 1 SWEET LIME OR 1 CHIKU+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: ( 6.00 pm -6.30 pm)
1 GLASS OF COCONUT WATER.
6 ) DINNER : ( 8.30PM -9.00 PM )
1 APPLE + 1-2 GLASS OF WATER
***** NOTE ONLY FRUITS ARE CONSUMED ON THE FIRST DAY OF GM DIET . BANANA SHOULD BE AVOIDED.
2ND DAY DIET PLAN
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 BOILED POTATO + 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
1 BOWL OF RAW CABBAGE + 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
1 TOMATO+ 1 CUCUMBER+ 1/2 BOILED BEET + 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 TOMATOES + 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF VEG JUICE(PALAK+ TOMATO).
6 ) DINNER:(9.30pm-10.00)
BOILED LAUKI(DUDHI)can add salt & other spices + H2O
******NOTE ON THE SECOND DAY OF GM DIET ONLY VEGETABLES ARE CONSUMED
3Rd DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 RAW APPLE + 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
1 BOWL OF PAPAYA+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
1 TOMATO+ 1 CUCUMBER+ 1/2 BOILED BEET + 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
1 SWEET LIME OR ORANGE+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF VEG JUICE(PALAK+ TOMATO) OR 1 CHIKU.
6 ) DINNER: (9.30pm-10.00)
BOILED LAUKI(DUDHI)can add salt & other spices + H2O
******NOTE ON THE 3 RD DAY OF GM DIET FRUITS & VEGETALES ARE ONLY CONSUMED
4TH DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1/2 GLASS SKIM MILK 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
1 BANANA+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
1 GLASS SKIM MILK WITHOUT SUGAR + 1to 1 & 1/2glass H2O
4)TEA:(4.00pm-4.30)
1 BANANA + 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 BANANA.
6 ) DINNER: (9.30pm-10.00)
I/2 GLASS SKIM MILK WITHOUT SUGAR
******NOTE ON THE 4TH DAY ONLY SKIM MILK & BANANA ARE CONSUMED. SUGAR SHOULD BE AVOIDED
5Th DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 KATORI PRESSURE COOKED BROWN RICE+ 1 to 1 & 1/2 glass of water.
2) MIDMORNING: (10.30 am-11.00)
2 TOMATOES+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
I KATORI BROWN RICE COOKED IN TOMATO GRAVY+ 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 TOMATOES CAN ADD SALT & JEERA+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF WATER WITH LEMON & SALT.
6 ) DINNER: (9.30pm-10.00)
BOILED BROWN RICEcan add salt & other spices + H2O
*****NOTE ON THE 5TH DAY OF GM DIET BROEN RICE & TOMATOES ARE ONLY CONSUMED
6Th DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 KATORI PRESSURE COOKED BROWN RICE+ 1 to 1 & 1/2 glass of water.
2 ) MIDMORNING: (10.30 am-11.00)
2 TOMATOES+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
I KATORI BROWN RICE COOKED WITH OTHER VEGs+ 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 CUCUMBERS CAN ADD SALT & JEERA+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF WATER WITH LEMON & SALT.
6 ) DINNER:(9.30pm-10.00)
BOILED BEET + CUCUMBER + CARROT + TOMATOES + RAW CABBAGE can add salt & other spices + H2O
******NOTE ON THE 6TH DAY OF GM DIET BROWN RICE , TOMATOES & OTHER VEGETABLES ARE ONLY CONSUMED
7Th DAY DIET PLAN.
1 ) BREAK-FAST: (8.30 am-9.00 am )
1 KATORI PRESSURE COOKED BROWN RICE+ 1 to 1 & 1/2 glass of water.
2)MIDMORNING: (10.30 am-11.00)
2 TOMATOES+ 1 to 1 & 1/2 glass of water.
3 ) LUNCH: (1.00 pm-1.30)
I KATORI BROWN RICE COOKED WITH OTHER VEGS+ 1to 1 & 1/2glass H2O
4 ) TEA: (4.00pm-4.30)
2 CUCUMBERS CAN ADD SALT & JEERA+ 1 to 1 & 1/2 glass of H2O
5 ) EVENING: (6.00pm- 6.30)
1 GLASS OF SWEET LIME JUICE WITHOUT STRAINING & SUGAR.
6 ) DINNER: (9.30pm-10.00)
BOILED BEET + CUCUMBER + CARROT + TOMATOES + RAW CABBAGE can add salt & other spices + H2O
*****NOTE ON THE 7 TH DAY BROWN RICE , VEGETABLES & FRUIT JUICES ARE ONLY CONSUMED.
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