Home of Health Tips

10 Health Tips for the Men in Your Life

noreply@blogger.com (Unknown) — Thu, 29 Aug 2019 00:47:00 -0700

10 Health Tips for the Men in Your Life

We all know that it's common for men to skip the doctor until they become sick, injure themselves or are faced with a serious health problem. And a majority of men will postpone seeking care for a few days to see whether they feel any better. It's the whole "if it ain't broke, don't fix it" line of thinking.

But there are steps the men in your life can take today to improve their vitality and help prevent health problems down the road. Of course, there are some things that can't be changed, such as family history and age, but every day choices can have a big impact on their current and future health.

Health Tips for Men:

Get routine health checkups, screenings and (don't forget) dental exams. Just because you're healthy doesn't mean you're off the hook. Going to your health care provider for regular checkups could just save your life. By keeping up with these appointments, your health care provider can make sure you stay up-to-date with immunizations (Yes, they're for adults, too!) and important preventive health screenings. It also gives you a chance to talk about any health concerns or changes you've noticed. Make sure to talk with your health care provider about your family medical history and ask which screenings you might need. For example

Body mass index (BMI)
Cholesterol
Blood pressure
Certain cancers depending on risk factors, including your age and family history (e.g., lung, colorectal, prostate, skin)
Diabetes/blood glucose (sugar) level
Depression (Did you know men are four times more likely to commit suicide than women, which is thought to be due to under-diagnosed depression?)
Sexually transmitted diseases
And, if you're like most people, you dread going to the dentist, but add that to your "to do" list. Dental exams aren't just important for your teeth and gums; your mouth may also be a red flag for other health conditions.

Eat a healthy, well-balanced diet. Eating a diet that's low in fat (less than 7 percent of calories should come from saturated fats), cholesterol, and salt, and packed with fresh fruits and vegetables (two cups of fruit per day; three cups of vegetables per day for men up to age 50 and two and a half cups for men aged 51 and over), whole grains and fiber can help improve your health, prevent heart disease, diabetes and certain cancers.

Get moving. Try to get 30 minutes of moderate physical activity on most days of the week. Taking a walk, jogging, swimming and mowing the lawn all count. But don't be a weekend sports warrior. Start slowly if you aren't normally active and gradually build up. No time? Research shows that even short bursts of physical activity—as few as 10 minutes of intense activity several times a day—can help men improve their health. Talk to your doctor about the right exercise program for you.

Lose the gut for good. It's important to maintain a healthy weight. Excess weight, especially around the waist, can be hard on your body. Carrying too much body fat forces your heart to work harder and increases your chances of heart disease and stroke, even if you have no other risk factors! So, try to curb weight gain as you age.

Drink alcohol in moderation. If you drink alcohol, limit your consumption to no more than two drinks per day. (One drink equals one 12-ounce bottle of beer or wine cooler, one four-ounce glass of wine or 1 1/2 ounces of 80-proof distilled spirits.)

Don't use tobacco. Tobacco smoke contains more than 4,000 chemicals and is a known cause of cancer. Smoking also increases the likelihood of high blood pressure, heart disease, lung problems and other health problems. And if you think chewing tobacco is safer, think again. Not only is chewing tobacco a known cause of cancer (carcinogen), it also contributes to gum disease and tooth loss and may be linked to fertility problems. And, few could argue that chewing and spitting is attractive to a partner. If you smoke or chew, talk to your health care professional about ways to quit. Consider nicotine replacement therapy products that include self-help programs, if appropriate.

Practice safe sex. If you are sexually active, remember to practice safe sex.

Buckle up every time. Always wear a seat belt when you're in a motor vehicle to prevent death or serious injury in an accident. Obey all rules of the road. Don't be a distracted or aggressive driver. Limit cell phone use and don't use other electronic devices while driving.

Think about safety in everything you do. Whether it's pulling out the weed whacker, going for a bike ride or grilling with the neighbors, safety is key. Here are just a few examples:

Take care when moving heavy objects. It's easy to strain yourself when lifting boxes, furniture and other heavy items. Use your knees and legs and not your back for leverage. And ask for help, if you need it.

Wear appropriate protective gear for your eyes and ears when using leaf blowers, lawn mowers and other machines at home or work. Excessive exposure to noise is the most common cause of hearing loss.

noreply@blogger.com (Unknown) — Thu, 24 Mar 2016 12:40:00 -0700

Smoking Cessation Drugs

Prescription and over-the-counter drugs can help you quit smoking, but e-cigarettes may not be the best option.

Nicotine is a powerfully addictive drug, and is the main reason it can be so hard to quit smoking and using other tobacco products.

If you want to quit but are struggling with the effects of nicotinewithdrawal, you may find it helpful to use a nicotine replacement product (so-called nicotine replacement therapy, or NRT) or a prescription drug that doesn't contain nicotine.

Prescription Drugs to Help You Quit Smoking

There are a variety of doctor-prescribed drugs that can help you quit smoking.

The drugs may be used along with some NRT products.

Speak with your doctor to find the best choice for you.

The options approved by the Food and Drug Administration (FDA) include:

Bupropion

Bupropion (Wellbutrin, Zyban, or Aplenzin) does not contain nicotine.

Instead, it is a prescription antidepressant that reduces symptoms of nicotine withdrawal by acting on chemicals in your brain that help trigger nicotine cravings.

For the best results, you should start taking bupropion one to two weeks before you quit smoking.

Your doctor may have you keep taking it for a few weeks after you fully quit smoking.

The usual dosage is one or two 150 milligram (mg) tablets per day.

This drug should not be taken if you have or have ever had:

Seizures
Heavy alcohol use
Cirrhosis
Serious head injury
Bipolar disorder
Anorexia or bulimia

The most common side effects of bupropion include:

Dry mouth
Trouble sleeping
Tiredness
Irritability
Indigestion
Headaches

Varenicline

Varenicline (Chantix) was developed specifically to help people stop smoking; it works by interfering with nicotine receptors in the brain.

The drug does this in two ways: it lessens the pleasure you get from smoking, and it reduces the symptoms of nicotine withdrawal.Varenicline should be started a week before you quit smoking.

Studies have shown that varenicline can more than double your chances of quitting smoking, and may be more effective than bupropion in the short term.

Varenicline is taken over a 12-week period at increasingly higher dosages.

Be aware that varenicline carries an FDA-required black-box warning because of use of the drug has been linked to depression, suicide ideation, and suicide.

People taking varenicline should be monitored for any kind of psychiatric symptoms, such as agitation, hostility, depressed mood, changes in behavior or thinking, or suicidal thoughts or behavior.

The most common side effects of varenicline include:

Headaches
Changes in taste
Nausea
Vomiting
Trouble sleeping
Gas

Other Stop-Smoking Drugs

Other prescription drugs, such as nortriptyline (Pamelor) and clonidine (Catapres), are sometimes recommended for smokers who cannot use varenicline or bupropion.

Both of these are older drugs that may have significant side effects.

Talk to your doctor to decide if either of these are a good option for you when you're ready to stop smoking

Nicotine Replacement Therapy (NRT)

The Food and Drug Administration (FDA) has approved five types of over-the-counter nicotine replacement therapy (NRT) products.

These include nicotine gum, patches, lozenges, and inhalers.

You can use more than one type at a time, but if you do, speak with your doctor to make sure you're not getting too much nicotine at once.

E-Cigarettes

Electroniccigarettes, or e-cigarettes, let you inhale nicotine without the smoke.

These electronic devices discharge a nicotine mist without some of the chemicals found in tobacco. They are among the most popular quit-smoking products on the market, but their use remains controversial among health experts.

Some doctors are concerned that e-cigarettes may be a "gateway drug" to tobacco products, and they contain several chemical compounds (such as formaldehyde) that can cause cancer.

Additionally, e-cigarettes are not regulated by the FDA, so the health risks associated with their use are not fully understood.

The Effects of Secondhand Smoke

noreply@blogger.com (Unknown) — Thu, 24 Mar 2016 12:27:00 -0700

All the cancer-causing ingredients in tobacco are also found in secondhand smoke

Secondhand smoke — also called SHS, passive, or involuntary smoking — can increase your risk of heart disease, lung cancer, and other serious illnesses.

According to a 2014 Surgeon General's report, about 2.5 million Americans have died from the effects of secondhand smoke over the past 50 years.

If you're a smoker, the health of a loved one could be a primary motivating factor in your decision to quit smoking.

What Is Secondhand Smoke?

Cigarettes, pipes, and cigars emit two types of secondhand smoke: Sidestream smoke, which is the smoke from the lighted end, and mainstream smoke, the smoke exhaled by a smoker.

Of the two, sidestream smoke is the more dangerous; it contains higher concentrations of carcinogens, is more toxic, and has smaller particles that can penetrate deeper into your lungs than those in mainstream smoke.

What Are the Dangers of Secondhand Smoke?

Secondhand smoke has the same nicotine and harmful chemicals that smokers inhale into their lungs.

It contains more than 7,000 chemical compounds, of which more than 250 are known to be harmful, and at least 69 are known to cause cancer.

In the United States, the costs of extra medical care, illness, and death caused by SHS top $5.6 billion per year, reported a 2010 Surgeon General's report.

Each year, it's responsible for an estimated 46,000 deaths from heart disease and about 3,400 lung cancer deaths in adults who don't smoke.

Children are particularly susceptible to the effects of secondhand smoke. Every year, it causes: Severe asthma and asthma-related problems in up to 1 million asthmatic children.

Between 150,000 and 300,000 lower respiratory tract infections (bronchitis and pneumonia) in children younger than 18 months

Children to be put into intensive care when they have the flu

In addition, there is some evidence suggesting secondhand smoke might be linked to stroke,lymphoma, leukemia, and brain tumors in children.

It's also linked to cancers of the larynx (voice box), pharynx (throat), nasal sinuses, brain, bladder, rectum, stomach, and breast in adults.

Where Is Secondhand Smoke the Biggest Problem?

Secondhand smoke is the most common:

At home: If you're a smoker, the next best thing to quitting that you can do for your family is to keep your home smoke-free.

Spouses, children, and even pets are at risk from the danger of secondhand smoke.

If you live in an apartment building, know that smoke can travel through air ducts and walls, so try to opt for a smoke-free building if at all possible.

At work: Many cities and states have enacted smoke-free work policies, and with good reason: the Surgeon General has said that they are the only way to prevent SHS exposure at work. In the car: Even if you smoke with the windows rolled down, you are putting your passengers at risk for exposure to secondhand smoke. In fact, some cities and states have laws that ban smoking in the car if you have passengers under a certain age or weight.

In public: More and more public spaces are banning smoking, from parks and restaurants to malls and public transportation.

To date, 28 states and the District of Columbia have passed comprehensive smoke-free laws, including banning smoking in restaurants. Whenever you have a choice, always support a smoke-free business over one that is not

How to Quit Smoking------ Health Tips

noreply@blogger.com (Unknown) — Thu, 24 Mar 2016 12:11:00 -0700

Here's a simple step-by-step plan to help you stop smoking.

You decided to stop smoking? Great — it's one of the best things you can do for your health.

But quitting isn't easy. Nicotine — the addictive ingredient in tobacco — is as addictive as heroin or cocaine, according to the American Cancer Society.

In fact, the average person attempts to quit six times before succeeding.

Fortunately, there are steps you can take to set yourself up for success and kick the habit for good.

Set a date: Pick a day and time in the near future that you expect to be relatively stress-free so you can prepare to quit smoking.

Quitting when you have a big project due at work, or even when you have something happy on your calendar like a birthday party (if you tend to light up when you are drinking or socializing), can be more challenging.

Write down your reasons: Consider why you want to stop smoking and jot the reasons down. You can refer to them once you quit when you get a craving. A few universal benefits:

My risk of cancer, Heart attacks , chronic lung disease, stroke, cataracts, and other diseases will drop.
My blood pressure will go down.
I'll look better. My skin will be more hydrated and less wrinkled, my teeth will look less yellow and my fingers won't be stained with nicotine.
I'll save money.
My hair, clothes, car, and home won't reek of smoke.
I'll have more energy.
I'll set a better example for my kids, friends, and family.
I'll live longer.

Get your friends and family on board: The more support you have, the more likely you are to quit smoking.

Ask your loved ones to help keep you distracted by taking walks or playing games, and bear with you if you become cranky or irritable as you experience nicotine withdrawal.

Tell any smokers not to smoke around you, or better yet, ask your smoking buddies to quit with you.

Identify your triggers: You'll be most tempted to smoke during the same times you do now. Knowing your habits and what situations may set off a craving will help you plan ahead for distractions.

For example, you may typically smoke while driving, drinking, or after dinner, or it may be that you reach for a cigarette when you're feeling stressed, lonely, or depressed.

Create healthy distractions to head off potential smoking triggers. If you smoke while you drive, keep a pack of gum on hand, or if you smoke after dinner, plan to take a walk or chat on the phone with a friend.

Anticipate cravings: It's expected that you'll experience nicotine cravings as your body begins to go through withdrawal.

The good news is that cravings aren't endless. They generally last for five minutes and no longer than 10.

When cravings strike, focus on something else: Drink a glass of water, review your list of reasons for quitting, take deep breaths, play with your cat or dog — do whatever it takes until the craving subsides.

Distract yourself: Keep celery stalks, carrot sticks, nuts, or gum handy to give your mouth something to do when cravings occur.

And finding some way to occupy your hands — knitting, woodworking, cooking, yoga, or yard work — will help keep your mind off smoking.

Expect to feel a little off: Nicotine withdrawal can make you feel anxious, cranky, sad, and even make it hard for you to fall asleep.

It helps to know that all these feelings are a normal and temporary part of the process.

Throw out all your cigarettes: Yes, even that emergency one you stashed away.

If you don't have cigarettes on hand, it will make it that much easier to stay the course when a craving hits.

Reward yourself: With all the money you'll save by not buying tobacco, you can buy new clothes, splurge on dinner, or start a new hobby.

Some people keep their cigarette money in a jar, then reward themselves with a treat each week.

Talk to your doctor about cessation medications: If you're not sure you can go cold turkey, don't.

Speak with your doctor about over-the-counter (OTC) and stop-smoking medications that can make quitting easier.

Simple tips for livening up your drinking water

noreply@blogger.com (Unknown) — Wed, 23 Mar 2016 02:35:00 -0700

Not everybody has a taste for water, but we all need it to ensure that our bodies continue functioning properly. If you want to drink more water, but aren't crazy about the taste (or lack thereof), here are some tips that can make it more enjoyable:

1. Add fresh fruit. Citrus fruits, such as lemons, limes, and oranges, are classic water enhancers, but other fruit flavors might also tempt your taste buds. Try crushing fresh raspberries or watermelon into your water, or adding strawberry slices. Cucumber and fresh mint are refreshing flavors as well — especially in summer.

2. Use juice. Any fruit juice can be a good base flavor for water, but tart juices, like cranberry, pomegranate, grape, and apple, are especially delicious. Go for juices that are all natural, with no added sugars. And remember: Fruits and their juices don't just taste good — they contain vitamins and antioxidants that can benefit your health too.

3. Make it bubbly. Many people prefer sparkling to still water. If plain old water isn't inspiring to you, try a naturally effervescent mineral water — which will give you the added benefit of minerals. Or try bubbly seltzer, a carbonated water. You can add fresh fruit or natural juice flavors to your seltzer, as suggested above, or look for naturally flavored seltzers at your local market. If you become a seltzer devotee, you might want to consider getting a seltzer maker for your home.

4. Get creative with ice. Some say that ice water tastes better than water served at room temperature. If that's so, flavored ice cubes may make an even better drink. Use some of the flavoring suggestions above and start experimenting with fresh fruit, mint, or cucumber ice cubes. Simply chop your additive of choice, add it to your ice cube tray along with water, then freeze. You may also consider juice, tea, or coffee cubes. If you want to be more creative, use ice cube trays that come in fun shapes, like stars, circles, or even fish.

5. Drink tea. Herbal, fruit, green, white, and red teas are generally considered to be better for you than black teas (or coffee, for that matter) because they contain little to no caffeine. And there are countless flavors of these teas to choose from. Start with the selection at your local market or health food store. If you're interested in pursuing more exotic flavors and sophisticated teas, start researching the vast array of specialty teas that come from all parts of the globe.

6. Try bouillons, broths, and consommés. If your palate leans toward the savory, you may pass on tea and start sipping one of these hot and savory liquids instead. Choose low-fat and low-sodium versions for maximum health benefits. Because soup is water-based, a cup of hot soup will count toward your daily fluid consumption.

7. Add fast flavor. If you're looking for a quick-and-easy flavor booster, you might also consider sugar-free drink mixes, and flavor cartridges that can be used with your faucet filter system.

Health Tips

The child years poverty linked to human brain changes related to depressive disorder

noreply@blogger.com (Unknown) — Wed, 23 Mar 2016 02:26:00 -0700

Children from poorer people are more likely to experience changes in human brain connectivity that put these people at higher risk of depression, compared with kids from more affluent households. This can be the conclusion of the new study by experts from the Washington University or college School of Medicine in St. Louis, MO.

Analysts determined brain changes amongst children from low-income people that were associated with
depression.
First study publisher Deanna M. Barch, PhD, chair with the Department of Psychological & Brain Savoir in Arts
& Savoir, and colleagues publish all their findings inside the North american Journal of Psychiatry.
The study builds on past research from the crew published last year, which will found that children brought up in poverty have lowered gray and white subject volumes inside the mind, compared with those increased in richer families.
In addition, they found that such brain changes had been connected to poorer academic accomplishment.
With this latest study, the team attempted to investigate if childhood poverty may as well cause brain changes
that influence mood and risk of depression, given that children raised in not as good families tend to become at
the upper chances of psychological illness and possess worse intellectual and educational outcomes.

Not as good preschool children at increased depression risk aged on the lookout for or 10

To reach their findings, Barch -- also the Gregory W. Couch professor of psychiatry at Washington's School of Medicine - and fellow workers enrolled 105 preschool kids aged 3-5.
The group calculated the poverty amounts of the children applying an income-to-needs ratio, which will makes
up a family's size and yearly income. In present, the federal thankfully level in the usa is $24, two hundred and
fifty 12 months for a family of four.

Between ages of 7-12, the kids underwent functional magnetic reverberation imaging (fMRI), which allowed the researchers to investigate the brain connections in the hippocampus - the place important for learning, recollection and stress regulation -- and the amygdala -- a region associated with stress and emotion.
In comparison with preschoolers from higher-income families, those from lower-income families demonstrated weaker contacts between the left hippocampus and the right outstanding frontal cortex, as very well as weaker connections among the right amygdala plus the right lingual gyrus.
The researchers found that these kinds of weakened brain connections amongst preschool children raised in
poverty were associated with greater likelihood of medical depression at the era of 9 or twelve.
"In this study, we all found which the way all those structures hook up with the rest of the mind within ways we could consider being less useful in regulating emotion and stress, " explains Barch.
What is more, the team found that the poorer children were for preschool age, a lot more likely they will were
to have weakened brain connections and despression symptoms at school age.

Early on intervention key for great emotional development

While the team's earlier research discovered that it could be possible to overcome some changes in brain
structure connected to low income - by increasing a child's home environment, to get example - no many
of these association was determined through this latest study.
Still, Barch stresses that this will not mean nothing can easily be done to inspire positive emotional development between children from poorer households:
"Poverty doesn't put a child on the predetermined flight, but it behooves all of us to remember that undesirable activities early in existence are influencing the creation and function of the brain. And if all of us hope to intervene, we all need to do that early in order that we can easily help shift children on to the best possible developing trajectories. "

Kidney Diet and Disease

noreply@blogger.com (Unknown) — Tue, 22 Mar 2016 12:21:00 -0700

Kidney Diet and Disease

If your kidneys aren't working as they should, your doctor will likely prescribe a diet with specific daily amounts of protein, sodium and potassium. Keeping these nutrients in balance might help prevent kidney disease from getting worse.

Assuming you have kidney disease, you need a registered dietitian nutritionist on your health care team. An RDN will educate you on how to eat very well and manage this latest and very important part of your health plan.

You shall desire a meal plan that meets your individual needs. A registered dietitian nutritionist shall help you accomplish this by taking your food preferences, lifestyle and special needs into account.

Protein

Protein helps build, repair and maintain every cell within your body and works extremely well to provide energy if needed. Whenever your kidneys aren't working well, they can't handle as much health proteins. It is vital you eat enough carbohydrates and body fat to provide your body with the energy you need. The limited protein you eat will be utilized to build and mend your cells then. Your new diet will have to include the right balance of protein, carbohydrates and fat. Key sources of protein include meat, poultry, seafood, eggs, milk, nuts and beans. Breads, cereals, vegetables and seeds contain protein, too.

Sodium

Sodium can raise your blood circulation pressure and make you retain fluids. For people with kidney disease, extra sodium and liquid can build up in your body, that may affect your heart and lungs. Your new diet can include a daily sodium limit. Your RDN will outline how best to stay within this limit. Sodium is found in salt and most processed foods. Make sure to examine labels for salt articles. Check labels of salt substitutes before using them also; many contain potassium which might must be limited.

Potassium

Like sodium, potassium must stay well balanced in your body. If your kidneys aren't working well, potassium amounts in your bloodstream can rise. Large potassium amounts affect your heart and soul rhythm, so your new diet may include a potassium limit. Your RDN shall explain how to stay within your limit. Potassium is found in many fruits and vegetables, beans, dairy and nuts foods.

An RDN may also help you with other areas of your diet to make sure you get the nutrition you need. These include:

- Total Calories. Calorie consumption is important in maintaining your weight in a healthy range.

- Phosphorus. Poor kidney function could cause phosphorus levels to go up in your blood. For that reason, a lower phosphorus diet may be needed.

- Calcium. A high phosphorus level within your body decreases the availability of calcium for your bones. Your diet shall need to offer the right harmony between phosphorus and calcium.

- Vitamins and Minerals (especially B-complex, vitamin C, vitamin D, iron and zinc). Limiting certain food groupings to ease the workload on your kidneys could leave you lacking certain minerals and vitamins.

http://doctor-tips-for-health.blogspot.com/2011/04/medical-diagnosis-and-management-doctor.html

18 Keys to Healthy Weight Loss

noreply@blogger.com (Unknown) — Sun, 20 Mar 2016 11:21:00 -0700

Fad diets tend to have lots of very restrictive or complex rules, which give the impression that they carry scientific heft, when, in reality, the reason they often work (at least in the short term) is that they simply eliminate entire food groups, so you automatically cut out calories. Moreover, the rules are almost always hard to stick to and, when you stop, you regain the lost weight.

Rather than rely on such gimmicks, here we present 18 evidence-based keys for successful weight management. You don’t have to follow all of them, but the more of them you incorporate into your daily life, the more likely you will be successful at losing weight and—more important—keeping the weight off long term. Consider adding a new step or two every week or so, but keep in mind that not all these suggestions work for everyone. That is, you should pick and choose those that feel right for you to customize your own weight-control plan. Note also that this is not a “diet” per se and that there are no forbidden foods.

1. Start with a healthful diet.

That means a diet that's rich in vegetables, fruits, whole grains, and legumes and low in refined grains, sugary foods, and saturated and trans fats. You can include fish, poultry, and other lean meats, and dairy foods (low-fat or nonfat sources are preferable to save calories). Aim for 20 to 35 grams of fiber a day from plant foods, since fiber helps fill you up and slows absorption of carbohydrates. A good visual aid to use is the USDA’s my plat, which recommends filling half your plate with vegetables and fruits. Grains (preferably whole grains) and protein foods should each take up about a quarter of the plate.

2. Keep an eye on portions.

You can eat all the broccoli and spinach you want, but for higher-calorie foods, portion control is the key. Check serving sizes on food labels—some relatively small packages contain more than one serving, so you have to double or triple the calories, fat, and sugar if you plan to eat the whole thing. Popular “100-calorie” food packages do the portion controlling for you (though they won’t help much if you eat several packages at once.

3. Eat mindfully.

This involves increasing your awareness about when and how much to eat using internal (rather than visual or other external) cues to guide you. Eating mindfully means giving full attention to what you eat, savoring each bite, acknowledging what you like and don’t like, and not eating when distracted (such as while watching TV, working on the computer, or driving). Such an approach will help you eat less overall, while you enjoy your food more. Research suggests that the more mindful you are, the less likely you are to overeat in response to external cues, such as food ads, 24/7 food availability, and super-sized portions.

4. Eat slowly, chew well.

A component of mindful eating, this allows more time for satiety signals to reach the brain (it takes about 20 minutes), so slow eaters tend to feel more full and eat less. The process of chewing itself may also stimulate satiety signals. In addition, eating slowly makes you more aware of the smell, taste, and texture of the foods, which can lead to greater satisfaction with fewer calories. Keep in mind also that the most pleasure often comes from the first few bites of a food; after that, it’s the law of diminishing returns. Thus, you should focus on those first few tastes of chocolate, cake, or other indulgences, as this may be enough to satisfy. For gadget lovers, the HAPIfork is an electronic fork that vibrates if you don’t pause long enough between bites.

5. Don’t rely on willpower.

Instead, control your “food environment” so that you don’t unconsciously overfill your plate and eat when you’re not hungry. That means, for example, not having junk foods at home or at least keeping them out of sight (such as on a top shelf or in the back of the fridge)—and changing your routines so you don’t regularly encounter temptations (such as avoiding the office pantry between meals if it has enticing foods and driving a route that doesn’t take you past your favorite food places). Usesmaller plates, bowls, cups, and utensils—you may even want to invest in portion-controlled plates (that delineate what reasonable serving sizes are) or portion-control devices (that allow you to measure your food directly on the plate); many different kinds are available online. Portion out snacks into small bowls or bags; don’t eat from large bags or boxes. You may not have control over everything in your food environment, but being aware of hidden food triggers and traps may be enough to keep you from overeating.

6. Identify emotional triggers that may be making you overeat.

For example, you may eat more when you are stressed, depressed, upset, angry, lonely, or even happy and excited. To distinguish between real hunger and emotional eating, rate your hunger/fullness levels before, during, and after eating on a scale of 1 to 10, with 1 being “beyond hungry” or “starving” (with associated headaches, lightheadedness, and weakness) and 10 being “beyond full” (as in after-Thanksgiving-meal stuffed). Ideally you should eat when you are at level 3 (hungry but not yet uncomfortable) and stop at level 7 .If you often eat for reasons other than hunger, find pleasurable non-food-related activities that you can do instead, such as going for a brisk walk or run.

7. Go for volume (low-energy-dense foods).

Eating foods low in energy density—that is, with fewer calories relative to their weight and volume—increases satiety, so you are likely to fill up on fewer calories. This well-tested concept was first developed by Barbara Rolls, PhD, at Pennsylvania State University in her well-regarded Volumetrics eating plan. In general, the best way to lower the energy density of your diet is to eat more foods that have a high water and high fiber content (notably fruits, vegetables, broth-based soups, and cooked whole grains) in place of low-moisture or high-fat foods (such as cheese, crackers, cookies, and fried potatoes). Incorporate more of these foods in recipes—add more vegetables to soups, stews, and pasta dishes, for example; fill sandwiches and wraps with lots of lettuce, chopped cucumbers, and grated carrots; top whole grain pizzas with more vegetables and less cheese. Snack on popcorn and grapes instead of raisins (for the same 120 calories, you can eat more than a cup of grapes compared to only 1/4 cup of raisins).

8. Get adequate protein (and include some with all meals).

There’s evidence that protein increases satiety more than carbohydrates do. Protein also helps limit muscle loss during weight loss. Look for sources of lean protein (such as beans and other legumes, white-meat poultry, and low-fat or nonfat dairy) or those also rich in healthy fats (such as fish, nuts, and soy foods). Some research suggests that distributing your protein throughout the day also helps in weight loss, rather than eating the bulk of it at, say, dinnertime. According to a 2015 paper in theAmerican Journal of Clinical Nutrition, higher-protein diets that include at least 25 grams of protein at each meal may reduce appetite and thus body weight, compared with lower-protein diets. However, people with or at high risk for kidney disease—and that includes many older people—should be careful not to consume excessive amounts of protein.

9. Eat regularly (don’t skip meals) and choose healthful low-calorie snacks.

Many people find that going longer than a few hours without food makes them more likely to overeat later (often on high-calorie treats). Find a meal-timing pattern that works best for you. If you eat between meals, plan ahead for healthful “mini-snacks” (100 to 200 calories), such as a small container of low-fat yogurt with a handful of berries; two tablespoons of hummus with a cup of baby carrots or sliced bell peppers; a slice of cheese or two thin slices of turkey on half a whole-grain pita; an ounce (small handful) of nuts; or a tablespoon of peanut butter and a banana.

10. Limit variety at meals.

Variety in your overall diet is important to ensure that you get a range of nutrients and other substances that contribute to good health. But having too many choices at once can lead to overconsumption (the “smorgasbord effect”) because foods with different flavors and sensory qualities whet the appetite, even if you are physically satiated—which is why there always seems to be “room for dessert.” It’s also easier to overfill your plate when you have a large number of choices. On the other hand, you’re likely to eat less if you have less variety, since foods similar in taste and texture dull the palate (a phenomenon called sensation-specific satiety). Be especially careful at all-you-can-eat buffets and parties. Scan the whole array of foods before making your selection, choose no more than three or four items that most appeal to you, and make only one trip. Using smaller plates also helps limit your choices.

11. Don’t drink your calories.

Beverages are not as satiating as solid foods, and people usually do not compensate for liquid calories by eating less food. It’s okay to drink milk but otherwise stick with water or other noncaloric beverages like tea and coffee (watch the cream and sugar). Choose whole fruits over juice. What about diet beverages? The jury is still out on whether they help with weight loss. The proposed 2015 U.S. Dietary Guidelines do not recommend sugar substitutes, citing a lack of evidence that they help in long-term weight loss. To liven up water, try a squeeze of lemon or lime or other fruit essence. If you drink alcoholic beverages, be aware of their calories (more than you may think) and that alcohol can have a disinhibiting effect on eating control.

12. Cook at home often.

That allows you to eat more whole foods and control how much oil, sugar, and other high-calorie ingredients you use. Studies have shown that people tend to eat more when they eat out—though you must still be careful to limit portion sizes at home. If cooking from recipes, look for healthy lower-calorie ones that include nutrition analyses, and stick to the serving sizes. Be aware also that just as restaurant portions have ballooned in recent years, recipe serving sizes have also been on the increase.

13. When eating out, follow these simple rules.

Take advantage of calorie listings on menus (or online beforehand) to find lower-calorie options, don’t order anything that’s been super-sized, and consider sharing entrées (or asking for half to be wrapped to take home before you start eating). Or have an appetizer or salad as your main dish. Reading over the whole menu before you order and asking questions of your server or the chef can help steer you toward more healthful, lower-calorie options. Request that dishes be prepared with no or minimal butter, oil, or other high-fat ingredients, and ask for salad dressings on the side so you can control how much you use. And be aware of the menu “tricks” that restaurants use to boost sales—often of cheaper and less-healthful foods.

14. Allow for (controlled) indulgences.

Most people find foods high in fat and sugar pleasurable, since they activate the body’s “reward system” (which releases chemicals in the nervous system relating to pleasure). Overly restricting such foods (or any other types of food you crave) can be counterproductive since it can increase your desire for them and lead to bingeing. An occasional treat is fine, as long as it doesn’t tip the scale with calories. You might, for instance, have a small daily treat or save up for some treats on weekends. On the other hand, some people can’t eat just a little and may be better off avoiding hard-to-resist foods altogether.

15. Keep a food diary.

Studies, including one in the Journal of the Academy of Nutrition and Dietetics, have found that dieters who regularly record what they eat lose more weight than those who don’t. It doesn’t matter how you do it—in a notebook, on the computer, or with an app on your phone—as long as you record your intake consistently and honestly (including even condiments and tastings you may take while cooking). This simple act makes you more accountable for what you eat and helps you see patterns in your eating habits that may be contributing to weight gain.

16. Get enough sleep.

An often overlooked factor in body weight may be your sleep habits. Though the optimal amount of sleep varies from person to person, too little sleep (fewer than six hours a night in one study) has been linked to weight gain because it may affect appetite hormones and lead to increased hunger and food intake, decreased calorie burning, and increased fat storage.

17. Consider weighing yourself regularly—at least once a week.

This increases self-awareness and can provide encouragement if the numbers are going in the right direction—or it can motivate you to get back on track if you detect an upward trend. A 2014 study in PLOS ONE of 40 overweight people found that more frequent self weigh-ins were associated with greater weight loss and that going more than a week without stepping on the scale was associated with weight gain. Regular self-weighing is a particularly effective strategy for maintaining long-term weight loss, according to the National Weight Control Registry, which tracks people who have successfully lost and kept weight off. Whether you weigh yourself and how frequently is a personal decision, however. Some people get discouraged by small fluctuations that occur over the course of a day or several days (which reflect normal shifts in fluid levels, rather than changes in body fat). Keep in mind also that weight is not everything: Another good—and sometimes better—gauge of weight-loss success is to measure your waist and other body areas, such as your hips and thighs.

18. Set realistic goals and have a realistic body image.

Just as weight tends to creep up over time, shedding excess pounds takes time. Don’t expect to be able to lose 10 pounds a week (any diet that says you can is counting on water losses, not fat loss). Small and steady losses—about one to two pounds a week—usually win the race in the long term. For most people, losing just 5 to 10 percent of body weight will provide health benefits. Also keep in mind that, depending on your body type and genetics, you may never be able to get back to your high school or college weight. And if you and your family members tend to have a certain body shape (like a pear, for example), weight loss will result in overall slimming but won’t reshape your body.

COUGH (Health Tips)

noreply@blogger.com (Unknown) — Mon, 25 Jul 2011 21:51:00 -0700

Noisy expulsion of air from lungs, at once is known as cough.

Causes

Acute (3 weeks)

Upper respiratory viral or bacterial infection such as common cold and acute bronchitis.
Other causes acute asthma, pneumonia, pulmonary embolism and pulmonary adema.

Chronic

Chronic bronchitis (smoker’s cough)
Postnasal drip, gastroesophageal reflux disease
Chronic bronchial asthma
Tuberculosis
Interstitial lung disease
Bronchogenic carcinoma
ACE inhibitors

Treatment

Eliminate irritant exposure such as tobacco smoke, occupational agents and discontinue ACE inhibitors and beta-blockers.

Treatment of the cause

· Common cold: antihistamine and decongestant combination.

· Asthma: bronchodilators and corticosteroids.

· Postnasal drip: intranasal steroid spray such as Nasacort AQ.

Symptomatic treatment

Dry cough

Syp: Actified DM

Syp: Pholcodine

Syp: Davenol

Syp: Tixylix

Syp: Sancos

Syp: Benatuss

Syp: Hydryllin DM

Productive cough: (Expectorants)

Syp: Hydryllin

Syp: Benadryl

Syp: Reltus

Syp: Histamol-D

Examination of sputum

Quantity

Scanty: Bronchitis, early stage of pneumonia, asthma.
Moderate amount: Chronic bronchitis, tuberculosis.
Large amount: Bronchiectasis, chronic bronchitis, and lung abscess.

Appearance

Watery: Pulmonary congestion, pulmonary edema.
Mucoid: Acute & chronic bronchitis, asthma.
Mucopurulent: All infections of lungs & bronchi.
Purulent: Bronchiectasis, lung abscess, pulmonary tuberculosis.

Color

Blockish: due to inhalation of carbon.
Rusty (khaki): due to altered blood mixed with sputum in lobar pneumonia.
Reddish: indicates hemoptysis.
Frothy pink: in pulmonary edema.
Sticky brown to red: in Klebsiella infection.

COUGH (Health Tips)

http://doctor-tips-for-health.blogspot.com/2011/04/medical-diagnosis-and-management-doctor.html

SHORTNESS OF BREATH (DYSPNEA)

noreply@blogger.com (Unknown) — Mon, 25 Jul 2011 21:40:00 -0700

Shortness of breath is an unpleasant subjective awareness of the sensation of breathing. Patient usually feels discomfort either from increased ventilatory drive or reduced ventilatory capacity.

Increased ventilatory drive causing increased respiratory rate occurs in:

Fever
Exercise
Acidemia: ketoacidosis, lactic acidosis, uremia
Hypoxia: asthma, COPD, cyanotic heart diseases.
Hypercarbia: COPD

Reduced ventilatory capacity occurs in:

Reduced lung volume in pneumonia, pulmonary edema and interstitial lung disease
Pleural pain
Increased resistance to airflow in asthma, COPD, laryngeal obstruction.

PATIENT EVALUATION

History

Ask about cardiac and respiratory risk factors such as:

Diabetes, hypertension, smoking for heart disease
Asthma, COPD and tuberculosis for respiratory disease
Renal disease for uremia
Medication for lactic acidosis

History of previous similar episodes and their diagnosis
Associated features such as palpitation, syncope, chest pain, nausea, vomiting and sweating are cardiac manifestations while cough, chest pain related to breathing, sputum are features of respiratory disease and low urine output and anemia indicate renal disease.
In acute, dyspnea, rule out cardiac failure, heart block, MI, angina, pulmonary embolism, pneumothorax and laryngeal edema.
Chronic dyspnea is progressive i-e patient’s working capacity gradually decrease. Chronic episodic dyspnea occurs in asthma, heart failure, acute or chronic bronchitis and recurrent pulmonary embolism. Chronic constant dyspnea occurs in COPD, pulmonary fibrosis and pulmonary hypertension.

Examination

Quick and relevant examination related to cardiac disease such as pulse showing tachycardia, bradycardia, irregular pulse, displaced apex beat, murmurs and basal crepts.

Respiratory examination such as rapid respiratory rate, abnormal percussion note, wheeze, crepts or pleural rub.

Investigations

ECG, chest X-ray, ABGs, RBS, urea and creatinine are usually enough for diagnosis.

Shortness of breath
http://doctor-tips-for-health.blogspot.com/2011/04/types-of-heart-failuer.html

HEPATITIS C

noreply@blogger.com (Unknown) — Thu, 14 Jul 2011 21:58:00 -0700

Hepatitis C virus (HCV) is a RNA virus
Mode of transmission: Blood and blood products, IV drug abuse, sexual contact (low risk), vertical transmission from infected mother to child, transmission via breast feeding has not been documented.
Hepatitis C virus (HCV) caused 90% of post-transfusion hepatitis before serological tests that allowed the screening of blood donors. Intravenous drug abusers are at high risk of HCV infection.
Incubation period averages 6-7 weeks.
More than 85% of cases lead to chronic hepatitis. Cirrhosis develops in 20-30% within 5-30 years and about 15% develop hepatocellular carcinoma. Male patients and people acquiring infection over 40 years have more rapid development fibrosis.
Hepatitis C may be a pathogenic factor in glomerulonephritis, autoimmune thyroiditis, idiopathic pulmonary fibrosis and probably lymphoma.

Clinical features

In acute hepatitis C clinical illness is often mild, usually asymptomatic with about 10% of patients have mild, flue-like illness and a rise in serum aminotransferases. Most of the patients are diagnosed years later with complications of chronic liver disease.

Diagnosis

Diagnosis of hepatitis C is frequently by exclusion with negative markers for hepatitis A and hepatitis B. HVC RNA (PCR) is positive 1-2 weeks after infection. Anti-HCV antibodies in serum take 6 weeks to develop.

Treatment

Alpha interferon for 6-24 weeks in acute hepatitis decreases risk of chronic hepatitis.

http://doctor-tips-for-health.blogspot.com/2011/07/hepatitis-health-tips.html

HEPATITIS B ( Health tips)

noreply@blogger.com (Unknown) — Thu, 7 Jul 2011 23:22:00 -0700

1. Mode of spread:

Intravenous route: Transfusion of infected blood or blood products. Contaminated needles used by drug addicts, tattooists or acupuncturists.
Sexual intercourse with infected person because virus is present in salvia, semen and vaginal secretions.
From infected mother to child at the time of delivery.

2. High risk persons are IV drug abusers, patients and staff and hemodialysis centers, homosexuals physicians, dentists, nurses and persons working in pathological laboratory and blood bank.

3. The risk of fulminant hepatitis is in 1-2% of persons with acute disease.

4. Can lead to chronic hepatitis, carrier state or hepatocellular carcinoma.

5. Perinatally infected infants generally have no clinical signs or symptoms, and infection produces typical illness in only 5-15% of children aged 1-5 years.

6. Incubation period: 1-6 months.

HEPATITIS B VIRUS (HBV)

Hepatitis B virus is a DNA virus also called Dane partcle; it consist of an inner core and an outer surface capsule.

The inner core is formed of core protein (hepatitis B core antigen-HBcAg). Core protein contains DNA and DNA polymerase. The capsule protein is referred to as hepatitis B surface antigen (HBsAg). Hepatitis B virus also contains e antigen (BHeAg).

VIRAL MARKERS

The hepatitis B virus proteins act as antigens to which infected person can make antibodies. These antigens an their antibodies are important in identifying hepatitis B virus infection; these are called viral markers.

1. Hepatitis B surface antigen (HBsAg).

It is located in the capsular material of virus and is the first viral marker detectable after infection with hepatitis B.
It appear in the blood in late incubation period before the elevation of aminotransferases and development of clinical features hepatitis.
If becomes undetectable usually after 1-2 month after the onset of jaundice and rarely persists beyond 6 months. In chronic hepatitis it remains detectable beyond 6 months.

5. Antibodies to hepatitis B surface antigen (anti-HBs)

Anti-HBs usually appear after clearance of surface antigen and persist for many years or perhaps permanently. Occasionally appearance of anti-HBs is delayed for several weeks of disappears of surface antigen (i.e. no antigen and no antibody detectable); this is called window period. During this period patient is infectious, therefore negative surface antigen does not rule out infection. If doubt is there, perform anti-HBc 1gM to confirm the infection.
Presence of these antibodies indicates previous infection or vaccination.
Disappearance of HBsAg and appearance of anti-HBs indicate recovery from HBV infection.

3. Hepatitis B core antibodies (anti-HBc)

Hepatitis B core antigen (HBcAg) is located in the central part of the virus but it does not appear in the blood.
Anti-HBc is the first antibody to appear, it appears shortly after HBsAg is detected. 1 gM type of Anti-HBc is a definitive evidence of acute infection and is predominant in first 6 months. 1 gG type of anti-HBc appear during acute hepatitis and is predominant beyond 6 months and persist indefinitely, whether the patient recovers (in which anti-HBsAg is also present) or develop chronic hepatitis (in which HBsAg is also present).

4. Hepatitis B 2 antigen (HBcAg).

HBeAg appears during incubation period shortly after detection of HBsAg. It indicates viral replication and infectivity.
Persistence of HBeAg in serum beyond 3 months suggests and increased likelihood of chronic hepatitis-B and presence of HBeAg during chronic hepatitis B is associated with ongoing viral replication, infectivity and inflammatory liver injury.
Disappearance of HBeAg is followed by the appearance of anti-HBe indicating diminished viral replication and decreased infectivity.
Some rare mutant forms of virus cannot synthesize the “e” antigen (pre-core mutant) and PCR for HBV DNA is required to confirm viral replication. Majority of hepatitis B virus is “wild type” that synthesizes ‘e’ antigen (HBeAg).
HBsAg-positive serum containing HBeAg is more likely to be highly infectious. For example mothers with HBsAg and HBeAg transmit hepatitis B infection to their offspring in more than 90% while mothers with HBsAg with anti-HBe rarely infect their offspring.

5. Hepatitis B virus DNA (PCR for hepatitis B)

The presence of hepatitis B virus DNA in serum is a more sensitive marker of viral replication and infectivity. It can be detected by polymerase chain reaction (PCR) method.

Significance of viral markers in hepatitis B

HBeAg: present in acute or chronic infection.
HBeAg: rises early and fall rapidly in acute hepatitis, persistence indicates development of chronic hepatitis and increased sensitivity.
HBV DNA (PCR): implies viral replication.
Anti-HBe: indicates previous exposure and immunity to HBV.
Anti-HBe: indicates diminished viral replication and low infectivity.
Anti-HBc:

IgM: high titer in acute and low titer in chronic infection.

IgG: indicates past exposure to hepatitis B.

Patient may be recovered or developed chronic hepatitis.

Clinical application to viral markers.

· Identify hepatitis B infection (HBsAg).

· Identify either acute or chronic infection (anti-HBc antibodies).

· Identify virus replication (HbeAg) that is required for treatment with interferon.

CLINICAL FEATURES

Clinical features are similar to hepatitis A although the illness may be more sever; however infection may be asymptomatic.
In addition, a serum sickness-like immunological syndrome may be seen in acute hepatitis during prodromal stage in up to 25% of cases. This consists of rashes (e.g. urticaria, maculopapular rash, Henoch-Schonlein purpura and polyarthritis affecting small joints.
Fever is usually present.

Extrahepatic immune complex-mediated conditions such as polyarteritis nodosa, or glomerulonephritis are occasionally seen.

INVESTIGATIONS

Non-specific

LFTs, complete blood count, urine analysis, PT and blood sugar-as performed in hepatitis A.

Specific

HBsAg and anti-HBc 1gM should be performed. If HBsAg is positive, a full viral profile is then performed.
In routine HBsAg is performed but it may be profile is then performed.
In routine HBsAg is performed but it may be cleared rapidly or titer is very low, therefore anti-HBc IgM should also be performed simultaneously.
HBV DNA (PCR) is the most sensitive test of viral replication.

COMPLICATIONS

Fulminant hepatic failure.
Post hepatitis syndrome: fatigue, fat intolerance and right upper quadrant pain.
Chronic hepatitis.
Cirrhosis.
Hepatocellular carcinoma.
Rare complications of viral hepatitis are as follows:

Pancreatitis, myocarditis
Atypical pneumonia
Aplastic anemia
Transverse myelitis
Peripheral neuropathy

HEPATITIS A (Health Tips)

noreply@blogger.com (Unknown) — Tue, 5 Jul 2011 03:07:00 -0700

This is the most common type of viral hepatitis, highly infectious and is caused by hepatitis A virus. This disease commonly affects children and young adults.
Spread of infection is mainly by the oro-fecal route and arises from the ingestion of contaminated water and food (e.g milk). Overcrowding and poor sanitation facilitate the spread. Infected person excretes virus in the feces for about 2 weeks before the onset of clinical illness and for up to 7 days after.
Hepatitis A is maximally infectious just before the onset of jaundice. Blood and stools are infectious during the incubation period (2-6 weeks) and during early illness.
Clinical illness is more severe in adults than in children.
No carrier state, complete recovery, does not lead to chronic hepatitis.
Mortality is low and fulminant hepatitis is uncommon except in cases where hepatitis A occurs in a patient with chronic hepatitis C.
incubation period 2-6 weeks.

DIAGNOSIS

Antibody to hepatitis A (anti-HAV) appears early in the course of the illness. Detection of 1gM anti-HAV is and excellent test for diagnosis of acute hepatitis A. Peak titers of 1gM occur during the first week of clinical disease and usually disappear within 3-6 months. Titers of 1 gG peak after one month of the disease and may persist for years.

CLINICAL FEATURES

Pre-icteric or prodromal phase

This phase of constitutional symptoms precedes the onset of jaundice by 1-2 weeks. Onset may be abrupt or insidious.

Initially there is flue-like illness such as malaise, easy fatigability, headache, arthralgia, myalgia and upper respiratory symptoms e.g. nasal discharge, cough and pharyngitis.
Anorexia: Out of proportion to the degree of illness.
Nausea, vomiting are frequent, diarrhea or constipation may occur.
Mild fever (100-102-F) with chills is usually present.
Abdominal pain: mild and constant pain in right upper quadrant or epigastrium due to stretching of capsule of enlarged liver.
Dark-colored urine (due to bilirubinuria) may be noticed

Icteric phase

After 1-2 weeks patient develops jaundice. This phase is called icteric phase. With the onset of jaundice there is often improvement of the prodromal symptoms. Features of this phase are:

Jaundice occurs in most (70-85%) adults with acute HAV infection. Jaundice is less likely in children and is uncommon in infants. The degree of icterus also increases with age.
Liver becomes enlarged and tender with pain in right hypochondrium due to stretching of liver capsule.
Splenomegaly and cerical lymphadenopathy are present in 10-20% of patients particularly in children.
Dark colored urine, pale stool due to intrahepatic cholestasis

.Convalescent phase

This recovery phase comes within 3-6 weeks of illness and is characterized by increasing sense of well being, return of appetite and disappearance of jaundice, abdominal pain and tenderness.

COURSE OF HEPATITIS A

The acute illness subsides over 2-3 weeks with complete clinical and laboratory recovery by 9 weeks. Less than 1% develop acute fulminant hepatic failure. Relapse may occur in hepatitis A but ultimate recovery is the rule.

http://doctor-tips-for-health.blogspot.com/2011/06/chronic-liver-disease-cld.html

Chronic Liver Disease (CLD)

noreply@blogger.com (Unknown) — Fri, 24 Jun 2011 00:07:00 -0700

Symptoms:

1. Right hypochondrial pain due to stretching of liver capsule as a result of hepatomegaly.

2. Ankle swelling due to fluid retention.

3. Gynaecomastia (enlargement of male breast), loss of libido and amenorrhea due to endocrine dysfunction.

4. Pruritus due to cholestasis, this is often and early symptoms of primary biliary cirrhosis.

5. Hematemasis and melena from GIT hemorrhage.

6. Confusion and drowsiness due to neurological complicatin (hepatic encephalopathy).

Signs:

Skin

· Palmar erythema: Indicating hyperdynamic circulation. (may also occur in pregnancy, thyrotoxicosis, rheumatoid arthritis, CO2 retention and old age).

· Clubbing: occasionally occur.

· Dupuytren’s contracture: (often in alcoholic cirrhosis).

· Spider nevi: These are telangiectasias that consist of a central arteriole with radiating small vessels. They are found in the distribution of the superior vena cava (i.e. above the nipple line).

Abdomen

· Initial hepatomegaly followed by small liver in well established cirrhosis.

· Splenomegaly: Indicating portal hypertension.

Endocrine system

· Testicular atrophy

· Gynecomastia: enlargement of male breast occurs due to decreased estrogen metabolism in diseased liver, it also results from treatment with spironolactone, a diuretic commonly used for edema and edema and ascites in cirrhosis.

With complications:

· Jaundice

· Encephalopathy: (drowsiness, stupor, flapping tremor of outstretched hands and fetor hapaticus)

· Collateral veins e.g. veins around the umbilicus forming caput medusae

· Peripheral edema

· Ascites

http://doctor-tips-for-health.blogspot.com/2011/04/types-of-heart-failuer.html

NORMAL LIVER FUNCTIONS (Health tips)

noreply@blogger.com (Unknown) — Wed, 15 Jun 2011 04:48:00 -0700

Recognition of normal liver functions is necessary to understand the manifestations that develop when liver becomes abnormal due to disease process.

SYNTHETIC FUNCTION (Health tips)

Protein synthesis

Liver is the principal site of synthesis of all circulating proteins except gamma-globulins, which are produced in the reticuloendothelial system. Plasma contains 6-8 mg/dl of proteins, mainly in the form of albumin, globulin and fibrinogen. Liver also synthesizes complement factors, transferin, haptoglobin, caeruloplasmin, protease inhibitors (a 1-antitrypsin), and a-fetoprotein.

Albumin has half-life of 16-24 days and 10-12g is synthesized daily. Its main functions are to maintain the intravascular colloid osmotic pressure and to transfer water-insoluble substances such as bilirubin, hormone, fatty acids and drugs.

Albumin synthesis is reduced in chronic liver disease and malnutrition. It can be lost in nephritic syndrome and in protein-losing enterpathy.
Hypoalbuminemia results in edema.

Coagulation proteins

Liver also synthesizes all coagulation factors (other than factor VIII) such as fibrinogen, prothrombin, factors V, VII, IX, X and XII.

Deficiency of coagulation factors results in bleeding tendency.

METABOLIC FUNCTIONS

Carbohydrate metabolism

Liver is the main source of plasma glucose as it is the main body storage site for glycogen. In the fasting state glucose is derived from glycogen breakdown of (glycogenolysis) and gluconeogenesis (formation of glucose from amino acids and fatty acids).

Liver damage can lead to hypoglycemia.

Fat metabolism

Liver synthesizes triglycerides, cholesterol, phospholipids and lipoproteins.

Protein metabolism

In addition to its synthetic function, liver is the central organ in protein catabolism and synthesis of urea formation. Ammonia is produced by the degradation of amino acids that is converted into urea. Urea is secreted by the liver into plasma for excretion by the kidney. This is the major pathway for the elimination of nitrogenous waste.

Ammonia level becomes high in severe liver disease that is harmful for brain and may lead to hepatic encephalopathy.

EXCRETORY FUNCTION

Liver is responsible for excretion of many substances in the bile.

Bilirubin metabolism

Bilirubin is produced mainly from the breakdown of mature in Kuffer cells of the liver in the reticuloendothelial system. Biliverdin is formed form haem after removal of iron; this Biliverdin is reduced to form bilirubin. The bilirubin produced unconjugated and water-insoluble, and is transported to the liver attached to albumin. Bilirubin dissociates from albumin and is taken up by the hepatic cells, where it is conjugated red cells with glucuronic acid and is excreted in bile.

In liver disease there may be obstruction to excretion of bilirubin manifesting as jaundice.

This conjugated bilirubin enters in intestine within bile, and is not absorbed because of its large molecular size in the terminal ileum. Bacterial enzymes hydrolyze the molecule, releasing free bilirubin, which is then reduced to urobilinogen. Some off this is excreted in the stools as stercobilinogen and the remainder is absorbed by the terminal ileum, passes to the liver via enterohapatic circulation and is re-excreted in bile. Urobilinogen bound to albumin enters the circulation and is excreted in the urine via kidneys.

Bile acids metabolism

Bile acids are synthesized in hepatocytes from cholesterol. They are excreted in bile and then pass into the duodenum. Bile acids are detergents, causing fat solubilization that is necessary for absorption of lipids and lipid-soluble vitamins such as vitamin A, D, E and K.

Decreases excretion of bile salts in liver disease causes:

- Pruritus (itching)

- Bleeding disorder: deficiency of vitamins such as vitamin K leads to decreased formation of vitamin K dependent coagulation factors resulting in bleeding tendency.

- Steatorrhea (fatty stool) due to fat malabsorption.

DETOXIFICATION FUNCTION

Liver plays a vital role in detoxifying nitrogenous compounds derived from intestine, as well as many hormones, drugs and chemicals.

http://doctor-tips-for-health.blogspot.com/2011/05/weight-loss-tips.html

LEAD POISONING ( Health Tips)

noreply@blogger.com (Unknown) — Sun, 5 Jun 2011 22:40:00 -0700

Lead is used in a variety of industrial and commercial products such as paints, cans, plumbing fixtures, leaded gasoline, improperly glazed ceramics, lead crystals, leafy vegetables grown in lead contaminated soil and storage batteries.

Lead produces adverse effects on CNS, GIT and blood.

METABOLISM

Lead is absorbed into the blood where 95-99% is sequestered in red cells, where it is bound to hemoglobin. Therefore lead is measured in whole blood rather than in serum. The largest proportion of absorbed lead is incorporated into skeleton; however it also appears in nails, hair, sweat, saliva and breast milk.

Toxicity occurs due to its affinity for cell membrane and mitochondria. Therefore it interferes mitochondrial phosphorylation. Na+ K+ and calcium ATPase.

CLINICAL FEATURES

CHILDREN

Symptomatic

Symptomatic toxicity in children develops usually at blood level of 80 ug/dl and is characterized by:

Abdominal pain and irritability followed by lethargy, anorexia, pallor (due to anemia), ataxia and slurred speech.
Convulsion, coma and death due to generalized cerebral edema and renal failure occur in severe cases.

Subclinical toxicity

Subclinical toxicity occurs at blood level>30ug/dl and causes learning disorders in children and motor neuropathy.

It presents with mental retardation, selective deficits in language, cognitive function, balance, behavior and school performance. Maximum impact occurs at around age 2 years.

ADULTS

Symptomatic

Symptomatic toxicity in adults develops when the blood lead level is >80ug/dl for period of weeks and is characterized by:

Abdominal pain, headache, irritability, joint pain, fatigue, anemia, peripheral motor neuropathy (e.g foot drop, wrist drop), deficits in short-term memory and ability to concentrate.
Lead-line appears on gingival-tooth border after prolonged high level exposure.

Chronic Subclinical

Chronic Subclinical intoxication causes:
Interstitial nephritis, tubular damage, hyperuricemia (with increased risk of gout) and chronic renal failure.
Hypertension.

FOR BOTH CHILDRENAND ADULTS

Increased bone level is a risk factor for bone diseases, anemia and hypertension.
Hyperthyroidism may causes lead toxicity by mobilizing stores of lead in bones.

INVESTIGATIONS

Blood lead level:

· Less than 10 ug/dl is considered non-toxic.

Levels between 10-25 ug/dl is associated with impaired neurobehavioral development in children.
Levels of 25-50 ug/dl may be associated with headache, irritability and Subclinical toxicity.
Levels of 50-70 ug/dl are associated with moderate toxicity.
Levels >70-100 ug/dl are associated with severe poisoning.

Blood CP: microcytic anemia with basophilic stippling.
Blood protoporphyrin: elevated.
Gamma aminolevillinic acid (heme precursor) increases in plasma and urine.
Nerve conduction velocity (NCV): prolonged nerve conduction time due to peripheral demyelination usually of extensor muscles of hand and feet.
X-ray bone: increased density at metaphyseal plate and growing long bones (lead lines) can develop in children.
UCE: adults chronically exposed to lead can develop elevated serum creatinine.

MANAGEMENT

Emergency measure

Coma: maintain airway, other management of unconscious patient.

Convulsion: anticonvulsion therapy.

Activated charcoal and endoscopic removal for recent acute ingestion.

Chelating agents

EDTA, dimercaprol and penicillamine.

Indications for chelation: blood lead level > 55 ug/dl in children and 80 ug/dl in adults.

BENZODIAZEPINE POISONING (Health tips)

noreply@blogger.com (Unknown) — Thu, 2 Jun 2011 22:40:00 -0700

Benzodiazepines are used as tranquilizers and as sleeping pills.
Poisoning is usually due to attempted suicide.
Alprazolam (Xanax), lorazepam (Ativan), bromazipam (Lexotanil) are commonly used benzodiazepines.

CLINICAL FEATURES

Features develop within 30 min of an over-dose and include:

Weakness, ataxia, dilated pupil, dysarthria and drowsiness.
Nystagmus and confusion are also observed. Minor hypotension may occur.
Coma and respiratory depression can occur with short acting benzodiazepine such as midazolam (Dormicum) or if benzodiazepines are combined with other CNS depressants such as tricyclic antidepressants.

MANAGEMENT

Gastric lavage is not advised in pure benzodiazepine overdose.
Activated charcoal should be given repeatedly to decontaminate GIT.
Impaired consciousness requires particular attention to maintain airway. Pulse oximetry is needed to monitor oxygen saturation.
Observation should be for at least 6 hours post-ingestion.

Flumazenil

(Inj. Anexate 0.1mg) a competitive benzodiazepine receptor antagonist can reverse CNS and respiratory depression. It is given IV as incremental dose of 0.2, 0.3 and 0.5 mg at 1 min intervals until the desired effect is achieved or a total dose of 3-5 mg has been given.

Flumazenil is not given routinely in mild to moderate poisoning (required when there is CNS or respiratory depression). It is expensive, costs more than Rs. 3000/injection.

Flumazenil should not be given in patients who are chronic dependent on benzodiazepine or who have taken tricyclic antidepressants with benzodiazepine; in these patients seizure may be precipitated. Removal of drug through dialysis is not possible because 85 to 99% or drug is protein bound in the plasma.

http://doctor-tips-for-health.blogspot.com/2011/05/turbo-fire-workout-how-to-lose-your.html

SNAKEBITE POISONING ( Health Tips)

noreply@blogger.com (Unknown) — Mon, 30 May 2011 22:17:00 -0700

Snakebite is a common emergency in our hospitals, patients usually come from the rural areas, most of the time they are aware of the snake species. Students may get patient of snakebite as a long case in exams.

Common types of poisonous snakes

Poisonous species of snake fall into three families:

Viperideae: such as Russel viper, pit viper.
Elapidae: such as cobra, krait, and coral snake.
Hydrophidae: such as sea snake.

PATHOGENESIS & CLINICAL FEATURES

Poisonous snakes have a pair of enlarged teeth called fangs in their upper jaws that inject venom into the tissues of their victim.

Snake venoms are complex mixtures of proteins and small polypeptides with enzyme activity.

Effects of venoms may be:

Hematotoxicity: They cause the vasculature leaky resulting in local or systemic bleeding leading to hypotension and shock.
Cytotooxicity: causing local tissue necrosis, mygolinuria and renal failure.
Coagulopathy: causing bleeding or clotting disorders.
Cardiotoxicity: causing myocardial depression and reduced cardiac output.
Neurotoxicity: inhibiting peripheral nerve impulses leading to paralysis.

Viperidae:

Local swelling, echymosis and blistering at the site of bite.
Systemic involvement within 30 min including vomiting, hypotension and shock.
Bleeding and clotting disturbances (Coagulopathy): bleeding gums or venepuncture sites, bleeding may be fatal.

Elapidae:

Usually no swelling at the site of bite.
Vomiting, salivation.
Hypotension and shock resulting from loss of intravascular fluid into the soft tissues.
Neurological symptoms: muscle weakness causing ptosis, diplopia and dysphagia, with paralysis of respiratory muscles in severe cases.
Myocardial depression causing reduced cardiac output and rhythm disturbances.

Hydrophidae (sea snake)

Muscle involvement causing rhadomyolysis with myalgia and myoglobinuria the may lead to acute renal failure. Cardiac and respiratory paralysis may occur.

INVESTIGATIONS

Blood grouping and cross matching: as soon as possible before the effect of circulating venom interfere the blood grouping.
Complete blood count: to evaluate degree of hemorrhage and hemolysis.
Urea, creatinine and electrolytes: for renal status.
Liver function tests (LFT’s)
PT, APTT, BT, CT, FDP: to asses Coagulopathy.
Urine analysis: for hemoglobinuria and myoglobinuria.
ABGs may be required in severe cases.
ECG: to look for rhythm disturbances.
Chest X-ray.

MANAGEMENT

· All patients with suspected snake bite should be observed for 12-24 hours, as initial manifestations may be delayed, especially with elapid bites.

Reassuring the patients, not all snakes are poisonous and even bite by the poisonous snake may be “dry bite” i-e no venoum in the bite.
Try to identify the type of snake.
Immobilize the bitten area to minimize the venom spread.
Application of firm bandage to occlude lymphatic drainage (not the arterial supply); use of tourniquet is discouraged because they do not prevent spread of venom.
Incisions at the site of bite and attempts to such out the venom with mouth should not be made.
Pain and vomiting: symptomatic treatment. Aspirin should not be used for pain since this may aggravate bleeding.
Saline and dopamine for hypotension.
Monitor blood pressure, coagulation, renal, neurological and cardio respiratory status.
Large bore IV canulla should be inserted on un affected limb.

Antivenin:

Antivenin is indicated in patient with severe or progressing local tissue local reaction at the site of bite, clinical or laboratory evidence of systemic involvement.
In about 50% of snake bites no venom is injected (Dry bite) and antivenoms are generally not indicated. However when indicated antivenoms should be given early, as the antivenoms only neutralize venom they can not reverse the effects of venom. Allergic reaction is the frequent complication of antivenin.
Antivenom should be given slow IV, the same dose being given to children and adults.
Before starting antivenom a test does is given; 0.02 ml of saline-diluted antivenom is injected subcutaneously and observed for at least 10 min for redness, hives, pruritus or other allergic reactions. A syringe containing 0.5 ml of 1:1000 adrenaline must be available to combat anaphylaxis whenever antivenin is administered. Adrenaline is given subcutaneously. However skin test does not always predict which patients will have allergic reaction to anti venom; a skin test may be false positive or false negative.
Intravenous antihistamine and ranitidine should be given before starting antivenin infusion to limit the acute allergic reaction.
In severe cases the anti venom infusion should be continued even with allergic reaction with closely controlled conditions and adrenaline, antihistamine and steroids.
Antivenin should be diluted in 1000 ml of saline, Ringer’s lactate or 5% dextrose water and should be given slowly, in children 20ml/kg.
Physician should be at the bedside to intervene in the event of an acute allergic reaction. Total dose may be given in 1-4 hours. Further antivenin may be necessary if clinical abnormalities worsen.
Anti venom is usually available in big government hospital. Administrators are requested to make sure the availability of this life-saving medicine.

http://doctor-tips-for-health.blogspot.com/2011/06/lead-poisoning-health-tips.html

Breast Cancer Awareness Promotional Products (Health Tips)

noreply@blogger.com (Unknown) — Mon, 30 May 2011 00:23:00 -0700

Breast Cancer (Health Tips)

One critical disease which is faced by majority of our population is that of “Breast Cancer “. Every eight women is affected by this fatal disease. To make people aware of this fatal and horrible disease, there have been many campaigns and publicity is done, to benefit more and more people from this. To make these campaigns successful and fruitful, people must be tempted to participate and to have their interest in this. For this purpose promotional products are used on large scale. One of the products is that of pink color sport bottle. One can ask the question why pink?

It is pink because on internal level, Pink ribbon is used as a symbol of “Breast Cancer” so, pink is closely attached with “Breast Cancer” so, “pink sport bottles” is a step towards awareness in masses by way of engaging them in health sports. Activities Men can also support their apposite sex(women) by taking part in such campaigns. This will encourage and embolden women. Another product is that of “ Pink shot bottle” So, that products are helpful in decoration as well as spreading awareness.

Another device is that of “Tote bags”. Messages cancering awareness are attached to tote bags and they are also used in daily routine. “pink caps” are used for awareness. Message are attached to the caps which when exposed to public, results in awareness

“Turbo Fire Workout- How to lose your weight”

noreply@blogger.com (Unknown) — Mon, 16 May 2011 22:12:00 -0700

Now-a-days people don’t show moderation in taking food. Either they take too much to it or totally neglect it which causes bad health. Only good and balanced diet can result in good health. If you want to smart and reduce your weight, then act upon the following things. First, try to take a healthy and nutritious lifestyle. For this do the following things.

(1) Eat Meat: If your are having less weight than the age you bear, then take maximum amount of meat because meat catches weight for us. But we know that excess of everything is bad and try to get as much meat as you need. For those who wish to lose weight, they should abstain from large portion of meat.

(2) Vegetables: We all ought to eat vegetables. If you want keep correct and active and smart health, then vegetables would help you a lot and keep a check on your weight. Vegetables help you in keeping your digestive system right and remove extra fat from your body.

(3) Daily Exercise: Another vital factor in losing weight is that of exercise. In exercise try to build up your mussels because they are supporting columns to the whole of our body. We used different type of exercises but the most useful one is that of “Turbo Fire Workout” which help you get slimmer and healthy. This exercise is devised by “Chilean Johnson” and the series is liked by her fans. It consists of 20 month and show positive result each weak with perfect result till the end of the exercise.

http://doctor-tips-for-health.blogspot.com/2011/06/normal-liver-functions-health-tips.html

Weight Loss Tips

noreply@blogger.com (Unknown) — Tue, 10 May 2011 23:46:00 -0700

Weight Loss Tips ( Diet And Exercise)

Do you wish to reduce your weight and decrease it by pounds every 7 days? If you are ready than I can help you.

Share your motives with others. It will help you as well as others.

Try to prepare fresh and easily cooked food. Enrich you refrigerator with green vegetable such as broccoli snap, peas realize your hunger.

After exercise diet:

Don’t take cold liquids after exercise. because this id the critical stage as you are struggling to enhance the metabolic process to burn more calories and cold drinks negatively affect this metabolic process. Never limit your ingredients of diet try to have all types of nutrients in fiber, healthy fat.

Your diet must include a lot of vitamins and minerals. Try to reduce the amount of food from your plate. The trend is that our food is stuffed on plate and thus we eat more.

We eat more than what we need research has proved that it you offer a person more food, he eats more. So must try to serve ourselves with less food.

Try to do this for others for those whom you love. This will encourage you and you will not surrender. Don’t take a lot of sugar. It is not useful for health. This disturbs the amount of insulin and you become idle and lazy.

Make some slight charges. It will make you and your family healthier, buy cream, milk and cheese with low fat, quality. Kick away all futile and surplus things from your diet i-e chips, candy and soda. Stop using sugary and food ride in carbohydrate. Take maximum water and reduce your sleep hours.

Food Supplements Eating Green and a Body Cleansing Diet (Weight Loss)

noreply@blogger.com (Unknown) — Fri, 6 May 2011 02:34:00 -0700

Have you ever though what would be the result of throwing peelings waste food and other things from the sink into a large dustbin but not clearing the dustbin soon, it will be overloaded and it will get blocked and you will need the services of some technician to clean it and restore it to its previous position .

Same is the ease with our body. If we will eat cheap fast saucy and the type of food which is hard to digest, than the condition of our health will be like the dustbin. Such food contains chemical and harmful elements and is disastrous for health if we will not do anything to clean our bodies from such harmful and destructive things, then we will have to consult a doctor. Modern diet which we take is full of chemicals and unnatural ingredients like sodium and sugar. These are poisonous for our body. Those food stuff whore waste can not be removed, get stored in our bodies and causes a disease the following food stuff should be avoided:

1. Ready made and processed foods because they are devoid of energy and contain harmful ingredients.

2. Things derived from animal’s i-e fish, eggs and dairy.

3. Other harmful things are i.e Coffee, alcohol and soft drinks.

So what we should take in our food? Theses are as under Dark leafy vegetables, sea algae and cereal grasses and fluids because they require very little energy for digestion and those body utilizes this energy for cleansing process. They provide us high level of energy and which help in clearing process. And the best thing or food stuff is pure organic fresh green food stuff which quelling do cleansing process. They require least energy for digestion and their waste never get blocked in cells or tissues. They help in clearing out of other wastes and in digested materials.

Why to use Raw vegetables:-

Cooked food and vegetables does not contain that much energy as is contained by raw vegetables.

But inspire of being cooked they still certain some of their micro nutrients and do cleansing process.

“Take Maximum Water”

Our body consists of 75% water and it plays by role in maintaining our health it help in clearing out waste and futile matter . we must drink 2 liters per day. The more water we take the health their we grow. Our eyes sparkle, skin glows and we look better.

So we must take maximum amount of green and fresh vegetable to ensure health and fitness.

ORGANOPOSPHATE POISONING

noreply@blogger.com (Unknown) — Tue, 3 May 2011 02:33:00 -0700

ORGANOPHOSPHATE AND CARBAMATE INSECTICIDE SPOSONING

Organophosphate and carbamate insecticides are widely used in agriculture (For crop spray) and at home as insecticides for rodents, cockroach etc. Parathion, DDT, Finis, Baygon, Coopex are commonly used products. Most of the war gases are also organophosphates.

Mode of Action

Organophosphates and carbamates are also called anticholinestrases because they inhibit the enzyme anticholinestrase resulting in an increased acetylcholine activity at nicotinic and muscarinic receptors and in the central nervous system.

Intoxication may follow:

· Ingestion (for suicide or accidentally).

· Inhalation (usually when spraying crops or even at home using insecticide spray for cockroaches and other insects)

· Dermal absorption

CLINICAL FEATURES

Time from exposure to the onset of toxicity varies from minutes to hours but usually is between 30 min to 2 hours. Most patients recover within 24-48 hours but some insecticides may affect for weeks to months.

Muscarinic effects:

· GIT: nausea, vomiting, abdominal colic, diarrhea, tenesmus (due to increased gut motility) sweating, hypersalivation and fecal incontinence.

RESP: dyspnea, cough, wheezing, increased bronchial secretions, pulmonary edema. Death is usually due to respiratory arrest.

· Urinary: increased urinary frequency and incontinence.

· EYE: Miosis, blurred vision.

· Heart: bradycardia, hypotension, heart block in severe cases.

Nicotinic effects:

· Muscle twitching, fasciculations and muscle weakness. In severe cases paralysis of limb, respiratory and extraocular muscles.

· Hypertension and tachycardia.

CNS effects:

Anxiety, restlessness, tremor, convulsions, confusion and coma.

COMPLICATIONS:

1. Loss of consciousness

2. Respiratory failure (due to aspiration, excessive secretions, pneumonia, septicemia or ARDS). Cause of death is usually respiratory failure.

3. Aspiration pneumonia: due to vomiting in altered consciousness may be aspirated.

4. Urinary tract infection.

5. Septicemia.

DIAGNOSIS

Usually the diagnosis is clinical. History is available from the patient or relatives. It may be confirmed by measuring RBC and plasma cholinesterase activity: a reduction of cholinesterase activity in red blood cells and plasma to less than 50% of normal confirms the diagnosis of organophosphate poisoning.

MANAGEMENT

Oxygen: Admit the patient in ICU and give supplementary oxygen.

Gastric lavage: If the agent was recently ingested, empty the stomach by gastric lavage and administer activated charcoal.

· Do not induce vomiting because of risk abrupt onset of seizures and aspiration.

· If the insecticide is one the victim’s skin or hair, wash with soap and water.

Atropine: Atropine reverses excessive muscarinic stimulation and is effective treatment of salivation wheezing, abdominal cramp and sweating.

Administer atropine 2 mg IV every 15 min until bronchial and other secretions are controlled. Repeated doses or constant atropine infusion (0.02-0.08 mg/kg/hour) may be necessary for several days. Atropine causes tachycardia, if heart rate is more than 130/min then for protection of heart reduce the heart rate with IV diltiazem or propranolol (we have IV verapamil instead of diltiazem and metroprolol instead of propranolol in Pakistan).

Pralidoxime (Contrathion): It is a specific antidote that reactivates cholinestrases and is indicated for nicotinic symptoms due to organophosphate poisoning.

Dose is 1-2 g IV over 5-20 min (one vial of Contrathion contains 200 mg Pralidoxime and costs Rs. 500) i-e. 5-10 vials of Contrathion are diluted in 100 ml of water for injection. The dose may be repeated every 4-6 hours or start continuous infusion at the rate of 10 mg/kg/hr. Continue Pralidoxime as long as there is any evidence of acetylcholine excess.

(Signs of full atropinization: dry hot skin, dry secretions, pulse more then 70/min and dilated pupils).

Mechanical ventilation:

Indication

· Excessive secretions

· Depressed level of consciousness: to protect the airway.

· Poor gas exchange unresponsive to supplementary oxygen.

· Severe metabolic acidosis with hemodynamic instability (systolic BP<90 mmHg).

Mode of ventilator

SIMV + pressure support mode in either pressure controlled or volume controlled form. Positive end expiratory pressure is applied to keep oxygen saturation >94% at FIO2 40%.

Weaning from ventilator is usually carried out with pressure support weaning and T-tube trial.

Types of Heart Failuer

noreply@blogger.com (Unknown) — Thu, 28 Apr 2011 22:39:00 -0700

The Heart Failure may be classified in several ways.

1. Acute versus chronic heart failure

2. Left versus right and biventricular failure

3. Forward versus backward failure

4. Systolic versus diastolic failure

5. Low output versus high output failure

Acute versus chronic heart failure:

Acute heart failure:

Heart failure developing suddenly in hours or days in a previously asymptomatic patient is called acute heart failure.

Chronic heart failure:

Heart failure developing gradually is called chronic heart failure. In this type of failure a variety of compensatory changes may take place in early phase to improve cardiac function. These adaptive mechanisms allow the patient to adjust and tolerate not only the anatomic abnormality but also a reduction in cardiac output with less difficulty.

Left versus right & biventricular heart:

Left sided heart failure:

Left-sided heart failure is characterized by reduction in effective left ventricular output for a given pulmonary venous or left atrial pressure.

An acute increase in left atrial pressure may cause pulmonary congestion or pulmonary edema, while chronic increase in left atrial pressure leads to reflex pulmonary vasoconstriction which protects increasing pulmonary hypertension (as a compensatory mechanism).

Causes of left heart failure

· Ischemic heart disease (commonest)

· Systemic hypertension

· Mitral and aortic valve disease

· Cardiomyopathies

Right sided heart failure:

Right-sided heart failure is characterized by reduction in right ventricular output for any given right atrial pressure. The increased right atrial pressure is manifested as an increased jugular venous pressure and as hepatic congestion.

Causes of right heart failure:

· Secondary to left heart failure (most common)

· Chronic lung disease (causing cor-pulmonale)

· Pulmonary embolism or pulmonary hypertension

· Tricuspid and pulmonary valve disease

· ASD & VSD

· Right ventricular cardiomyopathy

Biventricular or congestive cardiac failure (CCF)

When both sides of heart are involved, features of both right and left heart failure are present. In most of the patient right heart failure is a result of preexisting left heart failure.

Forward versus backward failure:

Forward failure:

In some patients with cardiac failure predominant problem in an inadequate cardiac output that leads to diminished perfusion of vital organs leading to ischemia of theses organs is called forward failure. Ischemia of brain causes mental confusion, ischemia of skeletal muscles leads to weakness, ischemia of kidneys causes sodium and water retention leading to symptoms of heart failure.

Backward failure:

In some patients cardiac failure presents mainly with features of damming of blood into venous system such as lung congestion in left heart failure and congestion of liver, spleen and other areas in right heart failure.

Systolic versus diastolic failure:

In majority of patients heart failure is due to combined systolic and diastolic dysfunction, however isolated systolic or diastolic dysfunction may be present.

Systolic failure:

Heart failure may develop as a result of impaired myocardial contraction (systolic dysfunction). The most common cause of systolic ventricular dysfunction is ischemic heart disease usually after myocardial infarction. The left ventricle is usually dilated and fails to contract normally resulting in symptoms of predominantly forward failure.

Diastolic failure:

Heart failure may develop due to poor ventricular filling caused by impaired ventricular relaxation (diastolic dysfunction). The most common cause is left ventricular hypertrophy as a result of hypertension and coronary artery disease. Other causes of diastolic dysfunction are hypertrophic and restrictive cardiomyopathy, diabetes and pericardial disease.

Diastolic failure is common in elderly, women and in patients with history of hypertension. It is a common cause of patient’s visit to doctor, patients present with shortness of breath and there is history of hypertension only (usually no history of previous MI).

Low versus high cardiac output failure:

Low output failure:

Low cardiac output at rest or during exertion characterizes heart failure caused by common conditions such as congenital, valvular, rheumatic, hypertensive, coronary and cardiomyopathic diseases. Low output failure presents with evidence of systemic vasoconstriction such as cold, paler or cyanotic extremities. Pulse pressure is low.

High cardiac output failure:

Conditions that are associated with a very high cardiac output such as anemia, beriberi, paget’s disease of bone and thyrotoxicosis may lead to or precipitate heart failure.

The extremities are usually warm, and flushed and pulse pressure is wide or normal. Detail of high output failure are given at the end of this section.

Chronic Heart Failure:

Heart failure developing is called chronic heart failure. In this type of failure a variety of compensatory changes may take place in early phases to improve cardiac function. These adaptive mechanisms allow the patient to adjust to and tolerate not only the anatomic abnormality but also a reduction in cardiac output with less difficulty.

As the disease progresses these compensatory mechanisms fail to improve cardiac function.

In compensated cardiac failure, patient has impaired cardiac function but the adaptive or compensatory changes prevent the development of overt cardiac failure. Theses compensatory changes are increased heart rate, hypertrophy of cardiac muscles an dilatation of heart chambers. Acute cardiac failure is uncompensated and therefore more symptomatic because time is required to develop theses compensatory changes to develop.

COMPENSATORY OR ADAPTIVE MECHANISMS IN THE HEART FAILURE:

A number of compensatory changes occur in the cardiovascular system in chronic heart failure to maintain adequate blood flow to the vital organs of the body as following:

MECHANISM ADVANTAGE DISADVANTAGE

IN LONG TERM

Sympathetic stimulation increased heart rate (as cardiac output Increases energy expenditure

Depends on stroke volume and heart rate).

Sympathetic stimulation causing increased

Arterial tone, increased heart rate and

Increased ventricular contractility.

Remodeling Ventricular hypertrophy and dilatation to Leads to deterioration and death

Maintain adequate blood flow. Of cardiac cells

Fluid water retention due Increases ventricular filling pressure Cause pulmonary congestion

To stimulation of rennin- (augment preload)

angiotensin system

The clinical features in cardiac failure are based on the two factors:

Reduced cardiac output (forward failure)

This results from decreased heart function. This reduced output leads to diminished filling of arterial tree, resulting in ischemia of the organs.

Damming of blood (backward failure)

Heart becomes fail o pump the whole blood coming to it, resulting in damming of blood back into venous system, organs become congested & their functions are distributed.

In majority of patients there is combination of both factors mentioned above.

http://doctor-tips-for-health.blogspot.com/2011/06/chronic-liver-disease-cld.html

CHEST PAIN DUE TO MUSCULOSKELETAL DISORDERS:

noreply@blogger.com (Unknown) — Wed, 20 Apr 2011 00:21:00 -0700

CHEST PAIN DUE TO MUSCULOSKELETAL DISORDERS:

Localized tenderness is common. Pain may be sharp, lasting for few seconds or it may be dull that persists for hours or even days. Pain is variable in site and intensity; there is no definite pattern. It may vary with posture or movement, but does not cease instantly on rest. Pain due to cervical spondylosis is very common.

Local tenderness over rib or costal cartilage is usually present.

CHEST PAIN DUE TO AORTIC DESSECTION:

Hypertension and Marfan’s syndrome are the most common predisposing factors. Patient is usually old presenting with severe tearing chest pain radiating to interscapular region, not responding to anti-anginal treatment. Pulse may be unequal. Features of cardiac temponad or acute aortic regurgitation may be present. Chest x-ray may show wide mediastinum. Transesophageal echocardiogram (TEE), CT or MRI are helpful in diagnosis.

CHEST PAIN DUE TO EMOTIONAL CAUSES:

Emotional disorders may cause chest discomfort in the form of chest tightness, lasting for half and hour or more that in unrelated to exertion. It may be sharp and very vrief and located near the left nipple. This type of pain is also called “precordial catch” effort syndrome or Da Costa’s syndrome”. Emotional strain may be evident or not. This type of pain is common in females of our society. However never underestimate the young population because this chest pain may be a real problem as a result of mitral valve prolapse (MVP), aortic stenosis or hypertrophic cardiomyopathy.

Therefore always rule out all possibilities before declaring pain due to emotional disturbance, hysteria or malingering.

Written by

Dr. M. Inam Danish

Home of Health Tips

10 Health Tips for the Men in Your Life

Smoking Cessation Drugs

Prescription and over-the-counter drugs can help you quit smoking, but e-cigarettes may not be the best option.

Nicotine is a powerfully addictive drug, and is the main reason it can be so hard to quit smoking and using other tobacco products.

Prescription Drugs to Help You Quit Smoking

Bupropion

Varenicline

Other Stop-Smoking Drugs

Nicotine Replacement Therapy (NRT)

E-Cigarettes

The Effects of Secondhand Smoke

All the cancer-causing ingredients in tobacco are also found in secondhand smoke

Secondhand smoke — also called SHS, passive, or involuntary smoking — can increase your risk of heart disease, lung cancer, and other serious illnesses.

According to a 2014 Surgeon General's report, about 2.5 million Americans have died from the effects of secondhand smoke over the past 50 years. If you're a smoker, the health of a loved one could be a primary motivating factor in your decision to quit smoking.

What Is Secondhand Smoke?

What Are the Dangers of Secondhand Smoke?

Where Is Secondhand Smoke the Biggest Problem?

How to Quit Smoking------ Health Tips

Here's a simple step-by-step plan to help you stop smoking.

Simple tips for livening up your drinking water

The child years poverty linked to human brain changes related to depressive disorder

Kidney Diet and Disease

18 Keys to Healthy Weight Loss

1. Start with a healthful diet.

2. Keep an eye on portions.

3. Eat mindfully.

4. Eat slowly, chew well.

5. Don’t rely on willpower.

6. Identify emotional triggers that may be making you overeat.

7. Go for volume (low-energy-dense foods).

8. Get adequate protein (and include some with all meals).

9. Eat regularly (don’t skip meals) and choose healthful low-calorie snacks.

10. Limit variety at meals.

11. Don’t drink your calories.

12. Cook at home often.

13. When eating out, follow these simple rules.

14. Allow for (controlled) indulgences.

15. Keep a food diary.

16. Get enough sleep.

17. Consider weighing yourself regularly—at least once a week.

18. Set realistic goals and have a realistic body image.

COUGH (Health Tips)

SHORTNESS OF BREATH (DYSPNEA)

HEPATITIS C

HEPATITIS B ( Health tips)

HEPATITIS A (Health Tips)

Chronic Liver Disease (CLD)

NORMAL LIVER FUNCTIONS (Health tips)

LEAD POISONING ( Health Tips)

BENZODIAZEPINE POISONING (Health tips)

SNAKEBITE POISONING ( Health Tips)

Breast Cancer Awareness Promotional Products (Health Tips)

“Turbo Fire Workout- How to lose your weight”

Weight Loss Tips

Food Supplements Eating Green and a Body Cleansing Diet (Weight Loss)

ORGANOPOSPHATE POISONING

Types of Heart Failuer

CHEST PAIN DUE TO MUSCULOSKELETAL DISORDERS:

According to a 2014 Surgeon General's report, about 2.5 million Americans have died from the effects of secondhand smoke over the past 50 years.

If you're a smoker, the health of a loved one could be a primary motivating factor in your decision to quit smoking.