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.
Tuesday, October 14, 2008
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 .
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