Pneumococcal Disease Killing Our Children

Pneumococcal disease will strike close to one million children worldwide - but there are ways to reduce the toll



WHEN FOUR-YEAR-OLD DARRYL HENG had a runny nose and fever one evening in March 1999, his father Heng Soo Yeow wasn't too concerned. Kids get the sniffles, thought the Singaporean civil servant before taking Darryl that evening to the family doctor, who prescribed the usual flue medication.



When Darryl's condition did not improve two days later, Heng took him to see the doctor again. Darryl was given antibiotics, but he broke out in rashes over the next few days due to an allergic reaction to the drugs. A blood test at a clinic didn't reveal anything unusual either.



When Darryl became breathless one evening, Heng took him to the National University Hospital where X-rays showed he had pneumonia. Doctors explain that Darryl's condition was further complicated by a collection of puts outside of the lung. Darryl spent 21 days in the intensive care and was hooked up to more than 13 drips. He needed morphine for the pain. Just 28 days after the first flu-like symptoms appeared, Darryl died of complications from pneumococcal disease.



Darryl is just one of thousands of children in our region stricken by pneumococcal (pronounced NEU-mo-KOK-al) disease, a group of illnesses that includes pneumonia (lung infection), meningitis (infection of the brain covering), bacteremia (blood infection), otitis media (inflammation of the middle ear) and sinusitis (inflamation of the sinus).



At a World Health Organization (WHO) meeting in Kuala Lumpur in March 2006, it was reported more than 700,000 children die globally each year from complications related to pneumococcal disease. In developing countries, pneumococcal meningitis kills or disables up to three quarters of children who become infected.Despite being such a serious concern, Associate Professor Daniel Goh, President of the Singapore Pediatric Society, says less than 20 per cent of parents in Asia are aware of this deadly disease. "We need to help parents caregivers understand the importance of disease prevention through immunisation," says Professor Goh.


Pneumococcal Disease is caused by the Streptococcus (S.) pneumoniae bug, also known as pneumococcus. It commonly lives in the nose or throat, and enters the blood stream to cause several types of severe invasive pneumococcal disease such as that seen in Darryl. The spread of pneumococcus from the nasal passage to the upper and lower respiratory tract also results in non-invasive conditions such as middle ear infection and sinusitis which, if left untreated, can lead to hearing loss, learning disabilities, speech impediment, paralysis and even death in children.



There are 90 different strains of the bug. Of these, about 20 strains are associated with more than 80 per cent of invasive pneumococcal disease occuring in all age groups globally; the 13 most common strains cause at least 75 per cent of invasive disease in children. WHO warns that there is a serious and rapidly growing problem worldwide of strains becoming multidrug resistant. In Asia, at least three of the seven serious strains are multidrug resistant.



At any one time, medical experts estimate that 10 per cent of adults and up to 90 per cent of young children carry the germs harmlessly in their respiractory tract. But during an outbreak, for reasons scientists cannot fully explain, the disease is spread from both healthy carriers and patients to other people.



"The bacteria is transmitted through air droplets from one person to another usually by sneezing, coughing, or close contact," says Professor Lulu Bravo, vice chancellor for research at University of the Phillipines and executive director of the National Institute of Health.



Although serious pneumococcal infections occur throughout life, young children and the ederly are most at risk. Infants under two years old are particularly susceptible because they have less-developed immune systems and are more likely to have physical contact with others. According to Prefessor Goh, of the children diagnosed with pneumococcal disease in Singapore each year, as many as 25 per cent may develop complications or suffer some permanent disability, and up to six per cent may die.



IN JULY 2006, two-year-old Becky Lee came down with the flu, so her mother Leona took her to a paediatrician in Singapore. When Becky still hadn't recovered after two weeks and instead developed a fever of 40 degrees, Leona took her back to the paediatrician, who ordered an X-ray of her lungs. The  X-ray showed a buildup of phlegm - symptomatic of bronchitis - but the paediatrician ruled out pneumonia and prescribed another round of antibiotics for bronchitis. Becky seemed better the following day but her fever returned that evening. This time, Leona decided to rush her to KK Women's and Children's Hospital.
A CT scan eventually revealed that Becky has excess fluid in the membrane covering her left lung. The surgeons recommended keyhole surgery to drain the fluid.


"WHEN the doctor said surgery was needed to save her drowning lung, I broke down," recalls Leona. After the surgery, Becky continued with antibiotics for two weeks to ensure the infection was completely eliminated. Although normal and healthy now, Becky is still traumatised by the experience.



The symptoms of pneumococcal disease vary by illness but almost always involve fever and oftentimes resemble the flu. Pneumonia symptoms can bring on sudden shaking, chills, cough and chest congestion, while meningitis causes neck stiffness, vomiting, a rash of red purple spots and the victim will rapidly sicken."It is very difficult in the early stages of infection from the common flu, so seeking medical treatment is important," says Dr. Lee Bee Wah, a consultant paeditrician at Mount Elizabeth Medical Centre in Singapore, Other dangerous telltale signs include refusing food and drink, persistent vomiting, fast or difficult breathing, lethargy or drowsiness.



"Never treat a common flu or fever lightly," says Darryl's father Heng. "See a paediatrician immediately if things do not improve. The doctors tried everything to save my son but we still lost him."



WHEN ROSHNI MAHTANI had flu symptoms over Christmas in 2005, she thought perhaps she had overstrained herself. But when her high fever persisted, her doctor ordered a blood test. By then the 24-year-old Singaporean freelance writer was unable to breathe and couldn't even hold up her head. Chest X-rays showed that she had penumococcal infection. She survived the infection. She survived the infection after two horrifying weeks in hospital.



Although less vulnerable to the disease, teens and adults like Roshni can be affected if they have lowered immunity or chronic respiratory problems, says Dr.Lee.



Some scientists suspect that an increase in cold and flu cases may boost an individual susceptibility and encourage the infection to take hold. Other factors like the environment (exposure to tobacco smoke, air and dust pollution, toxic elements or chemicals), malnutrition and even lack of breastfeeding can contribute to one's predisposition to disease. "These factors are related to the decrease in the body's defences or immune mechanisms and increases the risk to respiratory ailments and general susceptibility to infection and pneumococcal disease," says Professor Bravo.



Studies have also shown that the risk of pneumococcal disease is higher among people who live closely or in crowded conditions, like housing estates. "It is also prevalent in areas with poor hygiene and unsanitary living conditions," says Professor Bravo.


Easy Ways to Reduce the Impact


"THE BEST PREVENTION IS TO vaccinate against pneumococcal disease," advises Dr. Musa Mohd Nordin, consultant paediatrician and neonatologist at Damansara Specialist Hospital in Kuala Lumpur. Prevnar (PCV7) is the first and currently the only pneumococcal disease in infants and children under two.



Vaccination also provides "herd immunity" by protecting those in close contact with children, further reducing the spread of pneumococcal disease in the community.
A study in Britain showed quick access to to antibiotics reduced deaths by 40 per cent when the family doctors, on suspecting pneumococcal disease, administered antibiotics before sending the patient to the hospital. "It is essential for antibiotics before sending the patient to the hospital. "It is essential for antibiotics to be given as soon as there is recognition of the disease," says Professor Bravo.



Early identification of contacs can help contain in the infection. If you have had close contact with someone who has pneumococcal infection, check with your doctor immediately.



WHO and the Global Alliance for Vaccines and Immunization are providing the tehnical and financial assistance for supporting and sustaining effective pneumococcal surveillance especially in developing countries. The Pneumococcal Awareness Council of Experts (PACE) was recently established to raise awareness for the disease and advocate for its prevention through vaccination.



WHO considers pnemococcal vaccination a priority for inclusion in national childhood immunisation programmers. A WHO staff told Reader's Digest that at least 17 countries worldwide will take up their recommendation this year.



The Malaysian Paediatric Association launched an awareness campaign for pneumoccocal disease in April 2007. And in Singapore, the Pneumococal Awareness Campaign alerts parents to the fact that pneumococcal disease is a common infection that leads to devastating conditions. On a larger scale, WHO also recently recognised pneumococcal disease as the leading vaccine-preventable cause of death in children less than five years of age.



"We regret not sending Becky for the pneumococcal jab earlier. "This experience has caused us much anxiety," says Leong. "We often take things for granted, thinking it would never happen. When it does, it may be too late.VC55K4VE6NFZ

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Posted in: Children,Children Disease,Disease,Health,Medical,Pneumococcal Disease,Surgery

If Your Back is Out Of Whack

PENNY RICKHOFF remembers exactly when her pain started. "I was on the tennis court finishing a set. The next thing I knew, I was in hospital." The 55-year-old interior designer has had two operations in the 15 years  since that first episode, but she still faces daily pain.

She's not alone. Most of us will experience back pain at some point. "The people who never have pain are the unusual ones," says psychologist Dennis Turk, who's on renowned team of pain researchers at the University of Washington.

Luckily,things are looking up for the aching millions. The last decade has brought a revolution in back care, says physician Richard Deyo, also at the University of Washington. This shift has changed how experts diagnose and treat this vexing problem.


Back when Rickhoff had her front court collapse, the standard advice was to stay in bed, "We now know that's the worst thing you can do," says Deyo. In fact, he argues, lying around actually boosts your risk of developing chronic back pain.


Doctors are also less likely to offer a diagnosis than they used to be. "There are many different diagnostic labels for back pain, but often they just cover up the fact that we don't what's causing it," explains Michael Von Korff, a back researcher at Group Health Cooperative in Seattle, Washington. "In the end, as long as you've excluded serious disease, the treatment is the same."


Unfortunately , sophisticated image techniques are often little help in diagnosing the cause of common back pain. Eugene Carragee, an orthopaedic surgeoun at Stanford University, analysed the MRIs of 96 people who had risk factors for disc degenaration. Those with damaged discs were only slightly more likely to report pain during activity than those without them.

Yet the sufferes in Carragee's study had one surprising thing in common. "When we looked at who hurt the most, the best predictor was increased emotional distress like depression," he says.


No-one denies that the pai is real. But people's attitudes about the discomfort play a major role in how they cope - and how fast they heal. "People get back pain and become anxious," says Deyo. "Then they limit their activities, and that makes it worse. It can be a downward spiral."


So what do experts suggest you do about backache? Not much. "Virtually all episodes of back pain go away on their own," says University of Washington neurosurgeon John Loeser.


The key is to drop the expectation of a simple diagnosis and an easy cure and instead find ways to manage your pain and prevent flare-ups. The vast majority of people can get relief with one or two of the most common treatments. Here are eight pain-busters worth trying.


Self-Care


You spent the morning lifting boxes, and your back has you begging for mercy. Doctors call these intense attacks acute pain. When misery strikes, they say, it's best to take immediate action. Try an over-the-counter pain medication like  
ibuprofen, aspirin or acetaminophen.


If you have recurrent back pain, you may want to get a prescription pain medication to have on hand for your next bout with acute pain. Since such agony usually subsides quickly, the risk of addiction is not very high.


Doctors suggest icing the area that is experiencing pain for 15 minutes at a time, three to five times per day. A bag of frozen peas makes a great ice pack. If the pain persists for more than a few days, substitute a heating pad for those 15-minute periods. Meanwhile, remain as active as you can.


To prevent further flare-ups, sleep on a firm mattress and curl up on your side with a pillow between your knees. Choose chairs that support your lower back. Rethink behaviours that exacerbate your woes.


Kim Hedberg, a 42 year-old business consultant, avoids sitting still for extended periods, lifting heavy objects and stressing herself out -- all of which can bring on an attack of back pain. "Every little thing helps," she says.

Exercise


Though you might feel more inclined to moan in bed, regular exercise may be the best thing you can do for back pain. The only time you should avoid intense workouts is during the first few days of an acute attack. "Studies show that people who do as many active things as they can are the ones who recover best," says Carragee.


Experts agree that no single work out will erase your pain, but they say two categories are important: aerobic activities such as brisk walking, and exercises such as crunches and back extensions that strengthen your back and stomach muscles. A trainer at any gym can show you moves that will be right for you.


Relaxation Techniques

Stress can cause your body to tense up, worsening your back pain, says Deyo. Relaxation techniques like meditation may help you let go of tensions that might be triggering your pain.


In a landmark 1995 report, a panel of experts assembled by America's National Institutes of Health concluded that techniques like meditation and hypnosis can ease any chronic pain. Scientists say that these activities seem to mellow out your nervous system. This appears to blunt your body's sensitivity to pain. Some relaxation techniques such as yoga and tai chi have the added benefit of including exercise.


Physiotherapy


Blair Hurst, 53, went to a pain clinic in desperate shape. "My back was so bad I could barely stand up," she recalls. A physiotherapist showed her stretching and strengthening exercises that helped diminish her pain -- and taught her how to move without injuring herself.


A physical therapist can teach your exercise to eliminate postural problems or muscle weaknesses and imbalances that might cause or aggravate pain. The therapist can also show you correct ways to lift and bend.


Recent research suggests that the combination of stretching and strengthening with endurance exercises and proper body mechanics speeds up people's return to work after sustaining a back injury.


Chiropractic


Chiropractors were long perceived as back-cracking hacks, but those days are over. Studies have demonstrated that chiropractic manipulations can truly bring relief to an aching back.


The theory behind the manipulations is simple. Chiropractors say that swelling, joint irregularities or muscle spasms can immobilise your back joints, causing chronic pain. By moving these joints with their hands, they say, they can relieve tension and allow them to move again. "It's like a concentrated exercise in the joints with their hands, they say, they can relieve tension and allow them to move again. "It's like a concentrated exercise in the joint," says chiropractor Daniel Hansen of The Texas Back Institute.


Massage


A massage therapist can target both the back and surrounding areas. For some, the results are immediate and long-lasting. The rubbing, pushing, and kneading increases blood circulation to the back and relaxes tense muscles.


Massage comes in many flavours. There is evidence to show that neuro muscular massage therapy -- which targets specific pressure points -- is especially effective for low back pain. If the technique is going to help you, you should notice a response by the sixth treatment, says physician Robert Schulman of the American Academy of Medical Acupuncture.


Acupuncture


A 1997 US National Institutes of Health panel concluded that acupuncture is indeed helpful for treating low back pain. Researchers think acupuncture spurs the release of endorphins, your body's natural painkillers.


In one study, medical acupuncturists reported that about two-thirds of their patients said that they were pleased with the results. Many people feel at least some benefit after the first visit.


Surgery


Only about two per cent of all back-pain patients require surgery. In fact, Deyo says, there are only four reasons to consider surgery: a herniated disc that's been causing sciatic pain below your knee for a month; a spinal stenosis (narrowing of the spinal canal); a displaced vertebra; or a tumour or other life-threatening or disabling problem.


Despite the cautionary approach of most researchers, surgeons are still performing a slew of procedures, and new methods are being toutedin journals. Deyo and other experts urge people with back pain to be wary.


"Many patients rush into the latest thing, and then five years later we discover that it's worthless --- or worse," says Deyo. If, after getting a second oponion, you've decided that the scalpel offers you best chance at relief, look for an experienced surgeon. And be sure you're clear on what kind of long-term outcome you can expect.

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Posted in: Acupuncture,Back,Back Pain,Back Therapy,Chiropractic,Disease,Health,IfYourBackOutofWhack,Massage,Medical,Physiotherapy,Stress,Surgery

How a Doctor Deals With Loss

A missed diagnosis results in death --- and a deeper understanding.


by: James Schembari


I WAS STANDING next to a friend at my father's wake in January when he nooded towards the door at an old man who had just arrived.


I hesitated, but then said coldly, "That's my father's doctor." This is the man who, as my father was wasting away from what we later learned -- three days before he died --- was cancer, told him and that he had Lyme disease.


The cancer was mesothelioma, a rare disease that is often asbestos-related and has been found in such people as construction and shipyard workers and navy veterans, like my father. He used to joke that as he fell asleep in his top bunk on a ship during World War II, the last thing he would see was the torn asbestos hanging from the pipes above his bed.


I have since discovered that the cancer sits in the lining of the lungs, hard to spot, almost impossible to cure. For all those who survived the war, it seems an unfair coda.

My father's short walk through the medical system had shaken me. I have always had faith in doctors, and the centre of my faith was the old man at my father's wake. He was not only my father's doctor, he had been mine since childhood. Yet when he walked into the wake, I had to control my anger. He stood by the coffin for a moment, and then went over to my mother.


"I thought you should know that I went back and looked over all the X-rays," he told my mum. "I wanted to know how I missed this. And even though I now knew what I was looking for, I couldn't see it. It doesn't turn up until the last X-ray. There's really nothing we could have done."


I could see the pain on the doctor's face as he spoke to my mum. He had said the words I expected, but which my anger hadn't let me accept: My father would have died no matter what anyone did.


How do doctors handle all the death they touch? And when they've known a patient for so many decades, do they feel they've let an old friend down? This doctor's final treatment of my father was to treat his family -- by having the courage to face us in our grief and in our anger, and to explain our loss.

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Posted in: Death,Disease,Doctor,Doctor's Loss,Health,Medical,Mesothelioma Cancer,Patient,Patient's Family,Treatment

The Advantage of Fruits For Our Digestion

NOWADAYS, people has the tendency to change in line with the development of their life style. They are inclining to consume low calory and fibrious food. As a result, there are many kinds of diseases appear. One of them is cancer called also as a ghost disease.


One of God's gift to our country is that the various fruit trees could grow well and produce fruits with useful elements for our body. They would be more advantegous if consumed immediately in fresh condition. 


Tropical fruits have the ability to activate our digestion system. Such as sending vitamin, enzym, mineral, vatty acid and amino acids on regular supplies to our body for renewing and making up cells and tissues.


1. Papaya


a. To help the digestion of food.


A fruit contains papain enzym. This enzym is useful in acid, alcalis or neutral condition. It works to repair digestion process and body assimilation.


b. To take care of skin


Found papain enzym in this fruit could make dirts liquid on skin's dirts liquid on skin's pores. Whereas, fruit's skin could be used to clean our skin from dirts of former infection.


c. To repair breath


Mineral and vitamin contained on a fruit could help the digestion of exaggerated precipitation the breath canal. Also relieve from cough and repair breath ability and lungs. Thus, our food digestion will be better because the oxygen is always needed by enzym to do digestion.


2. Banana


To help metabolism


Banana could help on calsium, phospor and nitrogen retention that collaborate to make healthy tissues. Banana with a kind of sugar could help good metabolism. This fruit causes alcalis movements in intestine's contents and containes soft fibre and much remainder pectin.

3. Pineapple


To help digestion and assimilation of food's elements. Bromelin enzym contained in pineapple could help body liquid not too acid or alcalis. Bromelin as a component for many kind of hormon could help liver to make protein albumin. By albumin, poisoning could help body liquid not too acid or alcalis. Bromelin as a component for many kind of hormon could help liver to make protein albumin. By albumin, poisoning could be prevented. This enzym also helps the body to clean it self dirts and kidneys.


4. Melon and Water Melon


Melon is a soft fruit, lots of water and delicious. Also could help digestion. Melon and water melon contain vitamin A and C that could help making skin's tissues. Vitamin C produce colagen of body cells, strenghthen the wall of blood canal in digestion building and help recuring destroyed cells and tissues.


Generally the composition of fibre on melon has two unique advantages:


a. The mastication of this fruit could train face muscles and jaws.


b. Mastication process of melon could cover the teeth and soft tissues in mouth. Thus, it could clean mouth and hollow of mouth all at once from unuseful bacteria.


Best melon contains abundant fructose, so that its flavor more delicious and sweet.


5. Apple


Apple contains pectin that could recover disturbed abdomen. Recovery effects are found on this activity as lining protectants, so that it could act as a sucker.  Pectin could help preventing poisoning by supply a kind acid need to vanish certain poisons. Pectin also escapes protein rotteness in digestion canal.


Acid in apple could help body reserve iron from food. Together with fructose (natural acid in apple), apple help digestion and assimilation of iron that could be used by blood cells then.

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Posted in: Banana,Bromelin,Calcium,Fibre,Fruits,FruitsForDigestion,Health,Metabolism,Nutrition,Papaya,Pineapple,Tropical Fruits,Vitamin,Vitamins

The Thing You Should Know About Diabetes

Every three minutes, someone dies from complications of diabetes. Although a cure has not been found, researchers are coming up with many new developments to help people cape with the disease.

MEANWHILE, here are some of the warning signs of insulin dependant diabetes (Type I) suggested by the American Diabetes Association: excessive thirst, extreme hunger, sudden weight loss, frequent urination (watch especially for bed-wetting by children who have been toilet-trained), weakness and fatigue, frequent infections and wounds that heal slowly, irritability, and nausea or vomitting.

Symptoms of non-insulin-dependent diabetes (Type II) include all of the above plus blurring vision or any other vision changes; tingling or numbness in the extremities; cuts or scractches that are slow to heal, especially on the feet, itchy skin, and drowsiness.

For those who are suffering from diabetes mellitus, diet is the best treatment. In this article, we will see a glance at Diabetes. Should diabetics on a diet? What about having fast food and how will the arrange their meals.

Meal Planning

Nowadays, meal planning is considered as a substitution of the item "on diet". Why is it called meal planning but not a diet? Because taking a diet is considered as a way that is used just for a while. When they are fine, the do not need to take a diet anymore. This case is different from diabetic, meal planning which is one of the treatments. It means an eating way that is directed in his life. So the persons around the diabetic like, the families, doctors, nutritionists, nurses, etc should help him/her lead to the right meal habit.

The aim of the meal planning is to help diabetic, so the could select their own meal according to the need of nutrient. Applying meal planning will make it easier for the patient when he/she goes to the party or a restaurant.

Meal planning is not considered as a tight diet, but an eating way which is directed and controlled to keep the blood fatty character and normal weight. Beside that, meal planning is to decrease psychological effects explaining that taking a diet is often called "must reduce the meal". The truth is not always like that.

For the thin diabetics, meal planning is to supply high calorie, so they will gain weight. The children and youths need sufficient calorie to help their growth.

Should diabetics on a diet?

Diabetes mellitus is a kind of disease where the patient's body couldn't manage carbonhydrate normally for a certain reason. The patient's body couldn't manage carbohydrate normally for a certain reason. The patient of such disease has the need of nutrient the same as the one who are not diabetic.


The things we should consider in indicating calorie needs are age, weight, physical activities, etc. As the body has a trouble to manage carbohydrate and glucose, the foodstuff which contains carbohydrate should be reduced a little and avoid glucose. 


In short, the things that should be noticed are as follows:


1. Eat regularly in the right portion and apply meal time that has been suggested by doctors and nutritionists.


2. Reduce the foodstuffs containing carbohydrate like: rice, glutinous rice, corn, and other foodstuffs made of flour.


3. Avoid consuming sugar or other foods containing sugar like: chocolates, candies, red sugars, jams, cakes, and fruits which are packaged in tins.


4. Eat fruits and vegetables.


Fast Food


Fast food is the meal which is ready to be served, and the customers just select the meal they like. 


example: Fried Chicken, Burger, Hot Dog, Ice Cream, Pizza, etc.


Usually people like to have fast food from Western countries, because they regard by having such fast food will "increase their life-style". Usually, fast food have characterictics:


1. Contains high calorie, salt, fat and cholesterol.


2. Contains sufficient protein, carbohydrate, and vitamin B.


3. Low in fibre, vitamin A, C, and calcium.


4. Contain preservative (sodium nitrit) especially in hot dog, burger, meat, etc.


The diabetics do not always avoid eating in a restaurant or in a party. The most important thing is that they should realize how much portion the meal they need for their body.


For them, the doctors and nutritionists will emphasize the importance of balance nutrients for each person, apply using substitutiton food in menu and take a regular exercise.


Here are the things that diabetics should think about:


a. The diabetics with high fatty blood and hypertension should not consume fast foods.


b. Fast foods could be consumed as a substitution from the half-portion (substitution of the portion of lunch or dinner). Fast foods should not be consumed for additional portion.


c. They are suggested to take a regular exercise.


d. Not to consume fast foods as a daily meal.


Youth is a time that needs sufficient calories and nutritients. Usually, the therapy by giving insulin and applying meal planning should be considered, especially in arranging the portion and meal time. The portion and meal time depend on the kind of insulin used and the kind of exercise taken.


It is better that the family members pay attention to the child or youth who is diabetic. They could have snack at school if they know the portion they need for their body. Regular exercises help the balance of meals and insulin.


Conclusions:


Diabetics need regular meal with the right portion and the right meal time. The success of controlling diabetes depends on the life-style concerned. Be calm in facing problems, keep self-confidence, stay trimmed, optimistic, and get blood sugar tests annually if there is a history of diabetes in your family.

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Posted in: Complications,Diabetes,Diabetes Mellitus,Diet,Disease,Health,Lifestyle,Medical

Losing Weight With Behaviour Therapy

SO YOU HAVE tried to lose weight, but it makes you miserable. Why? Because you've done it the same old way, right? Too often dieting doesn't work. Chances are that you have dieted--and that you've already gained back all the pounds you  lost.


The following is a revolutionary new concept of weight control based on behavior therapy. It doesn't focus on fat at all, but on you. It holds that eating too much is behaviour that you learn, and it applies principles of modern psychology to change these habits.


In a dozen experimental weight-reduction programs, psychiatriests and psychologists trained in behavioural methods have developed a series of techniques that are condensed here into a seven-point program to help you lose weight.

1. Learn your eating habits. 


You can't change habits until you know precisely what they are. Keep a diet diary with five headings: when you eat, what you eat, where you eat, who is with you, and how you feel when you eat.


2. Avoid your personal eating cues. 


Learn from your diets diary the particular circumstances that lead you to problem eating. If the very sight of food makes you eat, for instance, then remove all food from every room of the house except the kitchen. If you habitually snack at 10 a.am., wash your hair or tidy up the guest room at precisely that hour. If you have a job and invariably pause at the office food-vending machine, detour to keep it out of sight. 


3. Count calories. 


After a week of self-analysis, buy a calorie counter. If you cut your food intake by 500 calories a day, you will lose a pound a week. Don't aim for a greater weight loss, and don't try to reduce the calories below 1200 a day. Torturing yourself with a starvation diet is a fatal error; you need a regime you can live with. And don't skip meals: that's likely to result in binge eating by nightfall. Study your calorie counter for wise choices: cook green beans instead of peas, for a saving of 84 calories: save another 100 by eating fresh grapefruit instead of opening a can.


4. Practice good eating habits. 


Take one small bite of food, then put down your fork while you savor its texture and taste. Chew it thoroughly and swallow before you pick up the fork again. It takes 20 minutes from the start of a meal for the stomach to signal feelings of satiety to the brain. So try to strecth your meal to a half-hour or more.


5. Control social eating. 


Pre-plan. Save up a few hundred calories when you know in advance that you're dining out. Dull your appetite by having a cup of bouillon, a dish of gelatin or a raw carrot before you go to a cocktail or dinner party. If you still don't trust yourself, arrive late and miss the cocktail-and-nibbing ritual. In a restaurant, order the entire meat at once. The menu is designed to entice: you're better off without a second look.


6. Exercise calories away. 


There are two ways to lose weight--eat less and exercise more---and it's helpful to combine them. But you needn't become an exercise nut. For example, simply by being less efficient around the house, you can work more physical activity into your daily routine. Stop saving steps. Stair climbing expends ten calories a minute, two and a half ties as much as taking a walk.


7. Reward yourself for losing weight. 


Behavior is shaped by its immediate consequences. That's why it's hard to change an adult's eating pattern: the immediate pay-off for eating is pleasure, and dieting seems like punishment. to reinforce your new regime, you need a quick payoff. One possibility: drop a quarter in  a piggy bank for each day you stay within your calorie count---to pay for something your really yearn for Never, of course, reward yourself with food.


Some of this tips may seem familiar to you, or even trivial. But remember that a new habit is only acquired by painstakingly altering a gamut of responses. By tacking one small step at a time, by becoming your own behavioral engineer, you'll learn that you can control the way you eat. And the reward of success will lead to ever more success.

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Posted in: Diet,Health,Lifestyle,Losing Weight,Motivation,Tips

20 Important Facts About Hormones

1. ARE YOU FEELING tired, anxious or depressed and you don't know why? Are feeling restless, and angry, and you are not sure why? It could be caused by your hormones are a substance, usually a peptide or steroid, produced by one tissue and conveyed by te bloodstream to another to effect physicological activity, such as growth or metabolism.


2. Hormones affect nearly everything we think, say and do. They influence our body temperature, digestion, blood pressure, height, shape, sexual desire, emotions and also menstruation. Made up of chemicals that react with cells and organs to change how they behave, hormones control us more than we control them. 


3.Hormones are named after the Greek "hormao ("I stir up"). Some say that it is from the Greek "hormon", meaning "to urge on" from "horme", meaning "impulse." Hormones weren't discovered until early this century. Over 50 have been identified; new ones are still being discovered.

4. According to the Family Medical Guide, hormones are "messenger chemicals made in organs called endocrine glands. These glands are essentially hormone-producing cells clustered around blood vessels.


The hormones are released directly into the bloodstream, rather than through a duct, as in some other glands. Together with nervous system, hormones coordinate and control the functioning of various organs and tissues so that all parts of the body work together smoothly, efficiently, and correctly."


5. When a hormone is released into your bloodstream it circulate to all parts of your body, but it affects only a certain part or parts of the body that are called target organ for that hormone.


6. The amount of each hormone released into the bloodstream depends on your body's needs at the particular moment. The hormone levels in your blood change in response to events such as infections, stressful situations, and shifts in the chemical composition of your blood in some cases the level of one hormone in your blood regulates the level of another. For instance, several hormones produced by your pituitary gland specifically regulate the amount of other hormones released by certain other hormones released by certain other endocrine glands. The pituitary gland, a peanut-sized yet centrally important endocrine gland located at the base of the brain that exerts wide-ranging control of your hormonal system.


7. Some of the important hormones include adrenaline (help us cope with danger and stress), insulin (controls blood sufar), oestrogen (promotes sexual development and, with progesterone, triggers menstruation); prolatin (produces breast milk); thyroxine (regulates metabolic rate); and corticosteroids (help fight infection and maintain blood pressure).


8. Adrenaline or epinephrine is a hormone secreted by adrenal medulla released into the bloodstream in response to physical or mental stress, as from fear or injury. It initiates many bodily responses, including the stimulation of heart action and an increase in  blood pressure, metabolic rate and blood glucose concetration.


9. Hormonally, women are far more complicated that men. Oestrogen and progesterone levels fluctuate wildly during our menstrual cycles, yet everything has to be synchronised for a period to be described as "normal".


10. Factors such as crash dieting, obesity, stress, smoking, drinking and excessive exercise can all disrupt hormone production, making your periods scanty, erractic or even non-existent. Disruptions also occur for no clear reason; if you are worried, see your doctor. Drugs can correct some imbalances, although some imbalances may be the result of ovarian cysts.



11. Premenstrual syndrome is caused by fluctuating hormones, and progesterone and oestrogen are two key players. Symptoms can include feelings of depression, bloating and constipation. Exercise, relaxation techniques, a healthy diet and evening primrose oil can allviate some problems. In more serious cases, hormone replacement therapy or medication may have to be prescribed.


12. Many contraceptive pills will keep levels of oestrogen high, with some women saying that they feel constantly "premenstrual". If this is you, then consult your doctor---another brand of pill or a completely different method of contraception may well be the solution.


13. Hormones can be responsible for a variety of significant mood swings. Feelings of elation, restlessness, anxiety, depression and fatigue are all states that can be triggered by hormonal fluctuations and imbalances.

14. During pregnancy, oestrogen and progesterone levels increase and new hormones circulate to help foetal growth; they also trigger mood swings and can cause headaches. Exercise and a healthy diet may alleviate symptoms. Most problems disappear after birth as hormones normalise, though before this happens feelings of depression and irritability occur.


15. The control centre of all hormones is the pituitary gland, at the base of the brain. Cells in the pituitary sense the level of hormones in the blood and stimulate or reduce activity to maintain balance.


16. Because oestrogen levels drop during and after menopause, older women are at a higher risk of developing conditions such as heart disease and osteoporosis.


17. Adrenaline increases energy and is produced when you are understress. Relaxation techniques, such as yoga and meditation, can help control stress levels and help combat stress-related conditions, such as migraine and high blood pressure.


18. Thyroxine is produced by the thyroid gland in the neck. If this gland is overactive you may lose weight despite having a big appetite, sweat a lot and have protruding eyes. If it is underactive you may gain weight, be lethargic and have dry skin. Treated with drugs or surgery.


19. Acne can develop due to fluctuating levels of oestrogen and progesterone, and is common during puberty, pregnancy, migraines and menopause.


20. Body and facial hair are affected by testosterone levels. Slight increases in growth are not a problem. Large increases can also often be explained by racial or family genes---although they can be caused by conditions such as ovarian cysts. If worried, see your doctor.

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Posted in: FactsAboutHormones,Health,Hormone,Hormones

Strangers May Become Close Friends

Fear of strangers is usual for people. It happens to all of us. We feel that there is nothing to talk about. The problem is, we don't know what we have to give and share. We feel we are not interesting---a really wrong self-judgement. Every person is unique. Most people are interesting.


ONCE I was going home by bus and sitting right beside me was a beautiful girl. On the way there we were just silent, although deep in my heart I really wanted to break the silence and talk with her and get to know her. But I was tongue-tied. Perhaps, this was because the other day I had a bad experience with a stranger I wanted to talk to. She gave the cold look---one that would freeze even the most energetic salesman's enthusiastic heart. I didn't know why she acted so badly. Maybe she had had a bad experience with a stranger before. In response, I felt afraid of her: a stranger who just happened to be a really beautiful girl.

So I just kept silent during the one hour trip. We reached the first bus station where I change buses. Unfortunately, there was no bus so I had to wait. The girl who had sat beside me seemed to have the same intention. She had gotten off and was standing near the line of foodstalls in the bus station. She looked at her wrist watch every now and then.


Curious, and in need of a friend to talk to, I walked forward and asked her if she was going to the same destination as I. She smile and nodded. We then got involved in a warm conversation. To my surprise, she and I were form the same town. She told me that actually she was as curious about me as I was about her. I didn't feel that waiting for the bus was a nuisance any longer. We continued our conversation even after the bus came. With a friend to accompany me, it was a nice trip. I didn't even realize it when we arrived at our village.


At parties, we often we don't know how to behave or what to say to people we don't know. In job interviews, we are usually nervous because we want to impress the interviewers. On a journey when we meet interesting-looking people, we are often unsure how to start a conversation.


Fear of strangers is usual for people. It happens to all of us. We feel that there is nothing to talk about. The problem is, we don't know what we have to give and share. We feel we are not interesting---a really wrong self-judgement. Every person is unique. Most people are interesting. Dorothy Sarnoff writes in her book, Speech Can Change Your Life, that "there really is something wonderful about every imperfect, mixed-up uncertain human being."


If we know how to meet people and to start a conversation, we are sure to widen the circle of our acquaintances. This will surely enrich our lives. Some believe that having a lot of friends, acquaitances, keeping these relationship will make us live longer. Life will also be easier financially. Whether this is right or wrong, it is a fact that those who have many friends look happier than those who have none.


We don't have to be afraid of strangers just because we don't know them yet. The charm of strangers lies in the fact that we have never met them before. Isn't it right that our close friends were once strangers? They couldn't be born directly as your friends without introduction, could they?


THERE are some approaches we can take to break the ice of silence when we encounter strangers and we want to talk with them.


1. Comment honestly on how you are feeling


At a party you may start talking with a person who seems ready to listen by saying, I'm a stranger here. I'm shy." This open utterance will surely make him at ease with you because he may be feeling the same way as you. The best conversationalist is the one who has the wit and courage to be honest, not those  who look stiff and unfriendly.


2. Talk about the surroundings.

When you are on the bus or train and you are interested in approaching a person you don't know yet, try to comment on surroundings. If you see that there is fertile rice field out there, comment about it in such a way that she is able to hear you and is aware that you are talking to her.

3. Say something about your companion.


A little praise about her fresh face or her smile might open the door to a conversation with the girl you are sitting beside. Or try to give the person you have never met a comment about the book or you are really want to know about it.


4. Ask questions


Most conversations with a stranger usually start with a question. But if you want a long answer, don't ask a yes/no question. If you love to improvise, try the guessing game. Once I broke the ice of silence with a girl sitting beside me on a bus by guessing. I turned to look at her subtly and said, "You must be a nurse!"

She smiled broadly and said, "How did you know?"



I laughed, thinking that she was trapped by my approach, and answered, "Because you smell like drugs."


She burst out laughing (the other people there turned their heads to look at us). "O yeach, really?" And she sniffed her flowered shirt. A week later, I paid her a visit in her a visit in her dormitory behind one of the best hospitals in town.


5. Listen to answers.

Half of a good conversation is in the listening. There can be no real dialogue without listening. (Read the previous edition: Be a good speaker, listen!) There can be no real dialogue without listening.

But listening is an art. Look at your new acquaintance as she talks. Respon in a way that will encourage her to continue. That way, your listening can be active, not passive. Such as a conversation will help you discover and understand each other. 

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Posted in: Friend,Friendship,Psychology,Strangers,StrangersBecomeFriends,Tips

Foods That Help You Live Longer

Dr. Gary Fraser, an epidemiologist specializing in cardiovascular diseases, has taken to scattering nuts on his breakfast cereal. At the Loma Linda University Center for health Research near Los Angeles, California, Fraser and colleagues studied the eating habits of 26,500 Seven-day Adventists, members of a religious denomination whose adherents neither smoke nor drik and are mostly vegetarians. They discovered that those who munched a small and full of nuts five times or more each week had half the coronary-heart-disease risk of those who rarely ate nuts.


NUTS, preferably unsalted, wether roasted or raw, are a fine source of good monounsaturated and polyunsaturated and polyunsaterated fats and of vitamin E," says Fraser. They also contain magnesium, which can help prevent heart arrhythmias.


Welcome to the frontier of food science, where researchers are uncovering the disease-fighting and life-enhacing powers of everyday edibles. While some confine their studies to the laboratory, others investigate how foods of different cultures may be linked to low rates of cancer and heart disease. Their findings could add years to your life and make your palate more international.


The Mediterranean Connection


People who live in the countries bordering the Mediterranean Sea have, in general, impressive health and longevity. Some features of their cuisine--the reliance of fresh fruits, vegetables and whole grains, for instance---fit current concepts of a healthful diet. But other features don't. For example, scientists have been puzzled by a health mystery popularly known as the "French paradox." The French consume at least as much saturated fat as Americans--yet the death rate from heart disease for Frenchman is only about 40 percent of that for American men.

Garlic and Onions

Some researchers attribute this protection from heart disease largely to the consumption of wine. In southwestern France, the average man drinks two to three glasses of wine, mostly red, every day with meals.


Cardiologist Dr. Arthur Klastky has reported that light to moderate drinkers of alcohol beverages (no more than two drinks a day) have significantly lower rates of coronary artery disease. "Alcohol itself seems to be the cause of this protective effect," says Klatsky.


But it may be the nonalcoholic chemicals in wine also provide a health benefit. At cornell University in Ithaca, New York, Leroy Creasy, a specialist in the science of fruit cultivation, has been studying a substance produced by grapes to fight fungi. Called resveratrol, it is a natural pesticide that has been found in Japanese animal studies to reduce fat and cholesterol levels in the blood.


Other good sources of resveratrol are red or purple grape juice and raisins that artificially dried. "Sunlight can destroy this chemical," says Creasy, "so look for raisins that are not sun-dried."


Red wine also contains quercetin, which has displayed cancer-fighting properties in laboratory animals. According to biochemist Terrance Leighton, high levels of this chemical are found in red grapes, red and yellow onions, brocolli and yellow squash. It seems that quercetin is inert until acted on by bacteria in the digestive system or by yeast in wine fermenting vat, Leighton explains. It then turns into what may be one of nature's more potent anti-carcinogens.


When many people think of Mediterranean cuisine, they immediately picture garlic and onions. Modern science is finding surprising medicinal powers in these related bulbs, which contain many organic sulfur compounds.


In a test tube these sulfur compounds kill bacteria, fungi and viruses. Inside the body, aged garlic extract appears to slow blood coagulation time, which could reduce the risk of clots and heart diseases. Garlic's blood-thinning properties may be similar to those of aspirin. The Journal of the American Medical Association reported findings from an Indian study that six to ten grams of garlic given daily to 222 patients with histories of heart attacks "reduced the mortality and incidence of nonfatal reinfactions." (Patients taking blood thinners should check with their doctor before using garlic supplements.)


Several epidemiological studies in China have pointed to reduced stomach cancer risk in those eating diets rich in vegetables of he onion family. These include chives, shallots and leeks.


Oriental Wisdom


New scientific evidence from animal studies may someday make the green tea enjoyed in Japan a popular pickme-up elsewhere. When researchers at Rutgers University in New Jersey feed green tea to mice, skin cancers in the rodents (caused by ultraviolet light) were reduced by about 50 percent.


FUNG LUNG CHUNG, associated chief of the Division of Chemical Carcionogenesis at the American Health Foundation in Valhalla, New York, has been studying a chemical contained in green tea called epigalocatechin gallate (EGCG). Chung's group has found that this powerful antioxidant protected mice against lung cancer.


"Japanesse men smoke twice as much as American men," says Chung. "Yet, they have only about half the lung-cancer mortality. Perhaps the fact that Japanese drink green tea daily helps explain why."


Soybeans have been a staple in Asia for thousands of years. In a 1982 study of over 250.000 Japanese, researcher Takeshi Hirayama of Japan's national Cancer Center Research Institute found that people who ate soybean-paste soup daily had a significantly lower risk of dying of gastric cancer than did those who rarely or never ate the soup. A naturally occuring compound in soybeans called genistein may block cancer-causing genes. Genistein is found in the soybean curd called tofu, as well as in soy milk, soy protein isolates and most soy flour.


Soy sauce is made with a process that eliminates the geinstein. However, according to microbiologist Michael Pariza, the principal flavor component of traditional (fermented) soy sauce---a substance called HEMF---is "one of the more powerful anti cancer agents studied in animals so far."


The Artic Diet


Scientist were puzzled when they started studying the health of Eskimos in Greenland. They consume vast quantities of fat yet have remarkably low death rates from heart disease. One reason is that the Eskimo diet includes abundant fish---salmon, mackerel, herring and others---rich in usual oils that scientists label omega-3 fatty acids. If consumed for a long period, these fish oils appear to thin blood, lower its cholesterol, reduce in flammatory reactions, lessen the risk of atherosclerosis and, according to recent animal research, may protect against colon cancer.


According to cell biologist Michael J. Wargovich, there is not yet reason for gastroenterologists to recommend that their patients gulp fish-oil capsules. "But the evidence is certainly strong enough," he says, "to recommend a diet that includes more cold-water fish."


Food of the 90's


Some vegetables are even healthier than we thought, such as broccoli and related cruciferous vegetables---cabbage, Brussels sprouts, watercress and others---so named because of the cross shaped arrangement of their flower petals. In March 1992 a team of scientists at John Hopkins University in Baltimore, Maryland, announced that a sulfur-rich chemical in brocolli called suforaphane "may be a significant component of the anti-carcinogenic action of broccoli."


"In addition to sulforaphane, there are other reasons your mother was right to say, "Eat your brocolli," explains Dr. Jon Michnovicz, director of the Foundation for Preventive Oncology in New York City. "Cruciferous vegetables are bursting with chemicals called indoles that can block certain cancer-causing agents in animals.


"Our research has found that capsules of a purified indole speed up the breakdown of the hormone estrogen, which is a risk factor for breast cancer," says Michnovicz. "In mice we've found that this cruciferous indole substantially reduced the incidence, size and multiplicity of spontaneous mammary tumors."


What food will spark enthusiasm in the near future? One good prospect is citrus fruits, long loved as an excellent source of vitamin C but now being studied by scientists for a surprising treasure-trove of health-enhacing chemicals. In one study,conducted by nutrition specialists Dr. James Cerda, volunteers with high cholesterol levels were given capsules of grapefruit pection equivalent to two whole grapefruit daily for four weeks. These people lowered their blood cholesterol levels by an average of almost eight percent. "Since a one-percent drop in cholesterol causes about a two-per-cent drop in the risk of heart disease," says Cerda, "on average we lowered the heart-disease risk for these volunteers about 16 percent. In laboratory animals with existing atherosclerosis that were fed a high-fat diet for a year, those receiving  pectin had 62 percent less plague in their arteries than the controls did." Pectin is soluble fiber found only in citrus fruit itself, not in the juice. "We could say that two grapefruit a day might keep the heart doctor away," Cerda adds.


While researchers study the disease-preventing ingredients of specific foods, remember that achieving a more healthful diet is a more immediate goal. Current scientific wisdom recommends, in addition to limiting intake of meat and fat, eating more fruits, vegetables, grains and legumes.


"It's silly to focus too much on single foods," says nutrition researcher Herbert Pierson. "We don't eat one food. We eat mixtures of foods and need to in order to get the full spectors in them. We have lost to learn about the foods that nourish and heal our bodies, but we have responsibility to select foods with our brains as well as our taste buds.


"The old saying is true---you care what you eat," Pierson concludes. "And you have to make that choice everyday." 

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Posted in: Food,FoodforLongerLife,Health,Lifestyle,Nutrition,Onion,Tips,Vitamin