Why junk food is harmful to your body?

Many of us are very fond of fast foods such as pizza, burgers and other junk food. Although food is fuel for your body excessive calories are not good for your health.Fast food is said to harm your health because it is highly processed and most of them contains large amounts of carbohydrates, added sugar, unhealthy fats, and salt. High calori in junk food leads to obesity and overweight which is a risk factor life threatening health problems such as heart disease, diabetes, and stroke. Junk food has very poor nutritional value.

Junk foods make you prone to diabetes

If you consume high amounts of carbs,it result in a spike in your blood sugar.That will modulate the normal insulin response.These frequent spikes in blood sugar can act as contributing factor in insulin resistance and type 2 diabetes. 

Junk foods increases your bad cholesterol

Added sugar and fat in junk foods increases your LDL cholesterol and decreases your good cholesterol.

Effect of excessive sodium on your body

Excessive sodium increases water retension on your body and you appear edematous.It increases your blood pressure .Sodium also causes increased chance for renal stone and osteoporosis.

Effect on lungs

As junk food leads to obesity there is increased chance of shortness of breath.

Junk foods may result in depression.

Carbohydrate rich foods can increase the chance of acne 

When you consume food rich in carbohydrate the bacteria in your mouth produces acid which will destroy your tooth enamel and result in dental cavities.

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Significance of involuntary weight loss and its causes

Weight loss may be voluntary or involuntary.Voluntary weight loss occur due to dieting,exercise, starvation or decreased intake in older people.If the weightloss is involuntary particular attention should be given since it may be an indicator of underlying serious disease.Weight loss can be identified from the hospital or general practice weight record.In some patients weight loss occur without an underlying cause,which is regained and stabilise over time.

What is significant weight loss?

Loss of weight more than 4.5 kg or more than 5% of one’s body weight over a period of 6–12 months is called significant weight loss

Important causes of weight loss are the following.

They belong to four main groups 

1.Cancer

2.Chronic infection and inflammation

3.Metabolic disorder such as diabetes, hyperthyroidism

4.Psychiatric disorders

Cancer

It is the cause of involuntary weight loss in upto 25% of cases. Following are the malignancies which are frequently associated with weight loss.

Gastrointestinal, liver, blood, lung, breast, genitourinary, ovarian and prostate.20% of cancer death is due to severe weight loss and cachexia.

Gut problems(gastrointestinal)

Almost any disease of gut can result in weight loss.

Inflammatory bowel disease, Crohn’s disease or ulcerative colitis cause loss of appetite, fear of eating,loss of protein and nutrients from body. Malabsorption, peptic ulcer, pancreatitis Obstruction/constipation, pernicious anemia are the most common gut problems leading to weight loss.

Infections

Tuberculosis, parasites, fungal diseases, subacute bacterial endocarditis, and HIV are common treatable causes.

Endocrine and metabolic

Hyperthyroidism, diabetes mellitus, pheochromocytoma, adrenal insufficiency

Chronic heart and lung disease

Causes weight loss due to increased metabolic demand, decreased food intake due to disease and decreased appetite

Psychiatric causes

Significant weight loss is seen associated with depression and isolation so that patient fail to take care of nutritional needs. Bereavement is also a well known cause of weight loss.Alcoholism is an important cause of weight loss due to  malnutrition and self neglect .Other psychiatric disease causing weight loss are anxiety and paranoia, anorexia nervosa, bulimia

Neurologic disease

Stroke, parkinson’s disease, neuromuscular disorders and dementia

Old age

Decreased taste and smell, functional disabilities, age related change in body all result in poor nutrition

Drugs

Cause loss of weight due to decreased appetite, nausea, vomiting, stomach ulceration, diarrhea, dry mouth, altered taste all these are more common in elderly who are on 5 or more drugs .Examples are sedatives, antibiotics, nonsteroidal antiinflammatory drugs, serotonin reuptake inhibitors, metformin levodopa ,angiotensin-converting enzyme Inhibitors.

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Use Olive oil to prevent skin ageing

Glowing beautiful skin is a dream of everyone.But as age advances skin will start showing the signs of ageing.To delay the skin ageing you should start caring the skin from young age.This will definitely prevent the skin ageing and help to get young energetic healthy appearance to your skin.

Anti ageing properties of olive oil is known from ancient days itself. The Romans and Egyptians used this for preventing skin ageing.

How olive oil helps in preventing skin ageing?

Olive oil is rich in four antioxidants they are 

Hydrophilic phenols

Vitamin A 

Vitamin E

Other important antioxidants in olive oil are squalene and oleic acid.

These antioxidants will fight with the free radicals and delay the skin ageing. Olive oil because of its regenerative power will help to keep your skin soft, smooth and it will act as a good toner of your skin.

Chief antoxidant in olive oil that prevent skin ageing is hydroxylyrosol.It will prevent cell degeneration and prevent cell ageing

Vitamin E will fight with antioxidants that are produced due to sun exposure.It will also improve the skin elasticity.Thus it can prevent the sagging of skin and skin becomes firm and attribute good glowing look to your skin.

Due to the presence of antioxidants olive oil act as cleanser ,moisturizer and skin protector.

How to apply olive oil?

Take desirable amount of olive oil, gently massage on your face and other body parts and keep it for sometime then wash with lukewarm water.

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Four golden rules for beautiful glowing skin

Glowing skin is the most important element that add beauty to your face. For this you need not try the costly cosmetics available in the market, instead you need to practice basic skin care.This article is aimed to give you basic idea about the skin care.

The four golden rules of skin care are 

1.Cleansing to be done daily

2.Toning to be done daily

3.Moisturising to be done daily

4.Face pack to be done once a week

Before trying these identify the type of your skin because the treatment varry depending on the type of skin.There are three basic type of skin.

1.Oily skin

2.Dry skin

3.Combination skin

Cleansing

First step of skin care is cleansing.Cleasing will help to remove sweat ,excessive oil and other impurities. It should be done in the morning before make up or before going to bed.For skin cleansing you can use face wash or cleansing milk.

For dry skin and combination skin use cleansing milk.

For oily skin use active cleansing gel.

Skin toning

For skin toning use toner or astringent

For dry skin and combination skin use toner

For oily skin use astringent

Astringent contain alcohol, which will make the skin dry, so better to avoid in dry skin.

Moisturising 

Moisturising has different advantages.It help to retain watercontent in skin.Not only it prevent the waterloss but also absorbs water from atmosphere and from innerlayer of skin and keep the skin surface moist.Moisturising also protect your skin from sunlight and dust.

You should select the moisturizer based on the type of your skin.Most of moisturizer contain SPF (sun protection factor).these are more superior.Apply moisturizer all over your body immediately after bath.During day time use moisturizing body lotion.For night time application moisturizing cream with nourishing factors are ideal.

Face pack

Face pack to be used once in a week.Face pack is selected based on the type of your skin.To get an expert opinion about the tye of skin get the help of a beautician. After the age of 25 years it is better to do facial once a month.

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Foods that should be avoided by pregnant women to protect unborn baby

Pregnancy is the most special and  precious phase in every women life. Health of your baby is determined by the type of food you consume during pregnancy. All pregnant ladies should make a sense of what you can eat and what you should not eat during pregnancy.

Here I have listed few foods that all expectant mothers should avoid for the better health of their babies. Because certain foods are rich source of mercury and vitamin A which causes harmful effect on your baby. Certain other foods are well known to produce foodborne illness such as salmonellosis.

All expectant mothers should avoid the following foods to  protect your baby.

Fish with high mercury content

King mackerel, shark and swordfish 

These fishes are rich in mercury content high mercury content is harmful to the developing nervous system. FDA guidelines state that expectant mothers can eat up to 12 ounces (340 grams) of mercury contaminated fish per week, this  averages to about 2 seafood meals.

Food which are rich source of vitamin A

Liver, fish liver oil supplements ,high-dose multi-vitamin supplements and any supplement containing Vitamin A

During the early months of pregnancy high vitamin A content may produce birthdefect in baby. But the beta carotene rich foods which are converted to vitamin A in the body are safe during pregnancy.

Food unsafe due to food born illness

1.Cheese

Certain cheese are not safe during pregnancy. They may be contaminated with listeria and consumption is associated with listeriosis. In pregnancy it can result in miscarriage, premature labor and severe illness.So do not consume any cheese that have “unpasteurized” label. Example is Feta cheese. Brie Cheese, Blue Cheese.Hard cheese are safe during pregnancy.

You can consume pasteurized cheese like mozzarella and cottage cheese

2. Unpasteurized Milk

Drinking raw milk is not advocated due to increased chance of food born illness like listeriosis.

3. Uncooked eggs

Uncooked egg consumption can result in salmonella infection ,which predispose to early labour and dehydration due to vomiting and diarrhea.If you want to consume eggs cook it well.

4. Deli meats 

Avoid consuming deli meats if you are pregnant as it may result in listeriosis.

Caffeinated drinks

Better to avoid during pregnanacy as it can cross the placenta and affect your baby’s heart rate.

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Heartburn more information

Heartburn is a common problem seen in general population. It is a burning sensation felt behind the central part of upper chest (retrosternal area), usually seen after meals or awaken the patient from sleep. This is due to regurgitation of small amout of acid and undigested food, and not associated with act of vomiting or retching. Other sumptoms include increased salivation and sensation of lump in the throat.

Mimickers of heartburn

Due to the presence of discomfort in the upperchest and the presence of symptoms at neck and shoulder it may be mistaken for heartdisease.

Pain at night that is relieved by food or antacid is seen in peptic ulcer disease.

Pain on swallowing indicate malignancy or active inflammation.

Pain that is aggrevated by meals and not interfering with daily activities is seen in nonulcer dyspepsia.

Conditions where you get heartburn

Upper gut (gastrointestinal) disorders

• Peptic ulcer disease

• Acute gastritis

• Gall bladder stones

• Oesophageal spasm

• Non-ulcer dyspepsia

• Irritable bowel syndrome

Other gut  disorders

• Pancreatic disease (cancer,chronic pancreatitis)

• Colonic carcinoma

• Hepatic disease (hepatitis,metastases)

Systemic disease

• Renal failure 

• Hypercalcaemia

Drugs

• Non-steroidal antiinflammatory drugs(NSAIDs)

• Corticosteroids

• Iron and potassium supplements

• Digoxin

Others

• Psychological (anxiety,depression)

Conditions associated with heartburn

Reflux esophagitis is more in the lying down posture (supine position), and is increased by bending forward and after large meals.Patients also experience chest discomfort, nocturnal cough, hoarseness of voice , repeated clearing of throat and frothy mucus in the throat.

Drugs-There is relaxation of muscle of the lower part of esophagus which is increased by anticholinergics, theophylline, meperidine, calcium-channel blockers, chocolate, peppermint, tobacco and alcohol.

Direct injury to mucosa may be caused by Tetracycline, aspirin, iron.

Gastritis is associated with constant epigastric discomfort relieved by food or antacids.

Pregnancy -Heart burn is more common in pregnancy because of increased pressure in the abdomen and relaxation of lower esophageal sphincter due to hormonal change in pregnancy.

Aerophagia there is recurrent burping due to swallowed air due to anxiety, carbonated beverages, gum chewing

Indicators of early evaluation of heartburn are the following

1. Difficulty in swallowing 

2. Severe nausea 

3. Vomiting 

4. Weight loss 

5. Bleeding

6. Lack of response to treatment ,

7. Aggrevation of  symptoms with exertion ( seen in heartdisease )

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How to use eyeliner to get beautiful attractive eyes

• One of the best way to make your eyes stand out is to use eyeliner
• If you want more subtle and sophisticated look use brown eyeliner, to draw attention and create various looks use black eyeliner. 
• When applying eyeliner, first sweep a line immediately above the upper lashes, and then you should  carefully line the rim of the lower eyelid. 
• To get dramatic look a thick but subtle coating of eyeliner is given.
• If you want smoky eyed look, you can smudge the eyeliner a little.For this use heavy black, then after that apply slow shades of glitter, not a lot. 
• If you wish to make your eyes appear larger, first you should line the bottom inside rim with a white liner,this should be followed by a light application of a brown or soft black eyeliner on the outside, just under your lowerlash line. 
• These steps will definitely help to create the illusion of a larger and beautiful eye.

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What is the role of conventional DMARD in rheumatoid arthritis treatment

DMARD are disease modifying antirheumatic drugs, they are so called because of their ability to prevent and slow the structural damage to joint and save the joint in rheumatoid arthritis.These are known as slow-acting "second-line drugs.Prior to the invention of these drugs treatment is aimed to reduce the pain and discomfort to people than slow the actual underlying disease process.DMARD have thus revolutionized the treatment and elevated treatment goal. 

What are the advantages of DMARDS in RA?

1.These agents substantially reduce the inflammation in joints.

2.Prevent or slow down the joint damage.

3.Help to preserve the joint structure and function so the affected person can lead normal life and enable to do all daily activities as far as possible.

When to start DMARD?

Since the critical period in RA is first year of onset of disease, bone and joint damage occurs early, DMARDS cannot reverse the existing damage already occurred, they can only protect the joint from further progression of disease process.It is better to start them early to avoid joint destruction.As soon as the person is diagnosed with this disease Rheumatologists now start with a DMARD.Methotrexate is the most commonly prescribed drug.The faster the patient is strated on DMARD sooner it slow down the joint damage.

How they act in RA?

They will act on specific part of immune system and bring down the abnormally increased immune response.Basic pathology in RA is abnormal immune response which damage the joints.Earlier treatment with them have improved the function and reduced the structural damage to joint that is even within months of diagnosis.Most people need aggressive secondline drugs to treat the situation that is methotrexate.

How long it take to get improvement in disease?

The time requied to produce improvement varry depending on individual agent.

4 to 6 weeks of treatment with methotrexate

1 to 2months with salfasalazine

2 to 3 months for hydroxychloroquine

Sometime they need to take for years at varying doses to get optimal results

Conventional DMARDS  in Rheumatoid arthritis treatment 

DMARDS come in variety of forms and are listed below. 

Methotrexate (Trexall, Rheumatrex, Otrexup),leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine)

Methotrexate 

This is the initial DMARD of choice and is the main drug for combination therapy.This is an immune suppressing agent and decreases the joint inflammation.Since 1986 it is approved for treatment of RA.This is the initial second-line drug because of the following. 

1.Methotrexate is effective and it has infrequent side effects compared to other DMARDS.

2.Dose adjustment of methotrexate is flexible.Dose adjustment done as per need.

Side effects of this drug are ,it may affect bonemarrow and liver  rarely cause cirrhosis of liver and allergic reaction in lung.So regular monitoring of liverfunction and complete blood count is required in all people  while on this drug.Taking folic acid recommended to  reduce the risk of methotrexate side effects.

Dose of methotrexate is 10–25 mg/week orally or SQ Folic acid 1 mg/d to reduce toxicities.Other common side effects are mouth ulcers fatigue, hair loss ,vomiting and loose stool.Before starting treatment check CBC, LFTs Viral hepatitis panel and Chest x-ray.

Monitor CBC, creatinine, LFTs every 2–3 months while on treatment.

Leflunomide (Arava) 

Helps to relieve the symptoms and slowdown the progression of the RA.Clinical efficasy similar to methotrexate.Common side effects of this dugs are hair loss, diarrhea, rash in some people.Serious side effects include increased susceptibility to infection,liver damage, bone marrow suppression.This drug is not safe in pregnancy.As it produces birth defects it should not be taken during pregnancy and those women who want to become pregnant while on drugs.Dose is 10–20 mg/d.Before starting therapy blood count,liver function test and viral hepatitis panel should be done. While on this agent regular monitoring of CBC, creatinine, LFT every 2–3 months is recommended.

Hydroxychloroquine  (Plaquenil) 

It has been used for long periods  to treat RA..But it wont produce radiographic improvement.Dosage of this drug is 200–400 mg/d orally(=6.5 mg/kg)

This is used  in early mild cases and in combination therapy with other DMARD. The common side effect of this drug include upset of stomach, diarrhea,vomiting ,headache. muscle weakness ,skin rashes, and vision changes.Prior to starting this drug eye examination is done in all people who are more than 40 years old and those with past history of eye disease.People on this drug require regular monitoring of vision by an eye doctor (ophthalmologist) every year after starting drug.Other serious adverse reactions of this drugs are toxicity of heart and abnormality in blood count.

Sulfasalazine (Azulfidine)

This is an oral drug used to treat RA along with other antiinflammatory agents.This drug is usually well tolerated by people.The common side effects are stomach upset rash,vomiting and diarrhea.The serious side effect is low blood count thus predispose to infection.As Azulfidine  contain  sulfa and salicylate compounds this should  be avoided in people with past history of allergy to sulfa.Initial dose of drug is 500 mg orally twice daily and maintenance dose is 1000–1500 mg twice daily.Before starting these drugs blood count,liver function test and G6PD level need to be tested.For people on salfasalazine blood count should be monitored every 2–4 weeks for first 3months,then every3 months

Conventional  agents may be used alone or in combination in the treatment of RA 

Immunosuppressants in the treatment of RA

Immunosuppressants are used in the treatment of refractory aggressive case of RA , where all other therapy fails.Also in those people with severe complication of RA that is blood vessel inflammation.They include azathioprine (Imuran), cyclophosphamide(Cytoxan), cyclosporine and chlorambucil(Leukeran), 

These agents may suppress the bonemarrow and produce anemia,low platelet count and low toatal WBC  count.Thus increases the risk for infection,and bleeding.

Agents like Gold ,Pencillamine are rarely used nowadays due to poor clinical efficacy and toxic profile. 

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Super foods that fight against cancer

Cancer is a dreaded disease where prevention is better than cure.One of the major culprit in cancer is your unhealthy and faulty food habits.There are food substance that enable you to fight against cancer.They act by boosting our immune system and supporting our body.They help you to stay a head of cancer and improve your health.

Super foods that prevent cancer

We usually neglet those powerful foods that prevent cancer, they have powerful action on your health and immune system.

1.Vegetables and fruits
You should consume more variety of fruits and to prevent cancer.Vegetables that act against cancer are Broccoli, brusselsprouts, cabbage, carrots, cauliflower, eggplant, green beans, kale, onions(red), peppers, radishes ,soy, squash, sweetpotatoes, tomatoes,yams

Anti-cancer fruits include the following

Apricots,blueberries, grapefruit, grapes, lemons, mangoes, oranges, papayas, peaches, persimmons, strawberries, organic, tangerines

Include atleast five sevings of vegetables and fruits in your daily food

2.Fiber rich food 
Eat fiber rich food as they will reduce the cancer risk , which include whole grains,beans, fruits and vegetables.

3.Plant based foods,
Eat predominantly plant based foods, foods of plant origin are low in their caloric and fat content.They are rich in phytochemicals and antioxidants which are strong anticancer agents.Apart from the anticancer effect of fibers the legumes (such as seeds, rice, beans, and chick peas soy beans) have anti cancer properties due to their protease inhibitor function.So they reduce the growth of colon, breast and skin cancers. 

4.Green tea 
Consumption of green tea is useful in cancer prevention.

5.Peanuts and Peanut butter
Consume more Peanuts and Peanut butter.Consumption of vitmin E rich foods helps to reduce the risk of colon, stomach liver and lung cancer.Peanuts, peanut butter, sunflower seeds almond, almond butter are rich source of vitamin E they make your cells strong enough to fight agaist cancer.

6.Vitamin D rich food
Eat vitamin D rich food,as low vitamin D have been associated with the cancer especially breast, prostate and colon cancer.Wild salmon, vitamin D fortified dairy product such as yogurt and milk increases your vitamin D level.Vitamin D inhibit the blood vessel formation that feeds the tumor cell,thus helps to arrest the cell growth.

8.Foods rich in calcium
Consume foods rich in calcium.High calcium intake is associated with decreased incidence of colorectal cancer.Calcium acts in the following ways to prevent cancer

a.It can control the multiplication of cells that line the colon.As uncontrolled growth is the basic pathology in cancer it help to reduce cancer.

b.Calcium can bind with bile acid and protect the colon from the irritating effect of bile which is a carcinogen.

If you want to reduce the cancer risk consume 500 to 1000 mg of calcium daily along with dietary source of calcium.Dose required is 2000mg to suppress uncontrolled proliferation.Dairy products bony fish and yogurt are rich source of calcium.

9.Food rich in selenium
Consume food rich in selenium.Selenium has strong antioxidant property, thus helps to scavenge the free radicals that produce cancer.They are shown to reduce the colonic cancer.To get the maximum benefit of selenium consume it with vitaminE rich foods.Fish particularly redsnapper, shrimp, lobster, whole grain, vegetables are rich in selenium.

10.Acidophilus and cancer prevention.

Acidophilus are intestine friendly bacteria that can act as anti cancer agent and prevent colonic cancer

How it prevent cancer?

The growth of other intestine friendly bacterias is stimulated by them. They reduce bile acid to carcinogen conversion.
Lacto bacillus acidophilus reduces the colonic enzyme that produce carcinogen formation in the intestine.

Consume yogurt with the L.A.C. (live active cultures) seal 

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Drink green tea to reduce skin wrinkles and premature ageing

Wrinkles are creases produced in the skin,as a part of skin ageing. As age advances your skin will get thinner and less elastic,it fails to protect itself from damage, exposure to sunlight will intensify premature wrinkling of skin. To protect your skin drink green tea.

Green tea is regarded as a storehouse of antioxidants that benefits for your skin. These antioxidants are effective against free radicals. These free radicals are formed when your skin is exposed to the UV rays of the sun, they are accountable for premature ageing.

Green tea is the most beneficial food for your skin.

Green tea contains the following nutrients  
Vitamins-Vitamin C, Vitamin D, Vitamin K, Riboflavin.

Minerals-Zinc, Calcium, Magnesium, Iron.

If you drink green tea daily it will defenitely help to keep your skin glowing and healthy. Green tea is also an ingradient in certain beauty creams.

Why green tea is effective in preventing wrinkles?

Green tea has cell renewal property. It contains polyphenol compounds, these compounds will energize the aged keratinocytes cells. Thus it stimulate the DNA synthesis and prevent the premature ageing of the cells.

Other skin benefits of green tea are the following

1. If applied locally green tea is very effective in protecting your skin against sunburn and tanning.

2. Prevent skin cancer by fighting against the enzyme that produce skin cancer.

3. Green tea act as soother in certain inflammatory skin disease such as psoriasis.

4. Helps to reduce acne and pimples.

5. Improve the skin complexion.

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Food triggers of migraine and their control

Migraine attack in a particular patient is precipitated by certain triggers.One of the important trigger is food that you eat.Food trigger vary from person to person.The intensity of attack of headache produced by particular food also vary.If you have another trigger apart from food on the particular day there is increased chance of getting migraine.

Food related triggers is seen in approximately 10 percentage of people with migraine.It can be due to intake of certain food substances or food additives and preservatives or lack of food.Sometime there may be craving for particular food before an attack of migraine.

Missing meals and insufficient food intake is one of the most common and important trigger for your migraine attack.This is because decreased food intake lead to decrease in blood glucose level which is strong migraine trigger.If you are a migriane sufferer avoid skipping meals.Donot eat sugary snacks instead you should take care to eat a balanced diet.If you want to control your attacks consume nutritious snacks at regular interval. 

Food substance that act as migraine trigger are the following

According to national headache foundation following are the foods commonly associated with migraine (list is partial).Food agents that are frequently associated are aged cheese,processed food,salted foods.

1. Ripened cheeses (such as cheddar, Emmentaler, Brie ,Camembert and Stilton)

As the cheese ripenes or ages the proteins in it break down to a substance called Tyramine.Tyramin is the culprit substance for headache aggrevation.Longer the cheese ages the higher the tyramin contents it has.This tyramin content is high especially in  soft cheeses like brie and camembert blue cheese,Swiss cheese,all hard cheeses and  moldy  cheeses.If you want to avoid a migraine attack avoid these aged cheese.

2. Chocolate 

Many people experience food craving and increased appetite just before a migraine attack.So just before the migraine you may have a tendency to eat chocolate, so reaching for chocolate seems to be a result of migraine attack than its cause.Studies have showed that cocoa in chocolate may protect the nerves that is involved in migraine attack about 22 percentage of people experience it as a migraine trigger.

3. Ice Cream

Some migraine sufferes experience migraine aggrevation following intake of ice cream and other cold foods.This is especially when you eat cold ice cream too fast.If you are overheated there is increased chance of headache.This headache rapidly subsides.If you want to eat icecream and cold food drink or eat slowly.

4. Certain fruits especially banana.

Banana contains tyramin and the concentration of tyramin is 10 times higher in banana peel than banana pulp.So if you have identified it as your trigger while eating banana avoid the delicate inner peel that might stick on to it.

Other fruits such as citrus fruits,figs,papaya,avocado,red plums are all migraine triggers.

5. Caffeine

Excessive amounts that is more than 2 cups of caffeinated beverages such as tea, coffee or cola.

Effect of caffeine on migraine depends on its dose so it is included in headache medications.At lower doses caffeine actually reduces headache,but it act as a trigger when your daily intake is high.To experience the withdrawal headache you need to take about 200 mg that is about 2 to 3 cup daily.

6. Tannins

Tannins are that agent which give the astringent taste to food, and  act as a strong migraine trigger in some people.Food that contain tannins are tea, apple juice and cider,red-skinned apples and pears, and red wine.

7. Alcohol

Alcohol precipitate migraine headache through different mechanism. 

a. Beer, red wine vermouth  and sherry, all have high tyramine content.Tyramine is the agent that produce migraine trigger.

b. Alcohol also produce headache by decreasing the hydration.If  you have migraine better avoid alcohol.

c. Alcohol dilate the blood vessels in brain and increases the blood flow resulting in migraine. 

Among alcohol redwine is strongly related to migraine because of it high tyramine content and sulfite in redwine which is used as a preservative.

Other migraine triggers are

• Marinated, pickled, or fermented food

• Sour cream

• Nuts, peanut butter

• Sourdough bread

• Broad beans, lima beans, fava beans, snow peas

Leftovers

If the food is improperly stored the levels of tyramine increases and migraine sufferers experience headache following intake of such food.

Dehydration can produce migraine attack ,so drink atleast 10 to 12 glasses of water daily.

Food additives are commonly associated with migraine.

What you should do to avoid food trigger for migraine?

1.To identify your food trigger make  a list of food substance that you have consumed daily.Identify what all food that you have consumed on the day of migraine exacerbation.Avoid those foods.

2.There are certain foodsubstances that helps to reduce the migraine headache such as gingerjuice,ghee,butter and green tea.Antioxidants in green tea helps to reduce the headche.It is better to use green tea mixed with lemon juice.

3.Take food at regular time. 

4.Avoid fasting and skipping meals which  reduce the blood glucose level and  produces headache.

5.Adequate hydration helps to reduce headche, so drink plenty of water.

6.If you have migraine avoid alcohol especially redwine and whisky.

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Bittergourd juice for weightloss

Overweight is a pre runner of many disease, so everyone want to reduce body weight and desire is to achieve a slim and fit body.Many people wont get enough time to spend for weight reduction because of their busy schedule, this home made remedy for weight reduction does not need too much time.It is an healthy way to become slim and fit.It works from within your body.

Bittergourd

It is a green vegetable which is also called as bitter melon.This is first cultivated in Amazon rain forest by the tribes, later in Asia, Southamerica, South Africa.This is used as food and has medicinal effect.

How bittergourd juice help to reduce weight?

1.Bittergourd help to reduce blood glucose.

2.Prevent extra sugar absorption.

3.Bittergourd has high fiber content that reduces the absorption of fat and sugar.

4.It has low carbohydrate and calorie content.

How to make bittergourd juice? 

Here are 2 recepies  

1.Take a bittergourd, peel off it with knife, thoroughly wash it under the running water.

2.Slice it into 2 pieces at its center,scoop out the seeds and white flesh.

3.Cut it into small pieces and soak it in a bowl full of water for half an hour.

4.Add half teaspoon lemon juice or salt into the bowl.

5.Put bittergourd pieces into the juicer, and take the juice

6.To overcome bitter taste you can use the following

    Lemon juice

    Apple juice 

    Honey and black pepper

7.With a strainer filter out the  vegetable pieces.

8.Refrigerate the juice for 1 or 2 hour. 

This healthy juice will help to remove some calories from your body and and help you to get slim and fit body.

Mixed vegetable and fruit juice containing bitter gourd

You need the following

1.Bitter gourd

2.Sticks of celery

3.Cucumber

4.2-3 apples

5.1 peeled lemon

Prepare bittergourd as mentioned above,then add all the vegetables and fruits.

You can add any vegetables and fruits of your choice.

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Stem cell transplantation, the future treatment of multiple sclerosis

Multiple sclerosis is a chronic degenerative disease.The major fraction of people treated with disease modifying agents experience flare up of disease. The course of disease is unpredictable, it may progress rapidly or slowly. According to the clinical features there are four different types of MS.Relapsing/remitting MS (RRMS) forms 85% of cases, here  patients are stable in between the bouts and often may recover completely however there is risk of RRMS transforming into secondary progressive MS (SPMS).In SPMS neurological function may steadily deteriorates without clear relapses.

Why treatment is difficult in multiple sclerosis?

clinical manifestation vary from person to person.Treatment is also like this, the drug that works well in one person may not be effective in other person. As the best treatment vary from one person to other treatment need to be individualized.The key to finding the treatment and cure of this disease is through trial and error and research.

Stem cell transplantation in multiple sclerosis

As MS is a complex disease, its successful treatment requires a combination of treatments that control each of the disease mechanisms

1.Autoimmunity

2.Loss of nervous system cells

3.Lack of regenerative capacity of particular cell in the central nervous system.

Why stem cells are used?

1.Stem cells have unparalleled regenerative capacity thus offer the promise of filling this therapeutic goal. 

2.They have flexibility to grow into different type of cells and can differentiate into cells that produce the covering of neuron (myelin). 

3.Stem cells are capable of modulating the immune system and able to produce factors that protect the neuron.

Different type of stem cell that are used.

Hematopoietic stem cells (HSCs) are the main type of cells investigated.

Mesenchymal stem cells (MSCs)

Neural stem cells (NSCs) 

Oligodendrocyte precursor cells (OLPs) .

What is done in stem cell transplantation.

First patient with multiple sclerosis is treated with high-dose immunosuppressive therapy, then their own hematopoietic stem cells, are transplanted .This type of transplantation is called autologous transplantation as it is done with patients own cell.

Stem cells are harvested from patients bone marrow and then injected into the Cerebrospinal fluid that surrounds the spinal cord of the patient.Injections are repeated at 3 month intervals frequent monitoring of safety and efficacy is monitored through follow up.After the final injection patient needs monitoring upto 27 months.

How does stem cell transplantation work?

RRMS the most common form of Multiplesclerosis, is a progressive autoimmune disease where the exaggerated immune system attacks the brain and spinal cord. Stem cell transplantation will remove abnormal immune cells that cause disease and reset the immune system.

Result of stem cell transplantation  

There were sustained remission of active relapsing-remitting MS (RRMS in most of the patients and majority experienced improvement in neurologic symptoms). Useful in patients with aggressive disease.

Variables that determines the benefits of stem cell transplantation are the following

1.Maximum benefit is seen in patients with active inflammatory disease which is determined by frequent active relapses and  or gadolinium enhancement on MRI 

2.Better to start the treatment as early as possible before irreversible disability.

3.Use of safe conditioning regimen for immunosuppression.

Early side effects 

Seen on blood and gastro intestinal system and are reversible. 

Success rate in recent trials

Various clinical trials are going on based on stem cell transplantation.There are encouraging and promising results in various studies, upto 80 percentage of trial participants survived  without experiencing an increase in disability, relapse of MultipleSclerosis manifestations or new brain lesions .

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Drugs used for treatment of obesity

Drugs may be used in the short term that is up to 3 months for obesity treatment as an adjunct to the dietary regimen, but they are not substitute for strict dieting.

Indication for anti obesity drugs.

Adjuvant treatment with drugs are indicated  in

1.Patients with a BMI >30 kg/m 2.

2.Patients with BMI >27 kg/m 2 with concomitant obesity related diseases.

3.Patients with BMI >27 kg/m 2 who do not get satisfactory weight reduction with dietary and physical activity therapy.

Significance of lifestyle program with drugs. 

Patients should be engaged in a lifestyle program when an antiobesity drug is prescribed. The life style program will provides them the strategies and skills which are needed to use these antiobesity drug efficiently because this support increases total weight loss.

Targets of drug therapy for obesity.

Suppression of appetite via centrally active drugs which alter monoamine neurotransmitters is the most thoroughly explored treatment.

A second strategy is to decrease the absorption of selective macronutrients from the gut such a fat.

Type of antiobesity drugs.

Centrally acting drugs

They are appetite-suppressing drugs, or anorexiants, affect satiety and hunger.

Satiety is the absence of hunger after eating.

Hunger is a sensation which initiates eating.

These agents increase the satiety and decrease hunger, thus help to reduce the intake of calories without a feeling of deprivation of food.

Example of centrally acting drug is sibutramine (Meridia).

Peripherally acting drugs 

Example of peripherally acting drugs is Orlistat.

It is a lipase inhibitor, inhibit the hydrolysis of dietary fat the essential step required for their absorption. Thus Orlistat blocks the digestion and absorption of 30% of dietary fat and help to achieve weight loss. Weight regain will occurs once the drug is stopped. Studies have shown that Orlistat produces a weight loss of about 9 - 10% at the end of one year. Orlistat has minimal gut absorption so it is devoid of systemic side effects. Tolerability to Orlistat is related to the malabsorption of dietary fat and passage of fat in the feces. About 10 percentage of people treated with  this drug experience gut side effect. They are flatus with discharge, fecal urgency, increased defecation and oily stool. These side effects of Orlistat is seen early in the course of treatment. The side effect can be reduced if the patient controls the dietary fat intake.Psyllium mucilloid if taken along with orlistat will helps to reduce the gut side effects. There is decreased concentration of fat-soluble vitamins D, E and ß-carotene is seen in patients treated with Orlistat.Vitamin supplements are necessary to prevent deficiency disease.

The Endocannabinoid System 

Rimonabant is the first selective cannabinoid CB 1 receptor antagonist, used for treatment of obesity. This drug antagonizes the orexigenic effect of endocannabinoid system and suppresses appetite. Rimonabant is a weight-loss agent which shows improvement in waist circumference and reduce the heart problems. However increased risk of certain side effect such as seizures, depression, aggressiveness and suicidal thoughts anxiety, insomnia are seen. Even though the drug was available in 56 countries in 2008, European Medicines Agency (EMEA) has officially withdrawn this drug in January 2009, due to increased side effect compared to its benefits.

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Life style changes for psoriasis

Psoriasis is a chronic skin disease which produce plaque and scales on skin giving unhealthy appearance to your skin.But if you care about certain factors they will definitely help you to cope with disease and improve the quality of life.

If you are a psoriatic patient you should get educated about this disease, understand  as much as about the disease about its treatment options and various researches going on in this field.Strictly follow your doctors advise  regarding the treatment options and lifestyle changes. You can join the support groups in your locality or online to get help from from them.

There are certain triggers for psoriasis. A psoriatic patient should know which all factors aggrevate his or hers disease,identification of these factors are extremely helpful as avoidance of trigger help to keep your disease in a stable state preventing flares.Infections, skin injuries, smoking and stress are few examples of psoriatic triggers. All psoriatic patients should avoid alcohol as alcohol consumption is associated with reduced effectiveness of your drug.

Coping with this disease is a challenge especially it affect large areas of your body that is easily visible to others especially face and hands.There are certain lifestyle modifications for psoriasis which even though cannot cure psoriasis may help to improve the appearance  and feel of your damaged skin ,

Read the following measures which may work for you.

Importance of daily bath if you are  suffering from psoriasis your skin may contain scales which wont look healthy. If you take daily baths this helps to  remove scales and  also calm inflamed  part of skin.For better results you can add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to  the water. You should avoid hot water baths and harsh soaps, both can  worsen  your symptoms and skin condition.For better results you can  use lukewarm water and mild soaps with  added oils and fats.

Use moisturizers they can help you to relieve discomfort and give healthy look to skin. For better results they are used , after bathing,while your skin is still moist .They act by preventing evaporation of water from your skin thus keeping the water content of skin.During cold season you have to repeat the application several times a day to get  good results.Use  either an ointment based moisturizer or oils if your skin is very dry.

Small amount of sunlight is shown to have beneficial effect on psoriatic skin lesions.But this should be done after discussing with your doctor .Because intense sun exposure is a trigger for your disease.While going out protect your skin with sunscreens that  has SPF of minimum 30. ,sometime you may need to apply it more frequently every 2 or 3 hourly if you are perspiring.Cover up the lesions with clothings especially when you are going out.

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New drugs that give hope to diabetic patients

Diabetes is a disease that can affect multiple system in the body. Since the prevalence of this disease in the community is very high and there is high chance to develop various complication if it is not controlled well lot of drug trial are going on this field. Newer drugs with different modes of action are tried to bring the blood sugar under control. Three such drugs are recently approved for treatment.

They are 

For people with type 2 diabetes drugs approved are 

1. Exenatide injection (Byetta)

2. Sitagliptin (Januvia)

3. Pramlintide acetate (Symlin)

For those with type 1 diabetes along with insulin Pramlintide acetate (Symlin) can be tried.

Why this drugs are useful in diabetes?

Insulin secretion from pancreas is stimulated by GLUCOSE. These newer drugs target the hormone incretin. Incretins potentiate this glucose stimulated insulin secretion from pancreas. As the insulin synthesizing and secreting action of GLP-1 is preserved in type 2 diabetic patients this has been developed as therapeutic agent for this disease. These are useful in treatment irrespective of the severity and duration of the disease. Diabetes is a chronic progressive disease sometime the agent that works for a period of time may become less effective and ,then we need to introduce new one.

Basic mechanism of action of these drugs.

Incretin are produced in the intestine in response to food intake. Incretin effect is mainly  mediated by two peptide hormones, they are glucose-dependent insulin releasing polypeptide(GIP), and glucagon-like peptide-1(GLP-1). Both GIP and GLP-1 are rapidly metabolized  into inactive metabolites by the action of  dipeptidyl-peptidase-IV (DPP-IV) enzyme. As the insulin synthesizing and secreting action of GLP-1 is preserved in type 2 diabetic  patients this has been developed as therapeutic agent. These are useful in treatment irrespective of the severity and duration of the disease. Thus the modulation of GLP-1 levels and GLP-1 activity by administration of the native hormone, its analogs, and mimetics or the agents that inhibit its degradation has become the chief focus of investigation for type 2 diabetes  treatment.

Advantage of this drugs in diabetes.

1. They enhance the insulin secretion.In addition to its effects on insulin secretion, GLP-1.

2. Stimulate the insulin synthesis.

3. Inhibit  the glucagon secretion ,glucagons increases the blood sugar.

4. Delays the  gastric emptying thus reduces the sugar. 

5. Reduction of food intake.

6. It has trophic effects on the pancreas. Stimulate betacell proliferation.

Drugs act on GLP1 receptor are

1. Exenatide injection (Byetta)

Indicated in those people with type 2 DM whose blood sugar fails to bring under control with oral drugs. They helps to control the blood sugar by mimicking the insulin action and slowing stomach emptying. Since the patient feel full faster and stop eating these agents will help to reduce weight. This is given as injection 2 times a day at mealtime. Special advantage of this drug is it help to reduce weight and wont produce hypoglycemia. But there is risk of hypoglycemia if taken with other agents that enhance the insulin secretion. Side effect of this drugs are nausea, inflammation of pancreas, risk of kidney disease. Exenatide should not be used in people with kidney disease. Approved for either as single therapeutic agent or in combination with other drugs. To minimize the initial side effect treatment started at lower doses, dose limiting side effect is nausea that is tendency to vomit. Exenatide extended release (Bydureon) advantage of this extended release formulations is it require injection only once a week. Action and side effects are similar to Byetta.

2. Liraglutide (Victora)

Liraglutide is other GLP 1 agonist it is injected once a day. Not used in those people with family history of medullary type of thyroid cancer.

3. Amylin agonist

Pramlintide acetate (Symlin)

Pramlintide acetate is useful for those with type 1 or type 2 diabetes who are on insulin. This is injected at mealtime,it should not be mixed with insulin in same syringe. Advantage of this drug is that it helps to achieve better control of blood sugar, mainly reduce the blood sugar spike after meals. Weight reduction is other added advantage of this drug. This is injected at mealtime. Unwanted side effects is hypoglycemia if used with insulin.

4. DPP-IV inhibitors

Sitagliptin (Januvia), saxagliptin (Onglyza), and linagliptin (Tradjenta)

All are orally active drugs taken once a day, indicated in type 2 DM, they may be combined with metformin. They wont promote weight loss. Associated with only few unwanted effects. Used with precaution in patients with kidney disease. They act by protecting the breakdown of incretin, so incretins are available for long duration for insulin stimulation.

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Banana mask for hair fall - Natural beauty tips

Hair fall is a problem faced by many people, thick and shiny hair add to your beauty more than anything. Are you struggling with hair fall? Try this banana mask to prevent hair loss and to get shiny, smooth hair.

Why banana is used for hair loss?

Banana is enriched with essential nutrients that are good for your hair that is why it is a chief ingredient in home made remedy for hair growth.

Banana is rich in

1. Potassium 

2. Powerhouse of vitamins A, E, and C.

3. It is a rich source of  natural oils. 

What are the hair benefits of banana hair mask? 

1. Nutrients in banana helps to keep your hair hydrated and healthy, if you use it regularly this will increase the moisture content of hair and thus smoothen the hair and give it natural shine.

2. Banana controls dandruff and it will reduce the itching of the dry scalp.

3. Soften your hair, helps to protect the natural elasticity of hair.

4. Banana is useful in preventing split ends and breakage. 

5. Encourages hair growth. 

6. Vitamins in Banana will helps to regain the strength of your hair.

7. Banana is a natural volumizer of hair so adds volume to your hair.

8. Hair is protected from sun and wind damage.

How often it should be used ? 

To get best results use it once weekly.

1. Banana hair mask for rapidly growing and long hair

a) Simple banana recipe - Take a ripe banana, make it into paste, apply this on your hair and cover with a plastic bag. Then wrap a hot towel around the head, this step will help to lock the nutrients. Remove the cap after 15 to 20 minutes. Wash hair with a mild shampoo. If you make the content into smooth paste there wont be any difficulty in washing it off. For better results add almond or olive oil to the banana mask. 

b) Mix ripe banana pulp and yogurt apply it on hair leave it there for 20 minute and rinse it off.

2. How to make hair fall mask with banana

Mix the ingredients.

Two ripe banana, a tablespoon of honey few drops of olive oil, or coconut oil apply it on scalp and leave for 20 minutes rinse well.

3. Banana pack for soft hair

Mix the following

Ripe banana.

Avocado or cocoa.

Coconut milk.

Apply the mask on your hair leave  for 15-20 minutes.

This pack helps to make the hair soft ,if cocoa is added instead of avocado it improves the natural colour of your hair.

4. Pack For Shine And Health:

Mix banana with 1/4 cup of olive oil and one egg white in a blender then puree for 1 to 2 minutes. Leave this  on your hair for 10 to 15 minutes after that wash hair with shampoo and conditioner.

5. Banana hair pack for dry damaged hair

a) Make a hair mask mixing pulp of banana and  few drops of almond oil, apply it on scalp and hair, keep it there for 10 to 15 minute  .then wash it off.

b) Blend ripe banana with three spoons of honey apply this mask on your hair. Let the hair pack sit on your hair for 15-20 minutes, then wash the hair.

Benefit of above mask.

Banana contains  vitamin A and C and Vitamin E of the almond oil make your hair shiny and silky. It also hydrate your skin make it soft. Honey helps to keep the hair hydrated.

6. Deep conditioning mask with banana

Mix banana and melted shea butter, apply it over the hair leave it there overnight and rinse with mild shampoo. To get much better result add avocado oil or hemp oil. This increases the moisture content of hair and give extra nutrients to hair This mask will work as a deep conditioner for your dry hair. 

Take care of the following 

a) After hair wash there should not be any chunks of banana in your hair, so while making mask  use banana in pulp form without chunks, blend all contents well

a) You should not let  the mask dry on hair, wash it when it is wet, so hair can be easily cleaned. 

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Treatment of heartburn and Gastro esophageal reflux disease

Aims of treatment is adequate symptom control.

For most patients, the aim is acceptable symptom control.

General measures for managing gastro-oesophageal

reflux disease

Obese and overweight people are advised to lose weight, this will help in better symptom control.

Patients are advised to  raise the head end  of the bed on 15 cm wooden blocks.This has been found to be useful

Medications - Avoid non-steroidal anti-inflammatory drugs.

Avoid or reduce dose of nitrates, calcium channel antagonists, and anticholinergics.

Patients are advised to avoid or reduce smoking,large evening meals, food or drink within 3 hours of bedtime  should be avoided - Small frequent meals are better in these patients.

Fats or chocolate should be reduced or avoided.

Problem producing food and drinks are avoided especially citrus fruits, fruit juices, tea, coffee, peppermint, onions, garlic, cinnamon, cloves

Antacids and analgesics.

Short term relief is obtained with antacids. Many people on self medication are on this drugs. Antacids form a layer over the stomach content and help to reduce the reflux. Better when given with food.

Acid suppression therapy

H2 receptor Inhibitors  and the proton pump inhibitors are the two major groups.  Proton pump inhibitors are more rapid and effective in symptoms  relief and  healing oesophagitis.

The optimal daily dose  of proton pump inhibitors are given below

Omeprazole 20 mg.

Lansoprazole 30 mg

Pantoprazole 40 mg.

Rabeprazole 20 mg.

Motility modifying drugs

Metoclopramide and Domperidone are the agents, they are useful in symptom control but not useful in healing esophagitis. Metoclopramide is particularly useful GERD ,however, these drugs may be more useful in heart burn with nausea or early satiety.

Surgery

Indicated only in those people require long term medical therapy. Conventional and Laparoscopic anti-refluxsurgery is useful.

Indications for surgical treatment

Patients poorly responding to medical treatment and patients with persisting reflux that is regurgitation of gastric contents without symptom of heartburn especially at night may get benefit from surgery.

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Screening for diabetes and prediabetes.

Diabetes is a  chronic disease that will lead to complication in multiple organs in the body on long term especially if poorly controlled. Global increase in diabetes is due to population ageing, sedentary life style, obesity and  altered dietary habits.

Type 2 diabetes remain undiagnosed until the complication develops. One third of people living with diabetes is undiagnosed. Sceening program will help in detecting early recognition of diabetes. All those people who are at high risk for developing diabetes should be screened.

Criteria for screening asymptomatic people.

(a) Individual at 45 years and above  particularly if BMI more than  25kg/m2. If normal it should be repeated at 3 yearly interval.

(b) Testing should be done in younger age  especially if they have risk factors.

1. Physically inactive.

2. First degree relatives with diabetes mellitus.

3. Members of high risk ethnic group such as African Americans, Native American, Lation, Asian American, Pacific Islander.

4. Females with history of gestational diabetes or delivered a baby more than 9 lb.

5. Females with polycystic ovarian syndrome.

6. Hypertensive  people with BP more than 140/90 mm of Hg.

7. Those with Triglyceride more than 250mg/dl or HDL cholesterol less than 35 mg/dl.

8. Previous test showed impaired glucose tolerance or fasting glucose.

9. People with  other clinical features of insulin resistance  eg. Acanthosis Nigricans.

10. People with heart disease.

Screening test

To detect future diabetes the following test are used

Fasting glucose test(FBS)

Oral glucose tolerance test ( 2 hours after taking  75gm of glucose blood test is done).

The cumulative incidence of diabetes over 5-6 yrs based on above test Normal FBS, normal oral glucose tolerance - low risk 4 - 5%.

Impaired FBS, normal oral glucose tolerance - intermediate risk 20-34%.

Normal   FBS, Impaired oral glucose tolerance - intermediate risk 20-34%.

Impaired FBS, Impaired oral glucose tolerance - 38-65%.

Blood glucose level 2 hours after food intake (postprandial blood sugar )is directly related to the mortality and morbidity in heart disease, so 2 hour oral glucose tolerance test is done as screening procedure in people with heart disease.

Fasting glucose test is more convenient to people, more reproducible and cost effective hence ADA recommend fasting blood glucose test as the screening test.

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