Antidepressants Blog

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*

LEARNING ABOUT ARTHRITIS FORMSCirculatory problems, infections, stress, or referred pain from other parts of the body can produce arthritis-like symptoms, but most of the cases of true arthritis can be diagnosed by blood tests or tests of synovial fluid obtained by aspirating joint fluid. Rheumatism is a word some people use for arthritis. It’s not a formal disease, however, but a term used to describe those aches, pains, and stiff feelings that beset all of us sometimes.Some forms of arthritis seem to have a hereditary factor: they run in families. Many allergies and environmental sensitivities run in families, too.It has been speculated that a virus might be the culprit, but that has never been proved. The symptoms associated with many allergic reactions resemble virus infections, too.Various theories have blamed the inappropriate leakage of enzymes or microbes through blood-vessel walls into joints that become arthritic. The leakage of fluid through allergen-affected blood-vessel walls is characteristic of many allergic responses, too.It has been noted that some forms of arthritis begin or flare up at times of emotional stress, though it is not known why. Many allergic people are more sensitive during times of stress, too.So far, despite the vast sums spent on research, about the only thing that conventional modern medicine claims to be sure about arthritis is that the cause is unknown. One aspect of the disease that particularly puzzles researchers is the group of apparently unrelated disorders that often accompany arthritis. After all, why should headaches, colitis, asthma, fatigue, depression, or rashes occur along with a disorder of the joints? Of interest to the bioecologists (who also do not claim to understand with certainty the basic cause of the disease) is the fact that these arthritis-associated conditions in other systems are common, body-wide allergic reactions. In a majority of cases arthritis consists of the joint and muscle reactions to specific, identifiable environmental substances that are also affecting many other body structures. These offending agents reach allergically reactive sites throughout the body via the bloodstream, after gaining entrance to the body through the digestive tract and/or the lungs.*9/295/5*

RELAXATION TRAINING FOR WAYWARD NERVES: CREATIVE VISUALIZATION – RECOMMENDATIONS FOR RELAXATION SESSION If you practise visualization every day you will begin to feel things changing, you will become stronger and more in charge. You may be moving away from a lifetime of negative thoughts, so don’t be too impatient – give it time. To many people the idea that they are valuable human beings worthy of love is very new, and visualizing themselves as children often brings tears. Welcome this if it happens: it is part of the healing you need. Also don’t expect to forgive everyone in the first session; one woman said ‘It took me nine weeks to give my ex-husband “a rose” but I felt so liberated when I managed it.’You need not remember this guided imagery word for word, it is only a model for you to work from; you can make up any imagery you choose. The key factors to include are: being in a peaceful place; cleansing; looking at colours; loving and forgiving yourself and others; allowing a healing light to travel over you; and repeating a positive affirmation such as, ‘every day etc’ or ‘I love and approve of myself exactly as I am’; ‘I am contented and healthy.’ If you like the suggested imagery but have difficulty remembering it you could put it on tape. Some people find their own voice irritating on tape; if this is your experience ask a friend, particularly someone who cares for you, to do it for you.*113\326\8*

LIVING WITH EPILEPSY: ALCOHOLGiles was a company director, successful, with a nice home, a family he loved and a good job. He had occasional grand mal seizures, and his doctor had advised him that he shouldn’t drive and reminded him that it was a condition of his licence that he let the vehicle licensing department at Swansea know that he had been diagnosed as suffering from epilepsy. His doctor also warned him that he shouldn’t drink alcohol.Despite this, Giles insisted on driving. He was careful about drinking; although he drank occasionally he would nearly always stay within the legal limit, and he never drove after he’d been drinking. One evening he had a business dinner, and as he was getting a lift home, he drank about half a bottle of wine. The next morning as he was driving himself to work he had a seizure. His car struck an oncoming Rolls Royce, badly damaging it and injuring the owners wife, who was a passenger. Unfortunately for Giles, an on-the-spot policeman saw what had happened, realized he had had a fit and reported him to the Licensing Authority. His insurance company was also informed; they wrote to his GP who confirmed that Giles did have seizures. The insurance company then refused to cover his claim, which was considerable as it included not only the Rolls but damages for injuries sustained by the passenger. Giles had to sell his house to meet the claim.Of course, Giles should not have been driving at all, regardless of whether he had been drinking. In addition, he had not properly understood that it is withdrawal from alcohol that tends to trigger seizures, not the drinking itself.You will have to drink with care while you are taking anticonvulsant drugs although you may not need to cut out alcohol altogether. There are several reasons for taking care with alcohol. It will react with your drugs and slow you down much more than you would expect. Alcohol causes what is known as ‘liver enzyme induction’. It stimulates the liver to produce more enzymes which break it, and other drugs, down more rapidly so that it can be excreted. If you have one or two drinks a day regularly over a long period and then stop suddenly, the liver function returns to normal and your anticonvulsant drugs will not be broken down so fast. They also tend to accumulate in your blood. If you are taking phenytoin, the raised level of the drug may cause seizures; the raised levels of any other drugs you are taking may also have toxic effects. And, as discovered, if you have been drinking and then stop, alcohol withdrawal itself may precipitate a seizure.If you have epilepsy, your best policy is not to drink at all. But if you find this impractical or impossible, do try to stick to these rules for safer drinking:Drink as little as possible and try not to develop a regular drinking habit, even if it is only a moderate one.Take ‘shorts’ or order half a pint of beer to avoid the water load that can sometimes precipitate a seizure.*58\193\2*

DIABETES: WORKING FOR PREVENTION… AND A CURE”The fact is that almost anybody with diabetes has a difficult time with it,” says Dr. Richard A. Jackson. He heads the Hood Center for Prevention of Childhood Diabetes, at the Joslin Diabetes Center in Boston. “They have to watch what they eat, when to eat it, what physical activities they may do – and none of this ever goes away.” But Dr. Jackson and other researchers are making huge advances toward prevention and, ultimately, a cure.”Even 5 years ago,” he says, “no one thought you could prevent diabetes. Today, we can prevent Type I diabetes in animals prone to develop the illness. Our pilot study made me more optimistic.”In the 1970s, researchers in London found antibodies that target the pancreas. In particular, the antibodies destroy the insulin-producing cells. These antibodies appear in the blood up to 10 years before the onset of diabetes. Blood tests to identify these “markers” can predict who will develop diabetes.Dr. Jackson’s pilot study examined 12 close relatives of patients with Type I diabetes; blood tests of all 12 revealed the antibodies. He treated five with small doses of insulin to give the remaining beta cells a rest and prevent their collapse; only one of the five developed diabetes. The other seven relatives turned down the therapy; all eventually became diabetic.”We still don’t have the money to do the things we want to do,” says Dr. Jackson. “We need additional support from research organizations and the public in general.” Dr. Jackson is part of a nationwide trial seeking to prevent diabetes in those at high risk. The researchers hope to screen up to 40,000 relatives of people with Type I diabetes. If you are related to someone with Type I, you may be eligible to join the study.Dr. Stephen Leeper, president of the Juvenile Diabetes Foundation, has a son, Mark, diagnosed with diabetes at 7.”We are convinced that, through research, diabetes cannot only be prevented but also cured -and all of us are determined to make that cure happen in our children’s lifetime,” he says.The Juvenile Diabetes Foundation is a voluntary health agency founded in 1970 by parents of children with diabetes. It is dedicated to financing research to find a cure. (Type I diabetes is the most common chronic childhood disease in the United States.)*10/266/5*

RHEUMATOID ARTHRITIS: BEGINNING YOUR AEROBIC EXERCISE PROGRAMSelecting a form of aerobic exercise depends on several factors: convenience, time restraints, the joints that are affected with arthritis, and most importantly, the form of exercise you enjoy. Possibilities include brisk walking, swimming, stationary bicycling, low-impact aerobics or dancing, cross-country skiing, and rowing. After you have chosen a program and your doctor has approved it, we recommend that you follow these guidelines when beginning:•   Always warm up for at least five to ten minutes with range-of-motion and stretching exercises.•   Start slowly in the beginning. Try five minutes of aerobic exercise the first day, checking your pulse before and after. If your pulse exceeds the target rate, slow down.•   Increase the time spent doing aerobic exercise by small increments each session. Alternating spurts of five minute high-intensity exercise with low-intensity rest periods is a good way to increase the duration of aerobic exercise. As you get in better condition, shorten and eliminate rest periods until you do fifteen to thirty minutes of uninterrupted aerobic exercise. In the beginning you should check your pulse at least every five minutes.•   Stop immediately if you develop chest pain, palpitations, dizziness, shortness of breath, extreme fatigue, weakness, or increased joint pain.•   If you have pain for more than two hours after exercise or experience increased joint pain or swelling the following day, modify the program.•   Always follow aerobic exercise with at least five minutes of cool-down exercise, allowing you heart rate and breathing to return to normal.*82/209/5*

BECOMING PARTNERS WITH YOUR DOCTOR: IT DEFINITELY PAYS OFFMany of us tend to believe that we have little or nothing to contribute to our own treatment program. But think again. Each of us is the one-and-only possible expert when it comes to:Our family historyOur symptoms and how they developedOur opinions about what has and hasn’t worked for us in the pastHow we feel about various treatment optionsOur lifestyle and the things that are important to usOur preferences, concerns and fearsDoctors report that 70% of their correct diagnoses are the result of information provided by the patient. What’s more, statistics show that patients who speak up, share information, ask questions and participate in treatment decisions enjoy a noticeable improvement in the quality and appropriateness of their care.So how do you go about becoming an effective partner with your doctor?Betweendoctorvisits Learn to observe your own body and keep a record of your symptoms and concerns so that you’re ready to report accurate information to your doctor. For example:Be able to give your doctor an exact temperature reading — and ready to report whether it’s an oral, axillary (taken in the armpit) or rectal temperature. This is much more helpful than saying that you or a member of your family is “burning up.” If you don’t have a thermometer, buy one and learn to use it.Learn to measure pulse rate and its regularity. Whether you are worried about a feverish child or a spouse who is experiencing heart palpitations, measuring the person’s pulse — which means counting the number of heartbeats in one minute — and noticing whether the rhythm of the beats is regular or irregular, can provide your doctor with useful information.For women over age 18, make a habit of examining your breasts once a month. Learn what is normal and customary for you and report any changes — such as unusual lumps or thickening — to your doctor. Once males are in their teens, they should begin examining their penis and testes each month for any changes that could indicate infection or cancer.Know what your normal weight is. If it changes, keep track of how much and over what period of time. Knowing about any sudden weight loss or gain can help your doctor diagnose certain illnesses. (Ask your health care provider for more information on weight, exercise and healthy diets.)Become familiar with your skin — moles, warts, bruises, birthmarks, etc., as well as overall tone and color. Learn to notice and track anything unusual — a mole that is growing or a sore that isn’t healing — that may need immediate attention.In short, get to know your whole body — from head to toe — so you will know what is normal for you. Keep a list of any changes, symptoms or areas of concern and bring it with you to your next doctor visit.For nonemergencies, check this book before calling your doctor. You may discover some self-care options that can save the time and expense of a doctor visit.If you decide to go to the doctor, prepare for the visit. Give some careful thought to your most important health concerns. Get ready to describe them — in order of importance — as completely and concisely as possible. Write down names of your medications and questions you want to ask your doctor.At the doctor’s officeBegin the conversation with the topics you are most worried about — not your minor complaints — and be as honest and direct as possible about your feelings and concerns. Keep it short and to the point, but take the time you need to describe your problemTaking an active role Whether your doctor suggests putting you on medication, running a few tests, or scheduling a minor procedure or major surgery — it always pays off to find out what’s going on and participate in the decision-making process.Yes, your doctor has years of training and offers invaluable medical advice. But only you can really decide if the benefits outweigh the risks — for your particular situation — and if the treatment plan is something you can live with and incorporate into your lifestyle.taking an active role in treatment decisionsAsk your doctor to explain the various treatment options — along with the benefits, risks and costs of each before going ahead with anything: “What is the official name of the test/procedure/ medication?” “Why do I need it?” “What will the procedure involve?” “What are the risks and benefits?” “How much will it cost?” “What are the alternatives?” “Would it be possible to just watch and wait for a while?” Take notes if it helps.If you don’t understand your doctor’s explanations, be persistent and ask again: “Could you go over that part again?” “Do you have any material I can read at home?” “Can you show me on paper what will happen?”If a prescription drug is suggested, ask about the side effects, and the possibility of using a less expensive but effective generic substitute.If a major test or surgery is recommended, ask if there are other treatment options that are equally effective, or if you can watch and wait for a while without putting your health at risk.Ask if there will be any restrictions on activity and, if so, how long the restrictions will be necessary. If some treatment is suggested that you know you just can’t or won’t be able to handle — “I have three kids at home! I can’t stay in bed all day!” — speak up. Chances are you and your doctor can work out a suitable alternative.Find out if there is anything else — besides or in addition to a prescription or treatment — you can do for yourself to help the problem or speed your recovery.Sorting through your options If it’s a nonemergency, don’t rush into anything! Remember that very few medical procedures are actually emergencies. There is usually time to think about the options and select the one that seems best for you.Use this guide to help you understand your medical problem, evaluate your options for care and plan questions for your doctor.If you find you have more questions for your doctor, or need additional information, call your doctor’s office and ask!Once treatment is decide…Make sure you understand all the treatment instructions. If not, as more questions!Carefully follow your treatment program. For example, write down your medication schedule and each time you take the medicines.Always fully comply with all instructions, and always talk to your doctor before altering your treatment or medication program.Keep track of any side effects and call your doctor if you are worried or have any questions, or if something doesn’t seem right.*124\303\2*