HOW DOCTORS THINK

HOW DOCTORS THINK: Jerome Groopman; Byword Books Pvt. Ltd., GF-15, Virat Bhavan, Mukherjee Nagar Commercial Complex, Delhi-110009. Rs. 395.

Like most of us, Jerome Groopman believes that practitioners of modern medicine are all too human and so are prone to make errors in judgment. But since the doctor’s errors can be fatal, every effort should be made to minimise them. That requires studying medical errors scientifically. This is precisely what the author does in this splendid volume.

The book, he says, “is about what goes on in a doctor’s mind as he or she treats a patient.” Every physician — even the most brilliant — makes a misdiagnosis or chooses a wrong therapy. Groopman differentiates “medical mistake” from “misdiagnosis.” While the former involves prescribing a wrong dose of drug or looking at an X-ray upside down, the latter is about the way doctors think, analyse a situation, or arrive at a diagnosis taking into consideration all the factors available at that time.

A majority of medical errors, according to him, do not qualify as technical mistakes, but are attributable to flaws in the physician’s thinking. He quotes a study of one hundred cases of incorrect diagnosis where inadequate medical knowledge was identified as the reason in only four cases. The rest are all due to what he calls “cognitive-traps,” which are of three types. First is “availability,” where recent or dramatic cases come to mind and colour judgment about the case in hand. Then comes “anchoring,” or short-cut thinking, where the doctor does not consider multiple possibilities but quickly and firmly latches on to a single one. And the third is “attribution,” where stereotypes can prejudice the doctor’s thinking and lead to conclusions that do not flow from the data on hand.

“Distorted pattern recognition” can be the result of the “ecology” of the patient. (A Navajo woman with breathlessness is diagnosed as a case of pneumonia when she, in fact, was suffering from Aspirin toxicity.) “Confirmation bias” refers to selecting data which suit the already made diagnosis and ignoring the rest. “Affective error” resembles confirmation bias in selectively surveying data.

To avoid falling into these cognitive traps, Groopman has this simple but sound advice: “Even when you think you have an answer, generate a short list of alternatives.” He cites examples from each speciality to explain these cognitive errors and goes on to show that availability of time, unethical promotional activities of the pharmaceutical firms, and patterns of health coverage like insurance can ultimately influence the treatment. “Zebra-retreat” refers to doctors’ shying away from a rare diagnosis and settle for a common one. “Diagnosis momentum” refers to mental fixation of a doctor, despite incomplete evidence. (An unkempt coloured labourer who admits to taking alcohol may be conveniently branded as having alcoholic liver disease when, in fact, he may be suffering from something entirely different, for example Wilson’s disease.)

Uncertainty

And there is a whole chapter on “uncertainty.” Based on previous studies, Groopman describes three types of uncertainty: one that results from incomplete or imperfect mastery of available knowledge; another, from the limitations in current medical knowledge; and the third, from the difficulty in distinguishing between the individual’s ignorance and the limitations of the present state of medical knowledge. The challenge of modern medicine is to make decisions “in the absence of certitude” which, according to him, forms the “core reality of practice of medicine.”

To patients, Groopman offers a very practical advice: expect from your doctors and demand of them, 3-Cs — communication, critical reasoning, and compassion. Note that he does not include academic brilliance! A medical practitioner who is able to deliver on these three counts is unlikely to err in his judgment. This book is a must-read for doctors who would like to re-evaluate their medical decisions, critically and constantly.

source: the hindu

12 Healthy Habit Changes For 2009

Habit 1: Drink more water.
Sure, I know about all the news reports that say it's possible to drink too much water.
Surprisingly, this same story is told just about every 4 years when news stations have no other "news" going on, and it always seems to stir up all sorts of awareness on the topic. The truth is, in all my years of guiding individuals on proper nutrition, I have yet to run into one person who had an H2O disorder.
A well-hydrated body has a much easier time at shedding unwanted body fat and preserving lean muscle mass. A healthy, active individual should be consuming 6to 7 Litres of water per day.

Habit 2: Eat more fiber.
I'll say it again. People do not get nearly enough fiber in their diets. Work on trying to get anywhere from 25 - 30 grams of fiber per day into your eating plan. Fiber provides a plethora of benefits from increasing the thermic effect (calories burned from digestion) of a meal, to trapping and evacuating excess fats.


Habit 3: Eat every 3 hours.
Start splitting your larger meals up into smaller, more frequent bouts of eating. Spreading your calories throughout the day allows for an increase in metabolism and insures that none of the nutrients you are consuming go to waste.
This can be difficult for many people who maintain busy lifestyles, which is why I suggest picking one or two days a week to do all of your cooking. At that point, Tupperware containers become your new best friend.

Habit 4: Eat more fruits and vegetables.

And eat a large variety as well. The more colors you consume the better. They're packed with fat-burning fiber, vitamins, and minerals.
We all know that vegetables are gold, but when it comes to fruit, it sometimes gets a bad rep. I often get the question "but doesn't fruit have a lot of sugar in it?" Again, I have yet to meet the person who has a well-balanced diet who has found that fruit was the main reason they couldn't let go of the extra body fat.
Get over it. If you're obese fruit isn't the culprit. Take a long look at everything else you're eating, and I'm positive you'll find something a little more worthy to drop.

Habit 5: Avoid alcohol.

Alcohol has damaging effect on your lungs, brain, and on your psyche, it makes you unaware and unconscious about life itself. Alcohol, makes you to destroy yourself.

Habit 6: Choose organic and local foods when possible.

There is no doubt in my mind that we will start to see more and more studies come out showing the adverse effects of consuming over-processed food. It's only a matter of time.
Digestion is a delicate process, a process our bodies have spent hundreds of thousands of years perfecting. In just the past few decades we have started introducing extra hormones, antibiotics, and other impurities into our foods. Our bodies have filters that take care of these things, but let's not put them to the test.

Habit 7: Reduce the amount of sugars consumed.
At this point it should be a no-brainer. If anything good has come from the hundreds of diet books written this past decade, it's the awareness that controlling your blood sugar is crucial to achieving optimal health. The sweets do not have to be eliminated from your diet completely, but you should have them well under control.


Habit 8: Stop going to the super market hungry.
Real simple. If you're hungry, you'll buy what you want, not what you need.
Our bodies are still hard-wired for survival. Unfortunately when you stroll down the aisle at your local food supply your brain will target just about anything in your field of vision and deem it an acceptable choice of nourishment, regardless of its nutritional value.

Habit 9: Take regular stand up breaks at work.
Do it for your posture, do it for circulation, and do it for your own sanity. Our bodies were not designed to be in a seated position all day long.
You could prevent much of life's chronic pains if you would just take a moment to stand up and stretch your legs every 30 or 40 minutes. Set a timer on your desktop if you have to; just get it done.

Habit 10: Start using the stairs instead of the elevator.
Even park farther away from your destination so you have to walk a few extra steps in the day. Adding a tiny bit of extra footwork can add up at the end of the year. I know it's not exciting or drastic, but the difference can be a few extra pounds that you don't need hanging around your waist.

Habit 11: Balance your physical and sedentary activities.
I'm talking about what you do with your free time. Have you ever spent a couple of hours on the weekend watching TV, playing video games, or browsing the Internet looking at cat pictures?
Try to create some balance by doing an equal amount of leisure activities on your feet. Take a walk, shoot some hoops, and maybe take up a new physically active hobby. Who knows, you might find something new you really like.

Habit 12: Keep a health journal.
One of the most powerful ways to be successful with your health is to write it all down.
Keep track of your workouts and your nutrition. It can be very hard to figure out where you're going if you don't remember where you've been. You'll be giving yourself a point of reference so you can truly see if any of the changes you make are creating a difference. If they're not, then at least you know that and can change your plan of action and recalibrate.

A lot of times we get a little too ambitious when it comes to our New Year's resolutions and try to take on more than we can handle. This inevitably leads to failure. Start with the small habits and work your way up the fitness ladder for a more subtle and long-term experience.



NADEEMUDDIN
[B.com, PG in P.P.H.C, RIA, PGD in M& A]
CEO, activelifeconsulting
Mail : activelifeconsulting@gmail.com
Call-9849345798

Living Happily with Asthma - a practical situations fact sheet

One third of worlds 115 million Asthma patients are in India. By 2025 there will be an estimated 100 million more asthma patients due to Environmental pollution and Lack of awareness towards the disease and its morbidity. India has second highest mortality rate of asthma in the world. Day by day the pollution levels are increasing everywhere forcing the humanity for suffocation. As with decrease in natural forests and increase in urban concrete forests, the newer spectrum of photochemical pollutants, due to combustion of petrol and diesel are on rise. Today the principal pollutants posing detrimental effects on Human lungs are the oxides of Nitrogen (NO2), Ozone (O3) and particulates.

→ Ozone levels more than 100µg/m3 is hazards to human lungs.
→No2 is emitted from unvented gas appliances and heating appliances, in indoor conditions and vehicular traffic fumes, at outdoors pose great threat to lungs. A level of NO2 more than 28.2microgram/m3 may contribute to Asthma.
→Particulate matter (PM10) consists of a mixture of particulate components including traffic and combustion generated Carbon. Particulate matter can be, Centered ultra fine particles, secondary salt particles (Nitrates & Sulfates), geological and also biological particles (Spores and pollens) of Particle size 2.5µm (PM 2.5 diameter) are capable upon inhalation of reaching, the deepest portions of the lungs and can cause irreparable damage to lungs. All these factors act as potential triggers of Asthma and make worse conditions in an already known asthmatic.

“People with Asthma are often sensitized and exposed to more than one allergen. And there also exists variability between individuals in the magnitude of response to the same levels of allergens.” Says Dr. Vyakarnam Nageshwar, Consultant Pulmonologist , Wockhardt Hospitals. He further adds “A high allergen exposure in sensitized individuals may contribute to poor asthma control. Exposure to dangerous allergens like “alternaria allergen” has been shown to cause sudden respiratory arrest leading to death in Asthmatics.


Indoor Pollutants or Domestic Allergens:-
Practical measures for Avoidance majority of exposure to indoor allergens and mite probably occurs in bed, where we spend on average a third of or lives in close contact with mattresses, Pillows and duvets.

a) Covers: - Covers of pillows, beddings and other furniture are the most common site of allergens. It is very important to cover mattresses pillows and duvet with covers that are impermeable to mite allergens. It is also must to ensure that covers are wiped at each change of bedding.
b) Washing: - All the exposed beddings should be washed at 55*c .as this temperature kills mites in beddings.
c) Feather vs. Synthetic Pillows: - Asthmatics are often wrongly told to avoid using feather pillows. In the last few decades, sales of synthetic pillows have increased enormously based on the misconception that synthetic pillows are non-allergic. But recent studies have confirmed that synthetic pillows being non allergic is just a Myth. A synthetic pillow accumulates the mite allergens more significantly faster than feather filled pillows.


Dr. Vyakarnam stresses on the fact that "People should be more aware of the fact that so called ‘Hypo allergic’ synthetic pillows and quilts are not hypo allergic at all.”

d) Carpets:-

These are important microhabitat for mite colonization and possible source of allergens.
-All fitted carpets should ideally be replaced with polished wood or vinyl flooring.
-Steam cleaning or exposure of carpets to direct sun light for at least 3 hrs will kill mites.
e) Pets at Home: -
The most powerful risk factor for severe asthma in children was pet ownership. Concentration of both cat and dog allergens are high in almost in all homes with pets. It was observed in recent studies that 62% of children are sensitized to dog and cat allergens, who had a poor control over their asthma, inspite of correct medication.
The best way to reduce exposure to cat or dog allergens is remove the animal from bed rooms and living rooms. “One should be alarmed that it takes months before reservoir allergen levels decrease and the symptoms of the patient subside, even after the animal removed from home.” Air borne allergen levels increase by 5 folds when pet is in the room.
It is an unfortunate condition that “Asthma is often severe and difficult to control in pet exposed Asthmatics.”

It is always safe to undertake an investigation of Lung Function Test (Spirometry) at the earliest sign of breathlessness, chest tightness, dry cough, nocturnal wheezing, sleeplessness at nights, which may or may not be associated with cold and sneezes. There exists a scientific way to get treated with inhalation devices to achieve an early and complete control on Asthma.

Dr. Vyakarnam further adds that “In a recent discussion with Yogic Guru Ramdev Baba we have been able to unveil a completely new dimension in the management of Asthma, which is the use of Scientific Yogic Pranayams which will benefit the Asthmatic sufferers . It is after a two hour discussion on Pranayamic postures for Asthmatic patients that we have been able to identify 4 basic Pranayamic Postures , a) Anulom Vilom, b) Kapal Bhati, c) Bhramari and lastly d) Bhastrika, these postures increase the lung capacity of the Asthmatic patient and decreases the symptoms”

How is management of Asthma different at Wockhardt?
At Wockhardt, we use a team approach which consists of a Pulmonologist , Clinical immunologist , Dietician and a physiotherapist for the treatment of our patients, providing our patients with complete comprehensive holistic treatment. We make sure that every patient is aware of his/ her condition, and there is adequate knowledge sharing with even the family members to provide adequate support to the patient. At Wockhardt we believe that we are only the facilitators in your care management and it is our patients who manage their Asthma in their individual ways. In the year 2008 Dr. Vyakarnam Nageshwar Consultant Pulmonologist, had patented a special Allergen Identification Record, which is a completely new approach for the management of Allergy and Asthma this has been recognized and published at the proceedings of the World Congress of Asthma. Talking about this Dr. Vyakarnam added “ The Contribution of Wockhardt Hospitals, Hyderabad towards management of Asthma has come across not because we have done something new its because we have looked at asthma from a different perspective our patients perspective.”

ABOUT DOCTOR





Dr. Vyakarnam Nageshwar is a young, dynamic Pulmonologist, active in clinical practice since half a decade. Over these years he has been involved in performing interventional Pulmonology procedures. To his credit there are over 500 Tube Thorocostomies, 600 Pleural Aspirations, 300 Pleural Biopsies, 200 Fiber Optic Bronchoscopies ,35 FNAC Procedures, 20 Tru Cut Lung Biopsies and 30 Thoracoscopies.
Dr. Vyakarnam Nageshwar, has also been involved in many Health Awareness Campaigns organized at different levels. The District Collector, Khammam, has honoured him as “Best doctor of Khammam District” for his care and compassion towards his patients. Besides many other laurels, he distinctly holds the honour of treating thousands of patients suffering with Chest diseases especially in HIV positive cases. For this work he received appreciation and blessing from The Holy Father Benedict XVL from the Vatican City (The Holy Pope) in recognition of his attitude of sincere commitment and involvement in relief of patient’s suffering. He is known for his Clinical acumen and dedication towards his patients.
His success rate in treatment of Asthma (Acute / Chronic) is noteworthy with very good patient satisfaction.




Expertise

· Fiber Optic Bronchoscopies
· Thoracoscopies
· Asthma Allergy Counselling
· Needle Aspirations
· Transbronchoscopic Lung Biopsies


Papers, Publications & Awards
· Author of the Text “ The Fundamentals of Hospital Practice and Patient care.”
· Co-author of the “Textbook of Community Medicine”
· He has presented many papers at the state and the national level conferences.

DR. VYAKARNAM NAGESHWAR
M.B.B.S., MD, FCTP, ATC (New Delhi)
CONSULTANT INTERVENTIONAL PULMONOLOGIST.
WOCKHARDT HOSPITALS
HYDERABAD. INDIA
PH : +91 99495 29392

Are there medicines to treat swine flu?

Swine flu is a type of virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

Q. What is swine flu?
A. Swine influenza, or flu, is a contagious respiratory disease that affects pigs. It is caused by a type-A influenza virus. Outbreaks in pigs occur year-round.
The most common version is H1N1. The current strain is a new variation of an H1N1 virus, which is a mix of human and animal versions.

Q. Does swine flu affect humans?
A. While the virus causes regular outbreaks in pigs, people usually are not struck by swine flu. However, there have been instances of the virus spreading to people -- and then from one person to another. The only difference is, says the CDC, transmission in the past did not spread beyond three people -- as it has done this time.

Q. What is behind the spread of the virus this time?
A. Researchers do not know yet know. People usually get swine flu from infected pigs. For example, farmers handling infected pigs can contract the virus. However, some human cases have occurred without contact with pigs or places they inhabited.

Q. What are the symptoms of swine flu?
A. The symptoms are similar to the common flu. They include fever, lethargy, lack of appetite, coughing, runny nose, sore throat, nausea, vomiting and diarrhea.

Q. How does the virus spread?
A. The virus spreads the same way the seasonal flu does. When an infected person coughs or sneezes around another person, the latter is put at risk. People can become infected by touching something with the flu virus on it and then touching their mouth, nose or eyes. An infected person can pass the virus to another before any symptoms even develop.

Q. Why is this spread troubling?
A. Scientists are concerned whenever a new virus is able to jump from an animal to a person -- and then spread from person to person. When the flu spreads person to person, it can continue to mutate, making it harder to treat or fight off.
The World Health Organization has said the current outbreak has "pandemic potential," and has urged governments to take precautions to prevent its spread. If the virus continues to mutate, drug makers won't be able to come up with vaccines fast enough.

Q. Can swine flu be fatal?
A. Just like the regular flu, swine flu worsens pre-existing medical conditions in people. So people with already compromised immune systems can die after contracting it.

Q. But doesn't the common flu kill more people?
A. Yes, common seasonal flu kills 250,000 to 500,000 people worldwide every year. But what worries officials is that a new strain of the flu virus can spread fast because people do not have natural immunity and vaccines can take months to develop.

Q. Have there been swine flu outbreaks in the past?
A. From 2005 to January 2009, 12 human cases of swine flu were detected in the United States, without deaths occurring, the CDC said. In September 1988, a healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died a week later. And in 1976, a swine flu outbreak in Fort Dix, New Jersey, caused more than 200 illnesses and one death.

Q. What does the World Health Organization mean when it says swine flu has "pandemic potential"?
A. If the virus spreads over a wide geographic area and affects a large segment of the population, it is upgraded from an "epidemic" to a "pandemic."

Q. How deadly have pandemics been in the past?
A. In 1968, a "Hong Kong" flu pandemic killed about 1 million people worldwide. And in 1918, a "Spanish" flu pandemic killed as many as 100 million people.

Q. How can one keep from getting swine flu?
A. There are no vaccines available. But several everyday steps can help prevent the spread of germs: Washing hands frequently; avoiding close contact with people who are sick; and avoiding touching surfaces that might be contaminated.

Q. Are there medicines to treat swine flu?
A. Yes, the CDC recommends using anti-viral drugs. They keep the virus from reproducing inside the body. And in an infected person, the drugs make the illness milder.

Q. Can one contract swine flu from eating or preparing pork?
A. No. Pork and other pig-derived products, if properly handled and cooked, do not transmit swine flu. The flu virus is killed by cooking temperatures of 160°F (70°C).

There are antiviral medicines you can take to prevent or treat swine flu. There is no vaccine available right now to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by

• Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners.
• Avoiding touching your eyes, nose or mouth. Germs spread this way.
• Trying to avoid close contact with sick people.
• Staying home from work or school if you are sick.

THE FIRST KNEE REPLACEMENT SURGERY USING REVOLUTIONARY MINIMAL INVASIVE SURGERY TECHNIQUE

Technologically advanced Minimal Invasive Surgery not only leads to less muscle cut – but also Makes the rehabilitation of the patient faster



Mrs. Sarojana, 65 yrs old housewife hailing from Hyderabad was suffering from severe knee pain and severe deformity in her knee. She was a very active person but the pain started affecting her daily activities and she was unable to walk. Now after the joint replacement surgery with the help of MIS technique she was able to straighten her leg with a flexibility of 1 - 100°. On the 2nd day of surgery she was able to walk independently without any support. Due to the advanced technique of MIS there was no cut or damage of the muscle which let to her quick recovery.


In the traditional surgery there is extreme loss of blood due to incision made during the surgery which delays the recovery time also. Whereas in the minimal invasive surgery small hole is made for the surgery which leads to very less blood loss thus leading to fast rehabilitation.


The patient was operated by Dr. Sudhir Reddy, Consultant orthopaedic Surgeon, Yashoda Hospital, using the revolutionary Minimal Invasive Surgery technique.


Dr. Reddy was convinced to use this new surgery technique. The surgeon believed that MIS technique has revolutionized knee replacement surgery as well as many fields of medicine.


"I wanted my patients to recover fast that too by not undergoing a painful surgical process which involves more of muscle damaging thus increasing the blood loss and thereby extending the recovery time to more than 6 weeks. So this MIS technique was designed taking into consideration all these and specific features have been incorporated into the technique which addresses these without compromising on other aspects," said. Dr. Sudhir Reddy, Consultant Orthopedic Surgeon, Yashoda Hospital.


"I lost hope of walking & faith of independent living. I was nervous to think about my painful & bedridden future. Dr. Reddy has given me a new lease of life," Mrs. Sarojana.


Minimal Invasive Surgery Technique


Joint Replacement Surgery has evolved tremendously over the last few years. Traditionally it is done through a large incision, muscles are cut, takes a long time to recover and on average patients take about 6 weeks to achieve the primary goals of independent walking and bending the knee up to 90°. With the new technique all these problems have been addressed. As there is very little damage to the tissues, the recovery s extremely quick, pain is much less, muscle strength is much better and bending at the knee is much more as demonstrated in this patient.


Benefits Of Minimal Invasive Surgery :
* Minimally invasive total knee replacement is a technique developed to dramatically improve the successful outcome and reduce the pain & recover time.
* In MIS technique a very small incision of less than 10 cms is made as compared to 25 cms of traditional TKR.
* In MIS technique muscles are not cut/damaged at all whereas in traditional TKR muscle of the leg is divided thereby leading to weakening the knee.
* Minimal Invasive surgery is a very special technique where special instruments are used to perform the surgery.
* Minimally invasive surgery improves the patient's lives after knee replacement. There is very little damage to the tissues, the recovery is extremely quick, pain is much less, muscle strength is much better and bending at the knee is much more.
* In the MIS surgery the operative time is longer, but hospitalization time is shorter.
* This technique causes less pain, less blood loss and thus speedy recovery.
* It drastically reduces the typical time taken to independent walking from 6 weeks to 2-3 days.

Traditional TKR MIS - TKR
Length of incision 25 ms < 10 cms

Time taken to walk with support 2-3 days Few hours

Time taken for Independent walking 4-6 weeks 2 days

Time taken to bend the knee to 90° 7 – 20 days < 1 day

Length of stay in hospital 7 days 2 days

Average flexion achieved 100° 120°

Blood loss 500 – 700 ml Minimal

Dr. Sudhir Reddy,
Consultant orthopaedic Surgeon,
Yashoda Hospital,
Somajiguda, Hyderabad. INDIA.
Cell : 09866939188
ksudhirreddy@gmail.com
ksudhirreddy@hotmail.com

six on the brink of superstar status

Had it up to here with apples? Join the club. But it’s hard to take it off the menu when it’s such a great source of vitamins and minerals.

Still, is a little variety too much to ask? Not anymore, thanks to research that’s shifting the spotlight to a new generation of health-boosting foods—many of which do double or triple duty to help prevent illness. Here are six on the brink of superstar status.

TOMATO This one is yet to get its due as a star, at least in India. There are still communities which don’t eat tomatoes on certain days of the week because of myths associated with it. Forget it. You don’t want to miss out on the benefits that include easing frequent migraine (the riboflavins in them). They also:
Nutritious tomatoes


• Protect your heart: Research conducted at the Harvard School of Public Health shows that women who ate seven to 10 helpings of tomato or tomato-based foods (soups and juices) in a week lower their risk of cardiovascular disease by 32%.

• Reduce risk of prostrate cancer: Analysis of 21 studies published in the journal Cancer Epidemiology Biomarkers and Prevention, confirms that tomatoes, rich in anti-oxidant lycopene, provide protection against prostrate cancer. They cut down the risk of prostrate cancer by nearly 11%.

KIWIFRUIT Don’t judge this fruit by its cover. Under that bristly brown peel you’ll find a bright green star bursting with anti-oxidants and full of fibre. Kiwifruit works to:
Kiwifruit


• Protect against free radical damage: A study from Rutgers University compared the 27 most popular fruits and established that kiwifruit was the most nutritionally dense. In addition, it makes the shortlist of fruits with substantial amounts of Vitamin E, and contains more vision-saving lutein than any other fruit or vegetable, except for corn.

• Lower blood-clot risk: In a 2004 study by the University of Oslo in Norway, participants who ate two or three kiwis for 28 days significantly reduced their risk of forming a blood clot. They also got a bonus benefit: Their triglycerides, a blood fat linked to heart attack, dropped by 15%.

BARLEY We know it does not taste great. And you have known it as a diuretic (a substance that increases the flow of urine from the body). But this hardy grain comes packed with health benefits. When wheat and oat are processed, they lose their fibre content. This is not the case with barley. It is full of soluble beta-glucan fibre which remain intact even when processed. Studies show this fibre helps you:

• Knock down bad cholesterol: A Department of Agriculture, US, research shows that barley can reduce bad cholesterol by as much as 17.4%. A 2004 study found that adults with moderately high cholesterol levels who went on a low-fat diet began to see an improvement when barley was added to the menu.

• Decrease blood sugar and insulin levels: That makes barley a better choice for people with Type 2 diabetes, says a 2005 Agricultural Research Services study at the Diet and Human Performance Laboratory in the US. Make the most of this super grain by including it in your meals whenever possible.

WALNUTS We treat them like any other Diwali gift and pass them on. Next time, don’t. They’re the healthiest nuts you will get. They will help you fire your metabolism and sleep better. Moreover, they:
Walnuts


• Prevent gallstones: Twenty years of dietary data collected from over 80,000 women for the Nurses’ Health Study done in the US, shows that women who eat at least 28 walnuts a week, just four walnuts a day, had 25% lower risk of developing gallstones.

• Benefit your bones: Latest research published in Nutrition Journal Penn State (January, 2007) suggests walnuts, rich in alphalinolenic acid (ALA), the essential omega- 3 fatty acid, are good for the skeletal system. They decrease the breakdown of bones.

BROWN RICE In India, we ignore it as the “poor man’s rice”. But nutritionally, it is far superior to its processed, polished and betterlooking version— the white rice. Known for its multiple benefits, brown rice has to be tried for your good health.
• Keeps ldl under check: A study done at the Louisiana State University and published in the American Journal of Nutrition says that eating brown rice reduces bad cholesterol (LDL) by 7%.

• Strengthens your nerves: Just one cup of brown rice provides you 88% of your daily requirement of manganese. It helps in production of energy from proteins and carbohydrates and is involved in the synthesis of fatty acids that are important for the functioning of a healthy nervous system.

BROCCOLI If there are stir-fried vegetables served at a Chinese meal, do not feel embarrassed picking out broccoli and loading your plate with it. The florets have enough nutrients (Vitamin C, betacarotene, calcium) and fibre packed in them to fight digestive disorders and heart and bone diseases. They also:
Broccoli


• Save skin damage: Plant nutrients and sulforaphane— an anti-cancer compound— in broccoli help repair sun-damaged skin. This was shown in a research conducted at the Johns Hopkins University. Broccoli counteracts skin cells’ carcinogenic response to ultraviolet rays.

Have asthma? Spend some time in the sun

I N SUSCEPTIBLE people, asthma — which killed 17-year-old Akkriti Bhatia — can be triggered by fac tors ranging from indoor allergens (dust mites in bedding, carpets and stuffed furniture), outdoor aller gens (dust, pollution, pollens and mould), tobacco smoke, cold air, extreme emotion (anger or fear), and physical exercise.

Add to this, medicinal triggers such as non-steroid anti-inflammatory drugs such as aspirin, and beta-blockers (used to treat high blood pressure, heart conditions and migraine), as well as lifestyle factors such as long working hours, erratic eating habits and shift work and you will not be surprised by the spike in asthma attacks in susceptible people.

A chronic breathing disorder, asthma is characterised by recurrent attacks of breathlessness and wheezing. In India, over 20 million people have asthma, with children and people over 65 years being at higher risk of acute attacks.

One way to reduce severity suggests , new research from the Harvard Medical School, is to have adequate amounts of vitamin D, insufficient amounts of which appear to aggravate asthma and allergy severity The study suggests that .

giving supplements to asthma patients with Vitamin D deficiency may help control symptoms better.

The study — which will appear in the May issue of the American Journal of Respiratory and Critical Care Medicine— linked low serum levels of vitamin D in children with several indicators of allergy and asthma severity including , hospitalisation for asthma, use of inhaled steroids and total IgE levels (used to detect allergy).

The study found that children with lower vitamin D levels were hospitalised more often for asthma over the previous year, had airways with increased hyper-reactivity and used more inhaled , corticosteroids, all signifying higher asthma severity. These children also had several markers of allergy includ , ing dust-mite sensitivity .

Earlier studies had shown that people who don’t get enough sunlight and have diets low in vitamin D are at higher risk of osteoporosis (brittle bones) and developing colon, prostate, rectal, ovarian and breast cancers.

Fat-soluble vitamin D helps maintain the calcium and phosphorus absorption in the blood. It also helps in calcium absorption, which explains why its deficiency makes bones brittle or misshapen.

Apart from being present in fatty fish (salmon, mackeral, tuna, sardine) and fish oils (cod liver oil, shark liver oil), the vitamin is mainly synthesised under the skin under the effect of sunlight.

Since as much as 90 per cent of Vitamin D is produced under exposure to sunlight, the general impression was that its deficiency can be rectified easily by getting enough sun exposure.

Wrong. It seems most people living in sunny India are not out enough to make sufficient Vitamin D.

A study in Osteoporosis International last year reported that Indians need more sunlight than fairer Caucasians to synthesise the vitamin because of higher skin pigmentation. Increased time spent indoors, use of sunscreen and sun-protective clothing all lead to decreased levels of vitamin D.

So, how much Vitamin D do we need? The minimum recommended intake is 200 international units (IU) daily for children and young adults, 400 IU for those ages 51 to 70 and 600 IU for 71 years and older. To get 400 IU of Vitamin D, you have to have 200 gm of oily fish or a multivitamin every day .

It’s easier to make your own Vitamin D by exposing the skin to the sun: half an hour without sunscreen, as dark skin takes more time to make the sunshine vitamin. Try it, and breathe easy .

S A N C H I TA S H A R M A

sanchitasharma@hindustantimes.com

Heart diseases & benefits of fitness

Heart disease is considered the number one killer in India. As medical technology and awareness improves, there is more we can do to reduce the incidence of cardiac events.
Holistic approach to prevent diseases

* Exercise Programming
* Nutritional Counselling
* Occupational Therapy
* Medication
* Psychosocial Counselling
* Stress Management
* Cardiac Education Topics
* Life style management workshops

Beneficial and Safe Exercise Tips!

1.Have you exercised before?

If you haven't, you should certainly discuss this with your physician and seek the appropriate exercise counseling or consult certified fitness specialist. A graded exercise test will inform you of your limits by establishing an appropriate/healthy level of physical activity. (working with an appropriate target heart rate).

2.What type of exercise is the most beneficial?

A combination of aerobic exercise (4-5 times per week for a duration of 30-40 minutes) combined with resistance exercises (2-3 times per week) is the most beneficial for overall cardiovascular health. Aerobic exercises are repetitive in nature such as walking, biking, rowing, swimming, etc… Resistance exercise are exercises that strive to improve overall muscular strength such as weight lifting, rubber bands, and other resistance exercises.

3.What if you do a lot of house work, or gardening or rushing around the office? Is this adequate daily exercise?

No! This increased activity may tire you out and be somewhat beneficial to your health, but it cannot replace regular aerobic exercise.

4.What makes exercise a better activity for heart health?

During aerobic exercise, your heart rate (pulse) increases for the duration of the activity thus training your heart and increasing cardiovascular benefits. During safe exercise it is recommended to monitor your heart rate and work consistently around your target heart rate (based on your stress test).

The benefits of regular exercise are as follows:

* Cholesterol control (lowers total and LDL and raises HDL, triglyceride level decreases)
* Blood pressure control
* Blood sugar control in persons with diabetes
* Increased energy levels
* Decreased body fat (weight loss)
* Increases functional capacity for daily activities
* Lower incidence of injury

Where should you exercise?

You can go out for a walk (or inside a Gym on extreme hot or cold days), home exercise equipment such as a treadmill or stationary cycle, or at a community based fitness program. If at any point you feel that you are unsure if you are exercising correctly, please seek the advice of your physician/ Fitness specialist.

Stress Management

Stress can be both positive and negative in our lives. Positive stress allows us to maintain motivation in achieving certain tasks. Negative stress creates a pressure where you cannot feel relaxed and always think about the stress. It is the negative stress that is associated with medical ailments ranging from headaches to heart attacks.

Often stresses are more of a perception than anything else. Stress can cause an increase in blood pressure and heart rate. Stress is and of itself a major risk factor in the development of coronary artery disease. The biochemical effects of stress on the body can also be responsible for the breakdown of the inner lining of the arterial walls.

It is impossible to control every stressful situation you find yourself facing, however, you can learn how to successfully manage them. The first tip in stress management is to be aware of what triggers the response (the stressor), and try to be proactive in the management of these situations. Often times it is more likely the perception of the situation that creates real stress than the situation itself.

A positive attitude is a key factor in the management of stressful situations. Try to maintain a balanced outlook. Do the things that you personally enjoy doing. Depending on your stressor you may find relaxation techniques helpful (including listening to music, meditating, exercise, etc…). Give yourself personal time and space to gather your thoughts and feelings so that you can more effectively deal with day to day stressors. Lastly, manage your time by doing one thing at a time. Many professionals and organizations help to guide people in stress management

Start Living "A HEALTHY & ACTIVE LIFESTYLE"

Have a great week & enjoy.

Mr. Nadeem
[B.com, PG in P.P.H.C, RIA, PGD in M& A, {MBA in HS}]
CEO & Active Life Consultant
Active Life Consulting
Mail: activelifeconsulting@gmail.com , nadeem@activelife.in
call: 9849345798

Heart diseases & benefits of fitness

Heart disease is considered the number one killer in India. As medical technology and awareness improves, there is more we can do to reduce the incidence of cardiac events.
Holistic approach to prevent diseases

* Exercise Programming
* Nutritional Counselling
* Occupational Therapy
* Medication
* Psychosocial Counselling
* Stress Management
* Cardiac Education Topics
* Life style management workshops

Beneficial and Safe Exercise Tips!

1.Have you exercised before?

If you haven't, you should certainly discuss this with your physician and seek the appropriate exercise counseling or consult certified fitness specialist. A graded exercise test will inform you of your limits by establishing an appropriate/healthy level of physical activity. (working with an appropriate target heart rate).

2.What type of exercise is the most beneficial?

A combination of aerobic exercise (4-5 times per week for a duration of 30-40 minutes) combined with resistance exercises (2-3 times per week) is the most beneficial for overall cardiovascular health. Aerobic exercises are repetitive in nature such as walking, biking, rowing, swimming, etc… Resistance exercise are exercises that strive to improve overall muscular strength such as weight lifting, rubber bands, and other resistance exercises.

3.What if you do a lot of house work, or gardening or rushing around the office? Is this adequate daily exercise?

No! This increased activity may tire you out and be somewhat beneficial to your health, but it cannot replace regular aerobic exercise.

4.What makes exercise a better activity for heart health?

During aerobic exercise, your heart rate (pulse) increases for the duration of the activity thus training your heart and increasing cardiovascular benefits. During safe exercise it is recommended to monitor your heart rate and work consistently around your target heart rate (based on your stress test).

The benefits of regular exercise are as follows:

* Cholesterol control (lowers total and LDL and raises HDL, triglyceride level decreases)
* Blood pressure control
* Blood sugar control in persons with diabetes
* Increased energy levels
* Decreased body fat (weight loss)
* Increases functional capacity for daily activities
* Lower incidence of injury

Where should you exercise?

You can go out for a walk (or inside a Gym on extreme hot or cold days), home exercise equipment such as a treadmill or stationary cycle, or at a community based fitness program. If at any point you feel that you are unsure if you are exercising correctly, please seek the advice of your physician/ Fitness specialist.

Stress Management

Stress can be both positive and negative in our lives. Positive stress allows us to maintain motivation in achieving certain tasks. Negative stress creates a pressure where you cannot feel relaxed and always think about the stress. It is the negative stress that is associated with medical ailments ranging from headaches to heart attacks.

Often stresses are more of a perception than anything else. Stress can cause an increase in blood pressure and heart rate. Stress is and of itself a major risk factor in the development of coronary artery disease. The biochemical effects of stress on the body can also be responsible for the breakdown of the inner lining of the arterial walls.

It is impossible to control every stressful situation you find yourself facing, however, you can learn how to successfully manage them. The first tip in stress management is to be aware of what triggers the response (the stressor), and try to be proactive in the management of these situations. Often times it is more likely the perception of the situation that creates real stress than the situation itself.

A positive attitude is a key factor in the management of stressful situations. Try to maintain a balanced outlook. Do the things that you personally enjoy doing. Depending on your stressor you may find relaxation techniques helpful (including listening to music, meditating, exercise, etc…). Give yourself personal time and space to gather your thoughts and feelings so that you can more effectively deal with day to day stressors. Lastly, manage your time by doing one thing at a time. Many professionals and organizations help to guide people in stress management

Start Living "A HEALTHY & ACTIVE LIFESTYLE"

Have a great week & enjoy.

Mr. Nadeem
[B.com, PG in P.P.H.C, RIA, PGD in M& A, {MBA in HS}]
CEO & Active Life Consultant
Active Life Consulting
Mail: activelifeconsulting@gmail.com , nadeem@activelife.in
call: 9849345798

Mr. Nadeem

Mr. Nadeem is a Reebok U.S.A, certified fitness trainer & active life consultant. He heads the Active Life Consulting an organization promoting the concept of Active Life to prevent disease and lead a healthy & fit life through all life phases. This organization is based out of Hyderabad.

Mr. Nadeem played for Indian national hockey team for over 8 years & continues to support the team with his advice in the areas of ‘Sporting Excellence’. He organized Many National & Inter national Sports and Games as a part of TATA Sports department.

Active Life Consulting [ALC], has focused services to serve its clientele & provides, consulting services in the areas of Health Infrastructure management for organizations planning to provide health management facilities to their employees, undertake health awareness & management seminars & workshops, provide exclusive coaching service for the key organizational players & celebrities.

He speaks at various forums to enhance health awareness in corporate groups & individuals. He has 6 years of relationship in supporting TATA Steel in health management, 3 years in Apollo Hospitals Group & 3 years with Addlife (Health club) of INDO American Cancer institute.

Nadeem’s expertise & knowledge is backed by strong commitment & passion to help individual’s lead healthy & active life. His credentials through his Masters in PPHC [Preventive & Promotive Health Care] & his practical experience of handling health related issues of scores of employees in his past at TATA Steel & Apollo provides for an unmatched, legitimate & medically accurate advice.

He supports almost all the premier health clubs and gymnasiums in Hyderabad with his expert advice & coaching and provides consulting services to many organizations & its employees. He shares his knowledge through programmes in TV, Radio, and Print Media & Website.

Active Life Consulting

Active Life Consulting is an enterprise actively supporting individuals & Corporate Teams to Live, Work, & Play healthily for sustainable growth in personal and professional dimensions.

Active Life Consulting [ALC] propounds ‘Active Life Concept’ as a tool for fighting all health related ills & issues. ‘Active Life ‘is also a great tool for a happy healthy & vibrant Living. One need to just be active & adopt an activity filled Life Style, to stay younger & live healthy, longer. Based in Hyderabad

ALC is currently supporting various individuals, corporate clients cut across industries in employee’s health, wellness & activity strategies.

Services:

• Activity and health awareness training sessions.
• Health & fitness infrastructure maintenance & Management.
• Corporate Health solutions- consulting in fitness, Nutritional, Lifestyle
• Exclusive & group coaching in health& fitness methodology
• Adventure based activity, sports & events Management, Team Building for your teams.

Clients:

Tata Consulting Services ( TCS) , Infosys, Infotech , Satyam , HSBC, DE Shaw, CA- Computer Associates, Air India, Aditya Birla group ,Royal Palm resorts- Goa, Polaris, Progress Soft, AP Police, National Police academy, DRDL, Aparna Group, Jayabheri group, Sreemitra Estates (P) ltd, ILTC, phoenix, Bhagyanagar India Ltd, IVY comptech, Navayuga InfoTech, Y- Axis, Fortuna technologies, Asian Gastroenterology, Sierra Atlantic, TTM, Portal player, UBS,DQ entertainment, Indian Airlines, Matrix Life Systems, Hotel Grand Minerva, Sister Nivedita College of Management, , among many others.

The Rules of Good Health

What is Health?

World health organization believes that health is not merely absence of diseases but a state of physical mental, psychological, social & spiritual well being.

Why this generation in 21st century needs to follow the life style changes and participate in wellness activities?

Over the centuries the cause of death has changed. In early civilization the major cause of death was violence due to natural calamities and war with dawn of civilization man began to live in communities and due to poor sanitation and living conditions the major killer become infectious disease such as cholera, plague etc with advent of antibiotics we have reached a situation where most communicable diseases are eradicated.

With the 21st century a new spectrum of death become epidemic and the major killer is not natural calamities, war and infection, the major killer is modern lifestyle accounting for almost 80% of deaths world wide today, obesity; lack of physical activity and exercise; mental stresses and tension, pollution, alcohol and smoking are the major culprits, which manifest themselves innocently as high blood pressure, diabetes or hyperlipidimia and then without warning strike fatally as heart attack, or cancer.

The first defensive step therefore is not through more hospitals, more physicians more sophisticated and expensive equipments but through prevention and teaching people preventive care it was not so much that people dying; they are killing themselves!

With proper weight, proper diet, proper exercise, controlling blood pressure & cholesterol and eliminating the use of tobacco and use of safety rules we can controlled the risk of heart diseases cancer and HIV etc.




The Rules of Good Health

A. Medical check ups
It is important for all including children to have a medical check up at least once a year. The reason is that the human body is capable of 100% efficiency even with 99% debility and most of the modern ailments such as high blood pressure, diabetes, cholesterol, etc are all silent and have no symptoms. A medical check up helps the individual to identify the current health status and other ailments if treated early can be controlled. If left untreated they can result in heart attack and other killers.

B. Nutrition
The second rule of good health is to eat the right food in the right quantities. We all know that too much sugar is associated with diabetes, too much salt is associated with high blood pressure, too much fat is associated with heart diseases and eating commercially prepared foods is associated with cancer. We all know high fiber diet comprising vegetables and fruits as protective against all these ailments. Accordingly we should eat a balance diet food should be taken in the following ratio
Grain & cereals -40%
Vegetables & fruits -35%
Dairy products -10%
Meats/ Dhal -10%
Other foods -5%

Foods to avoid :
Excess salt, excess sugar and commercially prepared foods. It is also important to eat less(calories ) rather than more and the best way to do is large breakfast, a moderate lunch and dinner will be very light.

C. Exercise
Excess food intake results in obesity which in turn causes blood pressure, diabetes, arthritis, and other ailments and even while it is important to eat moderately, it is equally important that one should do exercise every day in order to keep body healthy and fit. A fit and healthy body ensures that we do not get any ailments like arthritis spondeolosis, back ailments, cardiac ailments etc. the daily exercise programme may be for about an hour and should comprises of (according to age and capacity) aerobic activity like aerobics, walking, jogging to strengthen the heart and lungs, free hand exercises for muscles and joints and for those who knows yoga free hand exercise can be substituted with yoga. Weight training and gym exercise is very important to build the strength and to maintain the optimal efficiency of the body and posture. According to American college of sport medicine exercise should be done 5 days a week, 3 days cardiovascular workouts and two days strength workouts. Cardiovascular work out should be done at our Target hear zone (vo2 max) and 80% of our max weight for strength building.

D. Stress
If physical activities are important for good health, then mental relaxation is also very important. Mental tension and stress cause a whole range of psychosomatic ailments including Headaches, Insomnia, Asthma, Ulcer, Blood pressure, Sexual dysfunctions etc. stress is caused due to problems relating to work, Home, daily routine crisis and even personality. While the effects of stress can be reduced by daily exercise the more acknowledged method of stress management is meditation / yognidra. Sleep is perhaps the most important means of relaxation.

E. Dependencies
The major cause of cancer is smoking. Other causes include an in appropriate diet, excessive alcohol intake, environmental pollution and occupation hazards including dust, radiation, chemicals etc. certainly these must be avoided but giant steps can be taken to reduce cancer by simply managing alcohol to not more than two drinks a day and quitting smoking completely. Avoiding drugs.
F. Safety
Safety is very important factor. Safety compliance such as wearing helmets, using seat belts, keeping with in the speed limits, not utilizing alcohol before driving etc, will go a long way in reducing automobile accidents which is the major killer for the young group. If automobile safety is important than sexual safety is perhaps more important and lack of sexual safety has resulted in spectrum of HIV, which promises to be the biggest killer in future. A.P is second 2nd position in India. In order to contain this menace is important that we adhere to a monogamous sexual relationship and the use of condoms in those situations where we fail to mandatory. Keeping mind that more than 50% commercial sexual workers are HIV positive.



I have identified some simple rules of good health which are, to have a medical check up, to eat the right food in right quantities, to do some exercise, to manage stress, to quit smoking and to adhere to all rules of safety.

S.NADEEMUDDIN
Former International hockey player
Certified Reebok fitness instructor
Certified preventive and promotive health care practitioner
CEO - Active Life Consulting

Cell- 9849345798
nadeem@activelifeglobal.in
www.activelifeglobal.in

The Wonders of the Human Body

10 Ways to Rev Your Metabolism:

Your body is a lean, mean, fat-burning machine just waiting to happen! All you need is the knowledge and determination, and your extra weight will be gone in no time. In fact, you don’t necessarily have to make drastic changes. Try these 10 simple tweaks to your lifestyle, and you will see results.

1. Lift weights. Muscle is the key to a high metabolism. Gals, that doesn’t mean you have to look like a female wrestler. Building lean, sleek muscles ups your calorie-burning. Your resting metabolic rate (RMR) accounts for 60 to 70 percent of your daily calorie expenditure, and it’s closely linked to the amount of muscle you have. Muscle burns more calories than fat… even while you sleep!

2. Get moving with your cardiovascular exercise. When you perform cardio, enzymes are produced that break down fat and enable the body to use it as an energy resource. The average person has 100,000 calories worth of fat stored on their body -- roughly enough to run for 200 hours. For fat to be burned as energy, oxygen needs to be produced. People with a high cardio capacity are able to burn fat very easily because their bodies are efficient at delivering oxygen to muscle cells.

“There’s a fitness term called the ‘after burn’, “This refers to the calories that you burn 24 to 48 hours after your exercise session. What that means to you is a faster metabolism that burns fat at an accelerated rate.”

3. Try interval training. Your body has an amazing ability to adjust to routine. If you don’t change things up, you can get stuck in a rut. Try interval training -- bursts of high-intensity moves -- to boost metabolism. Studies show that people who do interval training twice a week, in addition to cardio, lose twice as much weight as those who do just a regular cardio workout. Just insert a 30-second sprint into your jog every five minutes or add a one-minute incline walk to your treadmill routine.

4. Don't overdo calorie-cutting. If you ingest too many calories, you gain weight, but if you restrict your calorie intake too much, it’s a surefire way to keep the pounds on. That may sound strange, but what your body is doing is entering survival mode. Your body is programmed to defend itself. If you suddenly drop a bunch of calories from your diet, your resting metabolic rate will slow down, because your body makes the assumption that you are starving.

Depending on your level of activity, you can safely lose anywhere from half a pound to two pounds a week. The easiest way to figure out your needs is to multiply your current weight by 22 . So, if you're 70 Kgs , aim for around 1,540 calories a day. Unless you're less than five feet tall, don't let your daily calories dip below 1,200. Research shows that women who consume less than this amount see their resting metabolic rate plummet by as much as 45 percent

5. Eat breakfast. Some of you out there just don’t have an appetite in the morning. Some just don’t have time. But breakfast may just be the most important meal of the day. Your metabolism slows when you’re asleep, and it doesn't rev back up until you eat again. If you skip breakfast, you’re talking upwards of 18-20 hours since your last meal! That’s a recipe for disaster. Start the day with a solid 300-to-400-calorie meal, preferably high in fiber.

6. Space your meals wisely. If you find that you get frequent snack attacks, kick-start your metabolism and curb your appetite by dividing your meals into five to six small, nutritious meals a day instead of three squares. Eat a 200-400 calorie mini-meal every three to four hours. Your body will expend more energy to digest the food and your metabolic rate will increase. If this is too much to handle, revert back to the three meals, but make them slightly smaller and add a couple snacks strategically placed mid-morning and afternoon.

7. Catch some z’s. According to studies, sleep loss may increase hunger and affect the body’s metabolism, which may make it more difficult to lose weight. People who lose sleep may continue to feel hungry despite adequate food intake because sleep loss has been shown to affect the secretion of cortisol, a hormone that regulates appetite. Make sure you get in your eight hours or more of shut-eye every night.

8. Drink water. Researchers in Germany have found that drinking water may increase the rate at which you burn calories. Study participants’ metabolic rates increased by 30 percent after consuming approximately 17 ounces of water. The energy-burning process of metabolism needs water to work effectively. Water also fills you up, curbs your appetite, flushes out your system and rids the body of bloat. Drink at least eight to 10 glasses per day, even more if you’re active.

9. Skip alcohol. Thinking about throwing back a couple before dinner? Not so fast. Several studies show that having a drink before a meal causes people to eat around 200 more calories. Drinking with dinner isn't such a good idea either: Other research has found that the body burns off alcohol first, meaning that the calories in the rest of the meal are more likely to be stored as fat. If you do have a cocktail craving, stick to wine, which packs only 80 calories a glass -- or minimize the calories by drinking a white-wine spritzer (two ounces of wine mixed with two ounces of seltzer).

10. Drink milk. If you’re not lactose intolerant, don’t shy away from low-fat dairy. Women who consumed milk, yogurt and cheese, three to four times a day, lost 70 percent more body fat than women who didn't eat dairy in a study published in the American Society for Nutritional Sciences Journal of Nutrition. The reason: calcium, along with other substances in dairy, actually revs up your metabolism, according to the study. Research shows that women reap the largest fat-burning benefit when they consume three servings of dairy and 1,200 milligrams of calcium a day.

Nadeem

Ceo, Active life consulting

Call us-9849345798, 04023841170

activelifeconsulting@gmail.com

www.activelife.in

InterviewingPeople

RHEUMATIC HEART DISEASE

Rheumatic heart disease is a serious public health problem in India . This disease affects mainly children and young adults. The cause of the disease is rheumatic fever which can affect the joints, heart and nervous system. The effect on the joints is mild but the heart can be seriously damaged leading to deformity of the heart valves. It can produce narrowing as well as leakage of the mitral valve, aortic valve and tricuspid valve.

The basic cause for rheumatic fever is a kind of allergy to a common infection of the throat (pharyngitis) caused by bacteria called "Streptococci". If on a regular basis patient is given inj. Penicillin, the disease can be largely prevented from progressing to a stage of needing surgery of heart

This disease was at one time prevalent all over the world but presently seen largely in the developing countries like India . This is probably due to better standard of living and lesser chance of spread of streptococcal infection. In India this disease is very common and affects children and young adults. It is important to diagnose the disease early so that treatment and preventive measures can be undertaken.

What are the early complaints of the patient with rheumatic fever?
The child usually develops joint pains. There may or may not be history of swelling of the joints. Only some children confirm throat infection. The effect on the heart usually comes a few weeks after the joint pains and can be mild or severe. But it is the long term effects of the rheumatic fever that are of greatest concern and usually produce breathing difficulty, cough, inability to sleep, blood in the sputum and in late cases swelling over the body. By this time usually one or more valves are damaged and need surgery or balloon valvotomy or valve repair.

The various methods of treatment for this condition are out of scope for this article. What is important for the general public to know are:
1. Rheumatic heart disease is largely preventable by diagnosing early case.
2. Any child or teenager complaining of throat pain should be taken seriously and should be taken to a doctor for ruling out streptococcal infection by appropriate tests and if found positive treated with a course penicillin or other appropriate anti-biotic.
3. Established cases of rheumatic fever should be put on long term penicillin prophylaxis which means one injection of Benzathine penicillin once in 3 weeks. These injections have to be given upto a minimum age of 21 years and in many cases much longer.
4. Compliance to the injection of penicillin is the single most important step in preventing this disease from progressing to a life threatening stage.






Dr.K.Sarat chandra,
MD,DM,FICC.
Additional Professor,
Department of Cardiology Unit -I,
Nizam's Institute of Medical Sciences,
Panjagutta,Hyderabad- 500082.
Mobile no. - +91-9848012212
phone no.[Off]- +91-40-23302426
Fax no.[Off.] -+91- 40-23302426
saratkoduganti@yahoo.co.in

DO YOY KNOW WHAT ARE STEM CELLS?

Stem cells are the primal cells of the body. The different cell types within the body are all derived from such cells- and hence the name. Stem cells are undifferentiated, "blank" cells that do not yet have a specific function. Characteristically, stem cells have a high capacity for self-renewal. This feature permits their continuous culture under laboratory conditions.

Stem cells have the unique ability to differentiate into a variety of cells. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another type of cell with a more specialized function - such as a muscle cell, a red blood cell or a nerve cell.

Self-Renewing

Given the right environment, stem cells can give rise to a number of tissues that constitute the different organs. Also serving as a kind of repair system for the body, stem cells can divide repeatedly and then differentiate and replenish cells within the body. These unique characteristics are the reason why stem cells are considered a breakthrough in regenerative medicine. They have the potential for providing cells and tissues to treat various debilitating, life-threatening diseases.

Stem cells can be derived from various sources such as the bone marrow, embryos obtained by in vitro fertilization, amniotic fluid and umbilical cord blood.
There are three broad categories of stem cells, which can be derived from various sources such as the bone marrow, embryonic tissue, amniotic fluid and umbilical cord blood.

Types of Stem Cells
There are three main types of stem cells, which are usually considered for their potential use in research and medicine. They differ in their ability to self-renew:

Totipotent
These stem cells have the potential to become any kind of cell in the body. After an egg is fertilized, it undergoes a series of divisions to become an embryo and later a fetus. The cells that are formed during these first few divisions are totipotent i.e. they can become any cell in the body. Human cells have this capacity only during the first few divisions of a fertilized egg. After 3 - 4 divisions of totipotent cells, these cells will not be able to differentiate into any cell type.

Pluripotent
This type of stem cell has the ability to become almost any kind of cell in the body-except the cells of the placenta or other supporting tissues of the uterus. Pluripotent stem cells result after totipotent stem cells undergo the first few divisions. Embryonic stem cells at the blastocyst stage and fetal stem cells are pluripotent.

Totipotent and Pluripotent cells are essential for the development of an entirely new organism, which is why they are found in the early stages of development.

Multipotent
These cells can give rise to several other cell types, but those types are limited to mostly cells of the blood, heart, muscle and nerves. These cells function as a repair system for damaged tissue. Adult stem cells are a good example of multipotent stem cells.

Sources of Stem Cells
Stem cells can be harvested from various sources like the bone marrow, embryonic tissue, amniotic fluid or umbilical cord blood. Stem cells are classified according to the source from which they are obtained.

Somatic Stem Cells
Stem cells are found in small numbers in adult tissue such as brain, bone marrow, peripheral blood, blood vessels, skeletal muscle, skin, liver and umbilical cord blood. These cells are also called 'adult stem cells', even though the term 'adult' is incorrect as stem cells also occur in babies and children.

The primary role of stem cells in the body is to maintain and repair the tissues in which they are found, as they are multipotent in nature.

Somatic Stem CellsOf all adult tissue, the bone marrow is an extremely rich source of somatic stem cells. Drawn from the spongy tissue found in the center of bones, the main function of these stem cells is to make blood cells that circulate in our bodies and fight infection. In stem cell therapy, bone marrow was the earliest source of stem cells due to its rich supply.

The other rich source of stem cells is the blood left over in the umbilical cord and placenta of a newborn child. Till recently, this blood was (and continues to be) often discarded as medical waste. However, now that umbilical cord blood is known to be a rich source of stem cells, more people are choosing to bank these cells for its potential future use.

Embryonic Stem Cells (ESCs)
Embryonic Stem Cells (ESCs)These cells are derived from embryos that develop from eggs that have been fertilized in vitro and are donated for research. The embryos from which these cells are derived are four or five days old and are a hollow microscopic ball of cells called the blastocyst. The cells are removed from the blastocyst and treated in a culture dish where they divide into more embryonic stem cells. Because these cells are pluripotent, they are attractive candidates for use in stem cell research and therapy.

Embryonic (or fetal) Germ Cells (EGCs)
Embryonic (or fetal) Germ Cells (EGCs)These pluripotent stem cells are derived from primordial germ cells, which give rise to the gametes (sperm & eggs) in adults. They are found in a 5 to 9 week old embryo/fetus in the area that is destined to become either the testicles or the ovaries. Like the embryonic stem cells, primordial germ cells too are transferred into a specially treated culture dish to form germ cell colonies. Deriving stem cells through this process is controversial since the embryo or the fetuses from which the germ cells are obtained are destroyed. The embryo or the fetuses, even though not fully formed, are considered 'human' in many cultures and hence their destruction leads to ethical dilemmas. Such a dilemma exists even if the embryonic germ cells are derived from a fetus that is obtained as a result of a miscarriage or abortion.

Peripheral Blood Stem Cells
Peripheral Blood Stem CellsStem cells, in limited quantities, can also be found in the peripheral blood circulation. Peripheral blood stem cells are easier to obtain than bone marrow as they can be drawn from blood. Some studies have shown that these stem cells engraft faster than bone marrow stem cells.

Kidney stones

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LifeCell launches Cord Tissue Banking in India

LifeCell International, India’s first & the largest stem cell banking service provider and a pioneer in stem cell research, technology & therapy, announced the launch of Umbilical cord tissue banking service in India, today. The technology to harness the potential of Umbilical Cord Tissue, a rich source of Mesenchymal stem cells was developed in-house at the LifeCell R&D center at Chennai., India. With this launch, LifeCell achieved a considerable technology landmark in the field of Regenerative science & healthcare industry in India.

Mesenchymal Stem Cells (MSCs) from bone marrow have been at the forefront of therapeutic strategies for a number of hitherto incurable ailments like Heart Disease, Type I Diabetes, Crohn’s Disease, GVHD, Osteoarthritis and Stroke. Further, MSCs from Cord tissue showed additional therapeutic potential in animal models to treat Parkinsonism, Skeletal muscle injury, Limb ischemia, Retinal nerve degeneration. Hence, these cord tissue MSCs appear to be superior to bone marrow MSCs and can be a potential substitute for them.

Talking at the occasion, Mr. Mayur Abhaya, President and Executive Director, LifeCell International, said, “We at LifeCell are very excited about this landmark achievement that we have made at our R&D center, by developing the technology to harvest and store Umbilical Cord Tissue in India. With additional service of cord tissue banking, , clinical trials, R&D, therapy solutions we are the only company in India providing comprehensive stem cells solutions. This will give us a competitive edge to tap the potential market. In a country like India with over 40 million births every year, the potential is immense and we see a huge opportunity ahead. We envision a 30% percent growth in our enrolments by 2010. Our revenue for this year is expected to close by Rs.400 Million.”

According to Dr. Ajit, Chief Scientific Officer, LifeCell International, “Previously, after the collection of the umbilical cord blood, the remaining solid cord tissue was normally discarded. However, this cord tissue is a rich source of Mesenchymal stem cells (MSCs) and we have invested two years of time in developing and validating a proprietary technology at our in-house R&D center for collection and storage of the cord tissue. These MSCs from cord tissue are superior to bone marrow MSCs, as these cells are fetal in nature and therefore more robust. Besides, the collection process is non invasive, painless and usually devoid of infection.” Added Dr. Ajit

Over the conversation about the awareness and acceptance of stem cells in India Mr. Mayur added, “Recent success stories of stem cells, daily news on research findings and breakthrough in clinical trials etc., are validating the potential of stem cells thereby increasing the demand for storing the baby’s stem cell for future potential use. The medical fraternity has been playing a vital role in supporting and spreading knowledge and awareness on this concept.”

Customers who want to store their cord tissue have a range of options with LifeCell. They may choose to bank the processed stem cells from the Cord Tissue for a ready use or store the cord tissue which can be used to harvest stem cells later for therapy.

Preserving the cord tissue comes as a package along with cord blood banking service of LifeCell at a cost of Rs.44,600/- for the first year and Rs.3,500/- every year as annual storage fee. However, if the client prefers to process the cord tissue and store the harvested stem cells, the process will cost Rs.63,100/- for the first year and Rs.5,500/- every year as annual storage fee. Both these options include processing and cryo-preserving the cord blood stem cells which is the basic service.

Clients could also go for the option of one-time storage fee of Rs.79,000/- upfront for storing cord blood and cord tissue and Rs.1,17,500 for storing cord blood along with processing of cord tissue.

LifeCell’s key differentiator has been quality and service and with a technology tie-up with the Cryo-Cell International, the world's first stem cell bank, LifeCell has the expertise of technology to maintain the best quality which has also been acknowledged and accredited by AABB. LifeCell offers round-the-clock service and is the only stem cell bank in India offering this service to over 40 centers in India & abroad.

Advantages of Mesenchymal Stemcells:

In a unit population of cells MSCs in the umbilical cord tissue are present in much higher numbers when compared with the bone marrow. These cells have shorter doubling time. Also the HLA ABC antigens are less of an issue with cord MSCs when compared with bone marrow MSCs.

About LifeCell International Pvt. Ltd: .

LifeCell is India’s first & the largest stem cell bank & stem cells solutions provider to bring the revolutionary concept of banking a baby’s umbilical cord blood stem to the country. The company and was incorporated in 2004 in technological collaboration with Cryo-Cell International, USA (the world’s first stem cell bank). LifeCell has established its prominence through a range of services & activities from multi-service banking, research & development, clinical trials, stem cell therapy solutions and technology tie-ups.

LifeCell is accredited by many institutions in India & abroad like AABB, DSIR, ISO and few others by maintaining international quality standards. The company has a large network & client base with over 40 centers in India & abroad and over 20,000 parents have banked their baby’s cord blood stem cells with LifeCell.

Today, LifeCell has consolidated its premium presence in the global stem cell industry as the World’s first and only comprehensive stem cells solutions provider.