What Are Keloid Scars?

A wound usually leaves a scar following its healing process. A keloid is also a kind of scar. Keloid scars grow too much and usually become larger compared to the original wound. They are characterised by hard nodules with smooth surfaces because of excessive production of a protein called collagen. Keloids may occur spontaneously or follow a skin trauma or surgery. They are generally itchy.

Sometimes, scars can achieve a little lumpy appearance. This process is known as hypertrophy.

How to Treat Dysmenorrhoea?

Menstrual cramps (dysmenorrhoea) are curable. Your physician may offer certain medications to relieve your pain. Sometimes, you may need surgery, if medications do not work well. Some home remedies and lifestyle changes also help manage the condition.

Medications

The following medications are considered for women with dysmenorrhoea.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs help relieve pain during your menstruation. Menstrual cramps occur due to a type of chemical substances called prostaglandins, which are secreted by the lining of the uterus (endometrium) during the menstruation. NSAIDs inhibit the production of prostaglandins and lessen the effect.

Dysmenorrhoea: Risk Factors and Diagnosis

Risk factors of menstrual cramps

Some factors can increase the risk of developing dysmenorrhoea (menstrual cramps). Risk factors, which are linked with menstrual cramps, include:

• Cigarette smoking
• Prolonged menstrual blood flow (more than five days)
• Younger the normal age (11 years or younger) at menarche (onset of puberty)
• Age 20 years or less
• Heavy menstrual bleeding (menorrhagia)
• Irregular menstrual periods (metrorrhagia)
• Family history of menstrual cramps
• Never having given birth to a child.

Dysmenorrhoea (Menstrual Cramps)

Dysmenorrhoea is described simply as a pain during menstruation. It is a very common symptom, which is experienced by 45-95 % of females of reproductive age.

Menstrual cramps appear like throbbing, cramping, or dull pains in the lower part of the abdomen. The pain can go to your thighs and the lower back too. Some women with dysmenorrhoea experience loose stools, nausea and vomiting, dizziness, and increased sweating.

Menstrual cramps usually begin at the onset of or just before the menstruation and last about eight hours to three days every month. For some females, it is only an irritable feeling. However, some women experience a severe pain, which affects their daily routines for several days each month.

Pre-diabetes: Development in Children

Pre-diabetes is a well-known risk factor for both cardiovascular disease and type 2 diabetes mellitus. It also is considered as a disease by itself (1). Five to ten per cent of adults with this disease usually advance to diabetes mellitus. However, children and adolescents, who are with pre-diabetes, can turn back to normal compared to adults.

The rate of pre-diabetes varies according to the definition used, race, and age. Considerable variations in prevalence depend on whether pre-diabetes described by IFG (impaired fasting glucose) or IGT (impaired glucose tolerance). The occurrence of IFG is 13-40 % (2,3,4), while the rate of IGT is 2-5 % in children (5). About 20 % of children have HbA1c levels of 5.7-6.4 % (6). The frequency of pre-diabetes is considerably greater in obese pubertal children, who are with a family history of pre-diabetes.

How Do You Know You Have Pre-diabetes?

Pre-diabetes

Pre-diabetes or impaired glucose tolerance is described by blood-glucose levels, which are raised above the upper normal value, but below the limit (threshold) for diabetes mellitus. It is important to diagnose pre-diabetes early, because it helps assess the risk of developing type 2 diabetes mellitus and stop the progression to diabetes and cardiovascular disease later in life.

Exercise and Your Heart Rate

During exercise, working tissues in your body usually need more blood with oxygen and nutrients. Then, your heart enhances its pumping activity by increasing the heart rate and the force of contraction (contractility). It is necessary to raise the heart rate within a certain range (target heart rate/THR) for maximum health benefits. Therefore, you should maintain your heart rate within THR during the workout. Exceeding THR is likely to harm you and your heart. It will put your health at risk.

Angina and Workout

Angina is a symptom of ischaemic heart disease. It is a central chest pain, which is usually described as ‘gripping’, ‘heavy’, or ‘tight’. Anginal pain may go to the arms and/or jaw. It can range from a mild ache to a very severe pain, which provokes fear and increased sweating. Sometimes, it may be associated with shortness of breath.

Usually, angina develops during physical or mental exertion. It disappears by stopping physical exertion or using glyceryl trinitrate (GTN). The main cause of angina is a narrowing of a coronary artery or its branch by fat deposits in the arterial wall (atherosclerosis or plaque build-up). Two coronary arteries and their branches supply blood to the heart muscle (myocardium). Atherosclerosis can partially occlude a coronary artery, causing insufficient blood flow to a particular part of the heart muscle. During an exercise, the heart works hard to pump more blood, oxygen, and nutrients to the working tissues. Therefore, the myocardium needs more oxygen, which is not sufficient in angina.

How to Recognise Ischaemic Heart Disease?

The heart muscle (myocardium) receives its blood supply with oxygen and nutrients through two main arteries (coronary arteries) and their branches. Partial or total occlusion of a main coronary artery or a branch can lead to an impaired blood supply to a part of the myocardium. An incomplete occlusion of the blood supply usually causes myocardial ischaemia. However, a total occlusion can lead to death of the particular part of the myocardium (infarction). These processes are known as ischaemic heart disease.

Ischaemic heart disease can weaken the ability of the heart to pump blood throughout your body. It mainly occurs due to narrowing of the coronary arteries by fat (cholesterol) deposits in their walls. This process is known as atherosclerosis or atheroma formation.

Osteoporosis and Young Women

Osteoporosis can be described as a disease characterised by low bone mass or density. A deterioration of the bone structure and thinning of the bones can be seen in osteoporosis. Therefore, it leads to enhanced bone fragility and a rise in the risk of fracture. Osteoporosis is most common among older women compared to men and young women. However, some young women as well as men can also get osteoporosis. Fortunately, some osteoporosis cases can be prevented.

Initially, we should know the causes and risk factors of osteoporosis in young women. If you are a young woman with a risk of developing osteoporosis, you can prevent osteoporosis by eliminating or modifying the particular risk factor.

Impetigo: A Skin Infection

Impetigo, which is a superficial skin infection, usually occurs due to  bacteria called Staphylococcus aureus. It is the most prevalent skin infection among young children. Impetigo is a highly infectious skin condition and is also more common in children compared to adults. Sometimes, it occurs due to Staphylococcus aureus, Streptococcus pyogens, or a mixture of the two bacteria. Impetigo is common in individuals in hot climates. It rapidly spreads from person to person by direct skin contact or less frequently, by clothing and towels or bedding. It easily passes among family members and school mates. The name ‘scrum fox’ describes the impetigo spread among rugby players. Occasionally, impetigo appears without an apparent origin.

Exercise and Your Menstrual Cycle

The nature of a menstrual cycle differs from woman to woman. Usually, the average duration of the menstruation is about three to seven days with a mean blood loss of 35 ml. Following this phase, a woman enters her follicular phase, at which the lining of the uterus (endometrium) thickens gradually and ovarian follicles ripen to release an egg again. Symptoms during the menstruation also vary from woman to woman.

Menorrhagia is described as an abnormally heavy blood loss during the menstruation. Normally, it is greater than 80 ml during a period.

Exercise can decrease the length and intensity of menstruation. However, it depends on a few factors. The type and regularity of your exercise and underlying conditions of prolonged or heavy menstruation affect the length and intensity of your periods.

Sugar and Your Child

Children usually consume a significant amount of foods containing sugars like candies, pastries, pastas, cookies, and white breads daily. If your children regularly eat sugars, they are more prone to develop certain health issues such as obesity, tooth decay, and behavioural problems. Luckily, these complications are preventable. Some dietary habits and behavioural modifications can help avoid them.

Hirsutism: An Embarrassing Condition

The extent of normal hair growth differs between people, families, and races. It is somewhat extensive in the Mediterranean and some Asian subcontinent populations. Too much facial or body hair growth in a woman is known as hirsutism. There is no absolute margin between the normal hair growth and hirsutism.

Usually, sex hormones affect the hair growth in the moustache, beard, breast, chest, armpit, the midline of the abdomen, genital area, and the thighs. A type of soft hair (vellus hair), which is normally present all over the body, is not affected by the sex hormones. If a woman has excess hair growth over the regions, which contain the sex-hormone dependent hair, it shows increased male hormone (androgen) production in the ovaries and adrenal glands. This process commonly occurs due to polycystic ovary syndrome (PCOS) but occasionally other rarer conditions. Other conditions include an abnormal growth of adrenal glands (congenital adrenal hyperplasia), Cushing’s syndrome, and tumours of the ovary and the adrenal gland.

4 Facts for a Long Life

Everyone needs and expects a long healthy life. However, most modern people have some kind of health-related problems, some of which may lower the life expectancy as well as the quality of life. Certain lifestyle modifications and simple measures can improve your health significantly hence the quality of life.

Physical activities

Inactivity is one of the critical problems in the modern society. Most people are unable to participate in adequate physical activities or exercise due to their busy lives. Physical inactivity can lead to various diseases and health-related problems. It reduces the muscle mass and triggers your aging process. Reduced muscle mass lowers the metabolism in your body hence increases the risk of developing diabetes mellitus, obesity, hypertension, high blood cholesterol, stroke, and heart attack. It can also reduce the efficiency of your activities.

Herpes Simplex Skin Infection

Herpes simplex is a virus, which causes a skin infection. It spreads from person to person by direct skin, sexual, or mouth contacts. There are two types of herpes simplex viruses (HSV). They are HSV type 1 and HSV type 2.

HSV type 1 is spread by direct contact and contaminated droplets. Most people achieve HSV type 1 in early childhood. However, the infection usually occurs without symptoms. Occasionally, it leads to fever with either clusters of painful blisters on the face or an inflammation and aching blisters in the mouth, including the gums (Gingivostomatitis). The fever is usually self-limiting.

HSV type 2 infections take place generally following puberty and normally affect the genital region. These infections are usually with no symptoms and transmitted sexually. However, HSV type 1 infection occurs in the genital area due to oral sex.

Exercises for a Better Pregnancy and Childbirth

Some people believe that exercises are unsuitable during pregnancy. However, physically fit women normally have shorter labours compared to others. They also experience less physical exhaustion during childbirth and tend to have fewer medical interventions as well. Regular exercises during pregnancy improve fitness and health of the organ systems. Therefore, they decrease discomfort and help have a better sleep during pregnancy. Exercises help keep up your body weight during pregnancy and go back to the normal weight following childbirth. They also improve your mood.

If you feel shortness of breath, contractions, or lightheaded during any exercise, you should stop exercising and drink enough water.

How to Improve Immunity in Children?

The immune system, which consists of a large number of white blood cells, helps protect your child from various diseases and infections. It identifies harmful microorganisms and substances as foreign materials and acts to eliminate them. However, children have a higher risk of getting infections compared to adults because their immunity is still developing. The immune system can memorise various microorganisms and substances, to which your child has previously exposed. Then, it is able to act vigorously against the particular foreign material following a subsequent exposure. Your child acquires immunity against various pathogens and substances with time. Therefore, the risk of getting illnesses decreases gradually. Anyway, some simple habits and measures can boost their immunity.

Facts About Vitiligo

Vitiligo is a common condition, which affects about one per cent of people. Some areas of the skin lose the normal pigment (depigmentation) and become white. It occurs due to loss of melanocytes in the affected areas. Melanocytes are cells, which are in the skin and produce the pigment known as melanin. This pigment gives the skin its normal colour. Vitiligo is an autoimmune disease. Sometimes, the immune system of your body may produce antibodies against the melanocytes. Therefore, these antibodies destroy the melanocytes in some areas of the skin. Then, the skin cannot sufficiently produce melanin.

Vitiligo occurs in women and men from all races evenly. However, it can be easily identified in individuals with dark skins. Vitiligo can affect people of any age. However, about 50 % of the patients get it before 20 years. It doesn’t spread to others. About 20 % of individuals with vitiligo have a family member with the same disease. The exact mechanism of inheritance has not been recognised yet. If a person has vitiligo, it doesn’t mean that his or her kids are going to have it too. There is no association between vitiligo and your diet.

Exercise and Arthritis in Your Knees

Arthritis is characterised by the joint inflammation, resulting in pain, swelling, and decreased movements of the affected joint. It is among the leading causes of disability in people over 55 years of age. In arthritis, the affected joint and the muscles, which move the particular joint, become painful, weak, and stiff.

Arthritis in the knee results in painful, weak, stiff knee joint, and the quadriceps femoris muscle. This quadriceps muscle, which has four parts or heads and runs from the hip to the knee, is the main protector of your knee joint. It is at the front part of the thigh and helps straighten the leg. Arthritis in your knee joint causes difficulty in bending, walking, and participating in exercise, sports, and daily physical activities. However, certain stretching and strengthening exercises help offer some relief.

Yoghurt for Losing Weight

Obesity and being overweight are big issues in modern populations. People, who diet to lose their body weight, usually fail to keep up their weight goals for a long period. However, regular exercise and calorie restriction with a balanced healthy diet help achieve your weight goals effectively. They are the key factors of a healthy weight loss.

A group of researchers from the University of Tennessee carried out a research to see an association between body weight loss and the yoghurt consumption. They published their results in International Journal of Obesity in January 2005. The researchers found that those who used to consume three portions of low-fat yoghurt daily shed more body weight, especially belly fat, compared to those who dieted and didn’t consume yoghurt.

Exercise and Your Nervous System

Your nervous system is among the two primary control systems of your body. Other control system is your endocrine system. The nervous system regulates the voluntary and involuntary activities and functions of the body. Therefore, it works with other organ systems in a coordinated manner and regulates their functions. It helps respond to challenges like exercise, sports, physical activities, and diseases. Your nervous system can be easily divided into central and peripheral nervous systems. However, these two parts work together closely. The central nervous system basically consists of the brain and the spinal cord. The peripheral nervous system mainly contains sensory (afferent) and motor (efferent) nerve fibres (these nerve fibres arise from the central nervous system) as well as the motor end plates on muscle fibres, and sensory receptors.

Exercise and Your Digestive System

Your digestive system (gastrointestinal system) helps absorb micronutrients, macronutrients, electrolytes, and water from the food you consume. Therefore, it is important for your health as well as the normal functions. The macronutrients include carbohydrates, proteins, and fats. The micronutrients are minerals and vitamins. These nutrients are essential to create the basic structure of your body and regulate the normal functions of cells and tissues. Without adequate amounts of nutrients, you cannot keep up your health, perform exercise and physical activities, and train for athletic and sport competition.

Exercise and Your Urinary System

Your urinary system mainly contains two kidneys, two ureters, the urinary bladder, and the urethra. Each kidney connects to the urinary bladder through a ureter, which is a tube-like structure. The bladder is a muscular hollow, and elastic organ, which can store urine temporarily. It connects to the outside via the urethra, which is a tube. A renal artery supplies the blood, oxygen, and the nutrients to each kidney. A renal vein carries blood from each kidney.

The urinary system basically helps eliminate waste products from your body and regulate the volume, electrolyte concentration, and the acidity (pH value) of the body fluids (in the blood, cells, and the tissues) within the normal range. It controls long-term acid-base balance, because changes in the metabolism cause alterations of the acidity (pH value) in the body. Therefore, it keeps up the internal environment stable. During the metabolism, the cells produce various waste and toxic substances. Your urinary system removes most of them (except for carbon dioxide and some others) via urine. It mainly helps regulate the volume and osmolarity (a measure of electrolyte concentration) of your body fluids by handling water and sodium balance within the body.

Exercise and Your Respiratory System

Your respiratory system mainly consists of the airways, the lungs, and the respiratory muscles. The respiratory muscles include the muscles of your chest wall (internal and external intercostal muscles) and the diaphragm. Sometimes, the neck and the abdominal muscles also help breathe. The respiratory muscles produce respiratory movements hence the inhalation and exhalation. During inhalation (inspiration), they help expand your lungs and create a low pressure within the lungs compared with the environment. Therefore, the air moves into the lungs from the outside. While in exhalation (expiration), the respiratory muscles reduce the expansion of your lungs, increasing the pressure within the lungs than the environment. Consequently, the air moves to the outside from your lungs.

Exercise and Your Cardiovascular System

Your cardiovascular system basically contains the heart, blood vessels (arteries, veins, and capillaries), and the blood. It takes oxygen from your lungs and helps transport oxygen, nutrients, other substances via the blood to all tissues throughout your body. It also facilitates nutrient absorption from your gastrointestinal tract as well as the elimination of waste products from the tissues. Your heart muscle (myocardium) rhythmically contracts to pump the blood throughout your body. This rhythmical activity is regulated by the nervous system and the endocrine system.

Exercise and Your Skeletal System

The skeletal system is the basic structure of your body, which consists of various types of rigid bones. It basically helps generate movements of your body, offering a lever system and protects the internal organ systems and other tissues. It also acts as a large storage of minerals, which is important to the normal functions of the body. Bone marrow is a soft tissue within the bone. It produces your blood cells. The skeletal system offers structural support and helps transfer your body weight to the ground through the lower limbs. During any movement of your body, the skeletal system should work with your muscular system in a coordinated manner to generate the particular movement. This coordination is done by your nervous system. Your muscles contract or relax in a coordinated way to move certain bones producing specific movements. This also helps maintain the body position as you wish.

Exercise and Your Muscles

Your muscular system basically consists of three types of muscles. They are skeletal, smooth, and cardiac muscles. These muscles contract and produce force according to the signals from your nervous system. Therefore, they create movements of your body.

Skeletal muscles, which are attached to the bones, contract with the help of the nervous system and create specific movements of the body. They are under your control and are ready to move as you wish. Skeletal muscular activity generates energy as well as heat. Therefore, it helps keep up your body temperature within the normal range. This process is known as the thermogenesis.

Management of Acute Asthma in Children (Over Two Years)

Some children with bronchial asthma may develop acute exacerbations or attacks. Sometimes, severe acute asthma attacks can be fatal. Therefore, children with severe acute asthma should be offered treatment quickly. It is safer to manage them in a hospital with resuscitation facilities. Children with acute asthma should never be sedated. Physicians in primary care should start treatments as mentioned below and transfer these children to a hospital immediately.

Acute Bronchial Asthma in Children (Over Two Years)

Bronchial asthma is a long-term (chronic) inflammatory disease, which leads to an episodic obstruction of the airways. It is a reversible condition and can be managed and controlled with lifestyle changes and some medications. However, some children with bronchial asthma may get acute exacerbations (attacks). Diagnosis of acute asthma can be done with the help of symptoms, signs, and some tests.

Eczema with an Unusual Distribution (Contact Dermatitis)

Usually, dermatitis or eczema implies an inflammatory condition of the skin. Sometimes, it may be in an unusual or localised distribution. Then, it is known as contact dermatitis or contact eczema. This particular condition occurs due to an exposure to something in the surroundings.

If you have a dermatitis and have no family or personal history of atopic disease, one of the environmental agents may be the probable cause. These agents can be allergens (causing allergic reaction or hypersensitivity) or irritants (causing direct irritation) in your environment.

Can You Really Prevent the Common Cold?

The common cold is highly infectious and is one of the prevalent infections in humans. It occurs because of more than 200 types of viruses. The common viruses are rhinoviruses. Others include coronaviruses and adenoviruses. Over 100 varieties of rhinoviruses are known to cause the common cold. Therefore, it is not easy for the immune system of your body to defend you from the infection. Usually, an average person experiences two to three episodes of the common cold annually. A normal child suffers from about six common cold infections yearly.

The spread of the common cold occurs mainly due to inhalation of tiny droplets, which enter the air when a person with the common cold coughs, talks, or sneezes. Otherwise, you can catch the infection by touching the contaminated objects or surfaces with nasal secretions from a patient and then touching the eyes, nose, or mouth. The spread of cold viruses also occurs through the personal contact, like handshakes.

There is no specific vaccine or other medication to prevent the infection. However, some simple precautions and lifestyle changes help reduce the risk of getting the common cold.

How to Manage Common Cold?

There's no exact treatment for the common cold. However, some simple measures help relieve symptoms and eliminate viruses, which cause the common cold.

You should keep up the hydration of your body by drinking an adequate amount of fluids. Avoid drinks containing caffeine and alcohol. Sufficient hydration of your body will help relieve congestion and flow mucous (nasal secretions) easily. Although you have a loss of appetite, it is better you have a balanced healthy diet. Some studies show that chicken soup helps reduce the symptoms. Eating hot and spicy meals may relieve the illness because, they help flow nasal secretions. Dietary nutrients will assist the immune system to eliminate viruses from your body and shorten the duration of the common cold. Your diet should contain adequate amounts of vitamins A, B1, B2, B5, B6, folic acid, C, and the minerals copper and zinc. Zinc and vitamin C help produce a type of white blood cells known as neutrophils, which fight against infections. Zinc may reduce the duration of the illness, if the patient takes zinc in the first day of the common cold. Vitamin C may prevent the cold. However, it has no effect during the illness.

Complications of the Common Cold

The most prevalent infection in humans is the common cold. Usually, it resolves without any complications in about one to two weeks. However, some people get certain complications, which can be serious and long lasting. Therefore, it is important to know the features of the complications because, these patients need antibiotics and other medications to recover.

What Is the Common Cold?

The common cold (acute coryza) is the most widespread disease in humans. It is a highly infectious condition. The common cold causes prominent upper respiratory tract symptoms, specially in the nasal cavities, and mild symptoms in other parts of the body. It occurs due to a wide range of viruses, of which the rhinoviruses are the most prevalent. Other viruses include adenoviruses and coronaviruses. More than 100 types of rhinoviruses are responsible for the common cold. Therefore, it is difficult for your immune system to protect you from this infection. Most people suffer two to three common colds a year. However, the incidence gradually declines with age. It may be due to acquiring immunity to various types of viruses. Additionally, it is one of the well-known causes of school and work absenteeism.

How to Manage Acute Asthma in Adults?

Usually, bronchial asthma can be controlled, if the patient has a good compliance with medications and lifestyle changes. However, some patients with asthma can develop acute exacerbations (attacks).

Acute bronchial asthma should be managed under the supervision of health-care professionals. People with near fatal or life-threatening bronchial asthma should be admitted and managed as inward patients. Individuals, who have persistent severe attack following initial therapy, should also be admitted. Patients, whose peak expiratory flow (PEF) is more than 75 % of the earlier best or predicted value one hour following initial therapy, can be discharged from emergency department.

How to Diagnose Acute Asthma in Adults?

Bronchial asthma is a chronic (long-term) inflammatory condition of the lungs. It occurs basically in the airways. Usually, bronchial asthma can be controlled with medications and lifestyle modifications. However, some people may develop acute attacks (exacerbation) of asthma.

Features of acute asthma

It is important to identify and manage acute asthma. There are some features, which help identify or diagnose acute asthma attacks.

• Severe shortness of breath (breathlessness), which includes too breathless to complete sentences in one breath.
• Increased heart rate (tachycardia) or pulse rate
• Increased respiratory rate (tachypnoea)
• Poor respiratory effort without wheezing
• Collapsed patient
• Bluish discolouration (cyanosis) of lips, tongue, or fingers, which is due to low oxygen in the blood.

However, these are not specific features of an acute asthma attack. Their absence doesn’t rule out a severe attack. Why is it important to identify acute asthma attacks? People with acute severe asthma and one or more psychosocial risk factors have a higher risk of death.

Importance of Warming-up Your Body

Why is warm-up important? Why should you warm-up before any workout plan or active sport? It helps prepare your body physically and mentally for high-intensity as well as high-volume physical activities. Warm-up lowers the risk of injury too. It should be started with mild-intensity aerobic exercises and/or exercises, which raise the range of motion (ROM) of the joints. Then, it may be increased in intensity gradually until the person is prepared for more vigorous activities. The intensity of warm-up should be low and should not exhaust the particular person. Usually, warm-up lasts for about five to twenty minutes. Normal warm-up raises the body temperature in about one to two degrees of Fahrenheit.

Obesity in Children

Why is obesity in children important? The rate of obesity has increased two times in children and three times in adolescents during last 30 years. Over one-third of adolescents and children were obese or overweight in 2010. These results are basically due to the imbalance between calorie intake and expenditure. Lifestyle, genetic, dietary, and environmental factors affect overweight and obesity.

Weight-loss Surgery for Obesity

Weight-loss surgery is also known as bariatric surgery. It is offered in some instances of morbid obesity (BMI is 40 kg/m2 or above) or people with a BMI between 35-39.9 kg/m2 and obesity-related complications, following conventional medical treatments have failed. Bariatric surgery helps lose the most weight, but it may lead to some severe complications. A number of gastrointestinal surgical procedures belong to bariatric surgery. They help lose body weight, mainly in three ways. Bariatric surgery restricts the quantity of food the patient can comfortably eat (restrictive procedures) or lowers the absorption of calories (malabsorptive procedures), or both. Bariatric surgical procedures cause a significant weight loss with improvement in quality of life and the risk of complications. Sometimes, they help lose 50 % or more of the excessive weight. However, they do not guarantee that the patient will lose all the excessive weight or that him or her will keep up it for a long period. After bariatric surgery, the patient needs to follow exercise, a healthy diet, and lifestyle changes as usual.

Medications for Obesity

Usually, physical activities and a healthy diet help manage obesity. However, it may be difficult to treat obesity alone with them in some people. Therefore, physicians may consider offering some weight loss medications. These drugs are recommended to obese people with a risk of obesity-related complications.

Pharmacological Management of Obesity

The management of obesity is basically based on regular physical activities, lifestyle modifications, and a healthy balanced diet. However, it may be difficult to manage obesity alone with them. Then, your doctor may prescribe some medications to solve the problem. Medications can be used in the short-term (for several months) or long-term (even up to two years) as an adjunct to the diet, lifestyle modifications, and exercise. However, drugs do not substitute for them. If you use medications without lifestyle changes, you can't achieve the weight loss goal.

Tips for Diet in Obesity

Dietary control has a significant role in the management of obesity. There are various diet plans such as low-fat or low-carbohydrate diets.

• Every low-calorie diet helps cut body weight and fat in obese people, regardless of dietary composition. However, short-term weight reduction is faster with low-carbohydrate diets. It is due to loss of body water, which is regained following end of the diet plan.

• Very low-carbohydrate diets may be nutritionally insufficient. They may cause nutritional deficiencies. Very low-fat diets are usually deficient in zinc and some vitamins like B12 and E.

Obesity and Dietary Control

Dietary control is an essential factor for the management of obesity. It mainly depends on a reduction in calorie consumption. The most typical diet plans allow a daily consumption of roughly 1000 kcal. This may have to be closer to 1500 kcal for a person engaged in physical activities. Very low-calorie diet plans are also recommended by some, normally over shorter durations. However, if they are not combined with lifestyle modifications, body weight regain is likely. If you need large amounts of fat to be shed, you should follow the diet plan continuously. Additionally, a permanent change in dietary habits is necessary to keep up the new low weight. It is fairly easy to reduce initial kilograms of your weight. However, long-lasting results in moderate obesity are poor, having an overall success of no more than 10 %.

Complications of Obesity

Obesity is a global problem now because, the rate of obesity is rising in many countries. Why is obesity significant? It is associated with many diseases and health-related complications.

What Is Obesity?

Obesity means an excessive storage of fat in the body. It can easily be detected by looking at a person. Obesity is commoner in developed countries compared to developing nations. However, this issue is becoming a world-wide problem now because, the rate of obesity is increasing in many developing countries.

Run and Lose Weight

If you want to lose body weight, you should make a caloric deficit. Therefore, you need to expend more calories compared to the intake through your diet. It is hard to generate a caloric deficit through food by itself. If you combine exercise with a diet plan, you can keep up weight loss with time. It is better to combine a healthy diet, which is low in simple sugar and fat, with mild strength training. Running will help you lose and keep up body weight.

Best Weight Loss Workout for Newbies

Most people, who are overweight or obese, are dreaming of weight loss. However, it is fairly difficult. Consequently, they tend to do a heavy workout straight away. If you are a beginner to physical activities, your body will want some time to adapt for exercise. Your heart, blood vessels, muscles, lungs, and other organ systems will take time to adjust themselves for your workout plan. Otherwise, your body may get injuries and exhausted soon. Therefore, you should start your workout with mild intensity physical activities for a shorter duration a day. Later, you can increase the intensity and the duration of exercise gradually. It is recommended to start with walking, running, jogging, mild to moderate intensity sports, and low-impact aerobics for beginners. Starting with mild intensity workout help you adhere to the exercise plan and lose body weight effectively. It usually avoids frustration.

Why Is Hypertension so Important?

Hypertension (high blood pressure) can be defined as persistently elevated arterial blood pressure. Therefore, constantly raised systolic blood pressure (SBP) of 140 mmHg or above, diastolic blood pressure (DBP) of 90 mmHg or above, or both are called hypertension.

Why is hypertension so important? Hypertension is a prevalent health problem worldwide because, 20-30 % of the adult population has this disease. Hypertension incidences are significantly higher in black African population (40-45 % of adults). Usually, blood pressure rises with age up to seventies. This increase is more noticeable for systolic blood pressure and is more common in males. Most people (80-90 %) with hypertension have primary elevation of blood pressure known as essential hypertension. It is difficult to identify an exact cause for hypertension in these people.

How to Assess Total Cardiovascular Disease (CVD) Risk?

Cardiovascular disease (CVD) is a group of medical conditions, which affects the cardiovascular system (the heart and blood vessels). Most common causes of CVD are high blood pressure and atherosclerosis. However, there are several other risk factors for CVD. Common cardiovascular diseases are ischaemic heart disease, cerebrovascular accident (CVA), heart failure, and peripheral vascular disease (PVD). CVD is so important because, CVD is the major cause of deaths around the world.

Bronchial Asthma: Stepwise Management in Children (5-12 Years)

Children aged five to twelve years with bronchial asthma should be offered a stepwise management plan. Physicians provide asthma medication at the step more appropriate to the initial severity of the condition. They may advise to move up stepwise to obtain asthma control as necessary or move down stepwise to find and maintain the minimal controlling step. If there is no adequate response to the management, physicians should verify compliance to medication and reconsider the diagnosis of bronchial asthma.

Bronchial Asthma: Stepwise Management in Children Less than 5 Years

Management of bronchial asthma in children is provided as a stepwise treatment. Health-care professionals recommend children with asthma to start medication at the step most suitable to the initial severity of the disease. They may recommend moving up stepwise to achieve asthma control as required or moving down stepwise to seek and keep up lowest controlling step. If the response to treatment is not adequate, health-care professional should check compliance to treatment and reconsider the diagnosis.

Bronchial Asthma: Stepwise Management in Adults

Pharmacological management of asthma is offered as a stepwise therapy. Health-care professionals advise their patients with bronchial asthma to begin treatment at the step most suitable to the initial severity of the condition. They may ask to move up stepwise to improve asthma control as needed or move down stepwise to look for and keep up lowest controlling step. If the response to therapy is inadequate, it is better to check compliance to medication and reconsider the diagnosis.

How to Diagnose Bronchial Asthma in Adults?

The diagnosis of bronchial asthma in adults generally depends on the clinical history (symptoms) and examination (signs) in the absence of an alternative explanation for them. Initial diagnosis of asthma can be made on a thorough clinical assessment and a measurement of airflow obstruction. It is recommended to perform spirometry as the initial test to evaluate the existence and intensity of airflow obstruction. Some symptoms and signs raise the probability of asthma while some reduce.

Basics of Pharmacological Management of Asthma

The goal of bronchial asthma management is control of the condition by pharmacological and non-pharmacological measures. Total control is described as follows.

• Absence of daytime symptoms
• Absence of night time awakening due to bronchial asthma
• No need for rescue medication
• No exacerbations
• No restrictions on physical exertion such as exercise
• Minimal side effects from medication
• Normal lung function (FEV1 and/or PEF should be more than 80 % of best or predicted values)

Prevention of Bronchial Asthma

There are several dietary, environmental, and other triggering factors, which may worsen and increase the frequency of asthma attacks. Therefore, avoiding these triggering factors will help prevent and improve bronchial asthma.

How to Diagnose Bronchial Asthma in Children?

Bronchial asthma is a relatively common disease among children. It occurs due to a chronic (long-term) inflammation of the airways characterised by recurring and variable symptoms, bronchospasm, and reversible airway obstruction. Common features of bronchial asthma include cough, wheezing, difficulty breathing (shortness of breath), and chest tightness.

Diagnosis of bronchial asthma in children mainly depends on the features of clinical history and examination. It depends on identifying a characteristic pattern of episodic symptoms in the absence of an alternative explanation. Some clinical features increase the probability of bronchial asthma while some lower the possibility.

Cardiovascular Disease (CVD) Prevention Policy

Cardiovascular disease (CVD) is a common term, which describes an illness of the heart or the blood vessels. CVD occurs due to the process of atherosclerosis and thrombosis. Coronary artery disease (CAD), stroke, transient ischaemic attack (TIA), peripheral vascular disease (PVD), and aortic aneurysm belong to CVD. Why is CVD so important? It is associated with high mortality and morbidity in many parts of the world because, CVD kills about 17 million individuals worldwide every year. This number is also rising gradually. CVD causes one-third of premature deaths in males and one-fifth of premature deaths in females. CAD is the major single cause of death worldwide. One-sixth of CAD episodes present with unexpected death, which is a well-known feature of coronary artery disease.

Alopecia Areata: Another Type of Hair Loss

Alopecia areata is a common cause for hair loss and may be immune-mediated. The immune system doesn’t identify the hair follicles (roots) as own and consider them as foreign substances in affected people (autoimmunity). The process of alopecia areata and regrowth of hairs are poorly understood. It is linked with some other autoimmune diseases like vitiligo (white areas of the skin), diabetes mellitus, and thyroid disease. People with alopecia areata are more prone to have these disorders, although the risk of developing those diseases is low. The health-care professional may offer a blood test for antibodies, which may predict whether an affected individual is prone to develop pernicious anaemia or thyroid diseases.

Male Pattern Baldness (Androgenic Alopecia)

Hair loss (alopecia) is a common problem. It occurs due to a disorder of the hair follicle in which the scalp skin appears normal (non-scarring alopecia) or due to a problem within the scalp skin, which leads to permanent loss of the hair follicle (scarring or cicatricial alopecia). Scarring alopecia causes shiny atrophic bald areas in the scalp skin. These areas are lack of hair follicles.

Other Risk Factors of CAD

Although there are major risk factors for atherosclerosis hence coronary artery disease (CAD), additional risk factors for CAD have been identified. They are:

• Sedentary lifestyle
• Psychological factors
• Genetic factors
• Alcohol
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Coagulation (clotting) factors
• Lipoprotein (a)
• C-reactive protein (CRP)

Sedentary lifestyle

Lack of physical activities is an independent risk factor for coronary artery disease (CAD). It is similar to hyperlipidaemia, hypertension, and smoking. Regular exercise possibly has some protective effects against the development of atherosclerosis hence CAD. Sedentary lifestyle is also a significant risk factor of hypertension, diabetes mellitus, obesity, and hyperlipidaemia, which are main modifiable risk factors of CAD. Lack of exercise raises the risk of developing stroke and CAD by 50 %.

Modifiable Risk Factors of CAD

Certain major risk factors of coronary artery disease (CAD) can be modifiable. These kinds of risk factors are more important than non-modifiable risk factors because, they induce atherosclerosis in genetically susceptible individuals and are possibly preventable.

Prevention of CAD is linked with the alteration of modifiable risk factors. Primary prevention can be explained as the prevention of atherosclerosis, which is the main cause for ischaemic heart disease (IHD), ischaemic stroke, and peripheral vascular disease (PVD). Secondary prevention can be defined as the treatment of the atherosclerotic disease or its complications. The goal of prevention is to minimise the prevalence of first or repeated clinical events due to CAD, peripheral vascular disease, and stroke.

Non-modifiable Risk Factors of CAD

Some risk factors of coronary artery disease (CAD) cannot be changed. Therefore, they are known as non-modifiable risk factors.

Non-modifiable risk factors are,

• Age
• Gender
• Race
• Family history

Introduction: Risk Factors of Atherosclerosis

Atherosclerosis causes coronary artery disease (CAD), which is multifactorial in origin. Usually, genetic predisposition itself won’t cause the disease. Some living habits promote the atherogenic process in genetically vulnerable individuals. A number of risk factors are recognised to predispose to atherosclerosis. Some of them, like age, gender, family history, and race, can’t be changed. They are known as non-modifiable risk factors for CAD. Some other main risk factors, like smoking, blood cholesterol, diabetes, and hypertension, can be modified. Therefore, they are referred to as modifiable risk factors.

Complications of Atherosclerosis

An atheroma (atheromatous plaque) grows slowly and narrows the lumen of an artery. Therefore, it reduces the blood flow in the affected artery gradually. A 50 % reduction in diameter of the lumen causes a 70 % reduction in the cross-sectional area. It leads to a significant obstruction in the particular artery. Clinical presentations of its complications can vary according to the site of atherosclerosis.

Process of Atherosclerosis and Thrombosis

A blood vessel (artery or vein) wall has three layers.

• Tunica intima (inner layer)
• Tunica media (middle layer)
• Tunica adventitia (outer layer)

Tunica intima contains a single layer of cells known as endothelium, which forms the lining of the blood vessel. Tunica media mainly consists of smooth muscles, which regulate the calibre of the blood vessels. Tunica adventitia basically has connective tissues. Atherosclerosis is a formation of fatty deposits in the arterial wall. A fatty deposit is known as an atheroma or an atheromatous plaque.

What Is Ischaemic Heart Disease?

Ischaemic heart disease occurs due to an imbalance between the blood supply and the myocardial demand for blood. Myocardium gets oxygen and essential nutrients from the blood via two coronary arteries and their branches. If coronary blood flow to a part of the myocardium is reduced, ischaemic heart disease occurs. This can be due to a mechanical obstruction or a decrease in the flow of oxygenated blood to the myocardium.

Panic Disorder: Information for Carers and Patient’s Questions

If you are a family member or carer of a person with panic disorder, the health-care team should provide you information regarding the condition and its management. The information should include advantages, disadvantages, and adverse effects of medication for panic disorder. You could ask them what can you do to help the person with panic disorder.

How Does Stress Kill People?

All of us have a certain level of stress in our life because, it is necessary to carry out our daily routines. However, long-term stress can be a silent killer. During a stressful situation, the adrenal gland of our body secretes cortisol hormone, which is one of the stress hormones. This process raises the blood cortisol level.

20 Health Benefits of Resistance Training

All of these health benefits are more prone to be achieved in two 15-20 minute training sessions weekly.

Resistance training,

• Reduces body fat and helps maintain or cut the body weight. Therefore, it prevents being overweight or obese.

• Reduces the risk of developing hypertension, ischaemic heart disease, diabetes mellitus, and stroke.

• Reduces the risk of some cancers (colon, breast, endometrial, and lung cancers).

• Improves the functions of the gastrointestinal tract.

What Happens If a Treatment for Panic Disorder Doesn’t Work?

If you have attempted one treatment option, and it has not managed the condition well, the health-care professional should talk about whether to consider another kind of treatment. For example, if you have managed with medication, they may provide psychological treatment or self-help.

If you have managed with any two treatment options (two of medication, psychological treatment, or bibliotherapy), and you are still having considerable symptoms, they should talk about whether you want to have a specialist appointment.

Panic Disorder: Self-help

You can do several things yourself to reduce panic attacks. If you decide to try self-help options, you can discuss with your health-care professional. Usually, they are effective in reducing panic episodes. There are several management options in self-help category.

• Bibliotherapy
• Support groups
• Physical activities

Bibliotherapy is a programme, which includes reading materials depending on the principles of cognitive behavioural therapy (CBT). It helps deepen and broaden the person’s understanding of the panic disorder. Patient can read about the condition him or herself. Bibliotherapy encourages active participation of the person in the management and stimulates a stronger feeling of own responsibility for recovery. Additionally, the affected individuals can read about people, which have had the panic disorder and have coped effectively or recovered from the condition. Sometimes, the health-care professional may offer additional assignments or information to be completed during the daily routines. It accelerates the recovery.

Why Is Energy Density of Foods Important?

For an effective weight loss, you should cut the calorie intake while controlling your hunger. Gaining and keeping up a healthy weight is a challenge. If you want to maintain your body weight, you should sustain a balance between calorie intake and energy expenditure. A person must eat lesser calories compared to expenditure in order to reduce the body weight.

A Few Adverse Effects of Smoking

If you already have gastric or duodenal ulcers, cigarette smoking can delay their healing. Tobacco smoke causes duodenal ulcer relapse too. It weakens the lower oesophageal sphincter (LOS) and induces reflux of gastric acid through the oesophagus. This process is known as gastroesophageal reflux disease (GORD). Then, you will feel heartburn and regurgitation.

Panic Disorder: Pharmacological Management

If you consider taking medication to manage the panic disorder, or psychological treatment has failed, your health-care professional will provide medications. They will discuss with you regarding the risks, adverse effects, and possible interactions of the different drugs. The health-care professionals may ask whether you have tried medication for similar condition before and how well it managed the panic disorder.

Panic Disorder: Psychological Management

If you choose psychological treatment as your management option, you should be provided cognitive behavioural therapy (CBT). CBT is a psycho-therapeutic method, which tackles dysfunctional feelings, behaviours, and intellectual functions via a number of target-oriented, precisely organised procedures. It will assist you to realise how your feelings, thoughts, problems, and behaviour impact one another.

Cigarette Smoking and Cancers

Cigarette smoking is undoubtedly the most significant preventable cause of several cancers because, it greatly increases the risk of developing a cancer in smokers than non-smokers. Tobacco smoke consists of greater than 70 carcinogens. Direct as well as passive smoking help enter these hazardous substances into your lungs and rest of the body via the blood stream. These carcinogens can damage DNA and modify your important genes. This process alters the normal pattern of cell division and growth, by making the cells grow and divide out of control.

Planning the Management of Panic Disorder

Whenever you first visit the GP or other health-care professional, you should tell them about your symptoms and their duration. They may ask you about family and social life, your routines and any drugs or other substances, which you are taking, including caffeine, alcohol, or other drugs. The health-care professional will explain and discuss all treatment options. They should respect your preferences, privacy, dignity, and confidentiality, when they plan the management. You and the health-care professional should then agree on the management plan.

What Is Panic Disorder?

The major symptoms of panic disorder are repeated sudden attacks of extreme fear and discomfort. Usually, it is associated with severe physical symptoms.

Physical symptoms of panic disorder

• Hyperventilation or breathlessness
• Dizziness
• Headache
• Palpitations (racing heart beat)
• Chest pain
• Restlessness
• Sickness
• Tremor
• Excessive sweating

Does Cigarette Smoking Harm Your Fertility?

You may be dreaming to have a cute baby. Do you know that smoking can destroy your dream?

Cigarette smoking has harmful effects on your fertility. It can adversely affect your ability to become pregnant as well as continue the pregnancy to term. Both direct and indirect smoking have a negative impact on the fertility in the same way. Adverse effects of cigarette smoking are more obvious in elderly female.

Smoking causes infertility as well as delays the conception in smokers than non-smokers. It can impair the normal reproductive function of the ovaries, and destroy the eggs. Toxins of the cigarette smoke are associated with early menopause too. Some toxic substances can interfere with the oestrogen production and induce genetic abnormalities in the eggs. Long-term smoking can irreversibly damage your ovaries. Smoking is also strongly linked with a raised risk of ectopic pregnancy and spontaneous miscarriage. If you are a pregnant smoker, you are prone to give a birth to a premature baby with a low birth weight. If someone smokes in your home, your infant has a higher risk of getting sudden infant death syndrome (SIDS).

How Does Cigarette Smoke Affect Your Cardiovascular System?

Cigarette smoking (direct or passive) is a main cause of ischaemic heart disease. It is strongly associated with increased risk of stroke too. Smoking impairs oxygen delivery to the myocardium and lowers myocardial cell use of energy (ATP or adenosine triphosphate). It also causes dysfunction of endothelial cells and increased platelet activity. This process speeds up the development of blood clots in the arteries (thrombosis), causing an ischaemic heart disease or a stroke. Heart failure, heart rhythm abnormalities (arrhythmias), and even death can result from an ischaemic heart disease. Up to one fourth of strokes are directly related to cigarette smoking, which raises the risk of stroke three-fold in smokers than non-smokers. However, the risk of developing a stroke goes down quickly after smoking cessation.

How to Support People with Generalised Anxiety Disorder (GAD)?

If you are a family member or a carer of a person with generalised anxiety disorder (GAD), you can play a significant part of the management. Usually, their health-care professional asks them whether they would like you to be engaged in their care. If the person would like to manage on their own, health-care professionals should respect their privacy and preference.

What Happens If Psychological Treatment or Medication for GAD Doesn’t Work?

If the first treatment option (applied relaxation, cognitive behavioural therapy (CBT), or medication) doesn’t manage Generalised Anxiety Disorder (GAD) well, your health-care professional should provide another treatment option, which has not been offered before.

If medication is helping you, but you still have some symptoms, you may be provided one of the psychological treatments (CBT or applied relaxation) along with the medication.

If none of the treatment options has helped you manage GAD, the health-care professional may arrange an appointment with a specialist.

Medication for Generalised Anxiety Disorder (GAD)

If you chose to have medication than psychological management, or psychological treatment didn’t help you, your health-care professionals should provide medication. They will offer a kind of anti-depressant known as a selective serotonin reuptake inhibitor (SSRI). Fluoxetine, Sertraline, Citalopram, Fluvoxamine, Paroxetine, and Escitalopram belong to the SSRI group. Anti-depressants can be an efficient management for generalised anxiety disorder (GAD). Taking an anti-depressant doesn’t mean that you have depression.

If the initial SSRI doesn’t work well, or you have adverse effects, which are troublesome, you should be provided a different SSRI or another kind of anti-depressant known as a serotonin-noradrenaline reuptake inhibitor (SNRI). Duloxetine and Venlafaxine are members of the SNRI group.

Dementia: What Goes on When a Person Is First Diagnosed - Part 1

If a patient is first diagnosed with possible dementia, the doctor will ask the patient if he or she wishes to know the diagnosis. The patient can decide that which carers or relatives should be informed. Finding out a person has dementia can be really disconcerting for the person as well as the family. The doctor will explain about the condition and provide the patient further assistance and advice. If the patient has had any psychological problems or physical illnesses, the doctor will help solve them as well. Therefore, he or she will offer treatment and help, if the patient has other long-term (chronic) conditions such as hypertension, diabetes, high blood cholesterol, obesity, smoking, and drinking a lot of alcohol.

What Is Dementia?

Dementia is a condition, which affects function of the brain. It usually involves the cortex of the brain in general, though sometimes in some places. This condition causes a progressive decline of intellectual function. Dementia is more likely to affect the elderly; however young people may also develop the disorder. It affects 10 % of the population over 65 years, and 20 % over 80 years. Dimentia is a significant cause of morbidity in elderly population and has serious social and economic effects. Symptoms of dementia may differ from one person to another and usually become worse with time. When they become very severe, it is hard for the particular person to perform many day to day activities or to take care of him or herself.

Healthy Life with Dietary Flavonoids

Flavonoids (bioflavonoids) are natural colours commonly found in plants (fruits and vegetables).

Dietary sources of flavonoids

• Strawberries
• Blueberries
• Citrus fruits
• Red onions
• White and green tea