DIET IN DIABETES:  HOW TO ACHIEVE GOALS OF DIET THERAPY ? IDEAL BODY WEIGHTTo achieve the goals, we need patient’s, dietary habit which includes -a. Timing of food – realated to occupation.b. Variety of food – which denotes choice of food of a diabetes patient.c. Quantity of food consumed by the patients – which denotes how much calories he needs and how much he consumes.Execssive intake of calories results in weight gain and obesity which in turn adversely affects the glucose tolerance by inducing target cell resistence to insulin action. Goal of diet therapy is to attain an ideal body weight by consuming desired amount of calories.Ideal body weight (IBW)IBW (in kg) = (Height in cms -100) x 0.9Body Mass Index (BMI) is calculated from the following formula-BMI (Body Mass Index) =     Weight in kg                                             (Height in Meters)2BMI – is normal –                17-27 (in male)                                               17 – 25   (in female)Lean (under weight)             < 17 Overweight                            > 27 – 32Obesity                                   > 32Waist/Hip ratio for central obesityNormal W : H ratio         =   < 0.9 for males                                           =   < 0.86 for femaleIf it is more than normal values then central obesity is present.*27\329\8*

TIPS ON TRAVELING BY AIR FOR PEOPLE WITH RHEUMATOID ARTHRITIS (RA)Notify the airline in advance of any special needs you have. Airline personnel can help you with your luggage and assist you in boarding and getting off the airplane. Airlines can often accommodate special diets.Try to travel during light air traffic hours and the least busy weeks of the year. It’s best to avoid crowds.If possible, find a flight that will deliver you to your destination without stopping in another city on the way, especially if the flight involves changing planes. If it isn’t possible to book a nonstop flight, allow for adequate time between flights. Arrangements can be made to have a wheelchair or cart transport you and your luggage to the next departure area.Carry as little luggage as possible onto the airplane. Heavy luggage should be sent through normal airline luggage processes.If you are wheelchair bound use the restroom before boarding the plane. Restrooms on board are often not easily accessible for someone in a wheelchair.When planning a hotel or motel stop, call in advance to find out whether their facilities will meet your needs. If the facilities will make it difficult for you to maneuver or if they will force you to exert energy that you would rather save to use elsewhere, then you’ll probably want to find someplace else to stay. Ask these questions:• How close is the parking lot to my room?• Where are the elevators in relationship to my room?• Is it possible to book a room that has bathroom tub and toilet “grab” bars?• If you are in a wheelchair are there ramps, and are the doors to the room and bathroom wide enough to accommodate a wheelchair?*124/209/5*

ENTERIC FEVER AS ONE OF THE MAJOR TROPICAL CAUSES OF FEVEREnteric fever refers to a clinical syndrome caused by Salmonella typhi (typhoid fever) or, less commonly, Salmonella paratyphi (paratyphoid fever). Disease may be acquired by either direct fecal-oral spread or through fecal contamination of food or water. Typhoid fever is common in many developing nations, and travel to Mexico, India, the Philippines, Pakistan, El Salvador, and Haiti accounts for the majority of cases.Following an incubation period of 5 to 21 days, patients usually present with sustained fever, anorexia, malaise, and vague abdominal discomfort. Although diarrhea may occur early, it often resolves before fever develops, and constipation is the usual complaint on presentation. A pulse-temperature dissociation may be noted on vital signs. Rose spots are found in 30% to 50% of patients but are subtle and must be searched for carefully. Hepatosplenomegaly may also be identified. Laboratory findings are nonspecific, with anemia, leukopenia, and elevated transaminases common.There are few distinctive clinical features, and the diagnosis should be considered in all febrile travelers, even those without gastrointestinal symptoms. Since current typhoid vaccines have an efficacy of approximately 70%, enteric fever is still a possibility in those who have been immunized. Diagnosis is achieved by isolation of the organism in cultures of blood, stool, urine, bone marrow, and duodenal aspirates. Prior or concurrent antibiotic use reduces the ability to isolate the bacterium. Fluoroquinolone antibiotics are the treatment of choice.*202/348/5*