Steps you can take to become slim

 Set realistic goals: Determine a healthy and realistic weight loss goal, and develop a plan to reach that goal.

1. Adopt a healthy diet: Eating a diet that is high in fruits, vegetables, whole grains, and lean proteins can help you achieve a healthy weight. Avoid processed foods, sugary drinks, and excessive amounts of saturated and trans fats.

2. Increase physical activity: Regular exercise can help you burn calories and lose weight. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

3. Monitor your progress: Keep track of your weight and measurements, and take note of how your clothes are fitting. This can help you stay motivated and on track.

4. Get enough sleep: Lack of sleep can disrupt your hormone balance and increase your appetite. Aim for 7-9 hours of sleep per night.

5. Be patient: weight loss is a journey and requires time and patience. Don't get discouraged if you don't see results immediately.

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Assessment of weight loss and treatment

Assessment of weight loss and treatment

1. Indications of assessment .
2. Following are the indication for assessment of weight loss . When the patient has
3. 5% weight loss in one month
4. 10% weight loss in six months
5. Body mass index <21
6. Change in fit of clothing
7. Change in appetite, smell, or taste
8. Abdominal pain, nausea, vomiting, diarrhea, constipation, dysphagia

Assessment of people with weight loss.
Those with significant weight loss usually manifest , four cardinal manifestation.They are given below
Loss of appetite,
Loss of muscle mass
Cachexia (combines weight loss, loss of muscle and adipose tissue,loss of appetite, and weakness),
Dehydration.
Detailed history and physical examination  including dental evaluation is very important .Other things to be done as part of assessment are
Cancer screening, Mini-Mental State Examination, Mini-Nutritional Assessment, ,Assessment Questionnaire, Observation of eating,  Activities of daily living , Instrumental activities of daily
Living.
Almost all patients with malignancy and more than 90% of those with weight loss due to a reason will have atleast one laboratory abnormality.

Tests to be done are
Laboratory tests

1. Complete blood count
2. Comprehensive electrolyte and metabolic panel,
3. including liver and kidney  function tests
4. Thyroid function tests
5. Erythrocyte sedimentation rate
6. C-reactive protein
7. Ferritin
8. HIV testing, if indicated in high risk persons
9. Radiology
10. Chest x-ray
11. Abdominal ultrasound (USG)

Treatment
1.First thing tobe done is to identification and treatment of  the underlying cause.
2.Certain causes are treatable which include metabolic, psychiatric, infectious, or other systemic disorders .That will help to restore the weight.
3.Drugs causing nausea and loss of appetite should be changed.
4.Nutritional supplementation , high-energy drinks,supplements should be taken between meals
5.In some patients  antidepressant mirtazapine results in a significant increase in body weight,

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Complications of obesity

Complications of obesity

Obesity is a risk factor for many disease.It increases the morbidity and mortality.Obesity has both physical and psychosocial aspect.There is 10 TO 12 fold increase in mortality in obese people in the age group of  25 to35 years compared to non obese.Weight reduction reduce the mortality and is strongly advised.Medical complications of obesity are many and well known. Complications are more in those who gain weight rapidly than slowly over long time.

The risk for heart disease and diabetes are more in those with abdominal obesity . This is assessed clinically by measuring waist circumference.

In men

Normal measurement is up to  94 cm

Complications are increased at more than  102 cm.

In women

Normal waist circumferences in women are: 80 cm,

Increased risk   80-88 cm,

substantially increased risk  88 cm.

The social complications may be painful.It will start from the school ,affect job opportunities and social status

CO-MORBIDTY

1. Type ii diabetes
2. Hypertension
3. Dyslipidaemia
4. Obstructive sleep apnoea
5. Venous stasis syndromes
6. Osteorthritis
7. Greater risk of breast,colon cancer
8. Greater risk of cardiac  & cerebral vascular events
9. Chronic obesity hypoventilation (pickwickian)
10. Pseudotumor cerebri
11. Poor Q.O.L.
12. Herniae
13. Cholecystitis
14. Difficulty in detecting physical findings

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Assessment of weight loss and treatment Indications of assessment .

Assessment of weight loss and treatment

Indications of assessment .

1. Following are the indication for assessment of weight loss . When the patient has 
2. 5% weight loss in one month
3. 10% weight loss in six months
4. Body mass index < 21
5. Change in fit of clothing
6. Change in appetite, smell, or taste
7. Abdominal pain, nausea, vomiting, diarrhea, constipation, dysphagia

Assessment of people with weight loss.

Those with significant weight loss usually manifest , four cardinal manifestation.They are given below

1. Loss of appetite
2. Loss of muscle mass Cachexia (combines weight loss, loss of muscle and adipose tissue,loss of appetite, and weakness)
3. Dehydration.
4. Detailed history and physical examination  including dental evaluation is very important .

Other things to be done as part of assessment are

1. Cancer screening
2. Mini-Mental State Examination
3. Mini-Nutritional Assessment
4. Assessment Questionnaire
5. Observation of eating
6. Activities of daily living
7. Instrumental activities of daily
8. Living

Almost all patients with malignancy and more than 90% of those with weight loss due to a reason will have at least one laboratory abnormality.Tests to be done are

Laboratory tests

Complete blood count
Comprehensive electrolyte and metabolic panel,including liver and kidney  function tests

Thyroid function tests

Erythrocyte sedimentation rate

C-reactive protein

Ferritin

HIV testing, if indicated in high risk persons

Radiology

Chest x-ray

Abdominal ultrasound (USG)

Treatment

1. First thing to be done is to identification and treatment of  the underlying cause.
2. Certain causes are treatable which include metabolic, psychiatric, infectious, or other systemic disorders .That will help to restore the weight.
3. Drugs causing nausea and loss of appetite should be changed.
4. Nutritional supplementation , high-energy drinks,supplements should be taken between meals
5. In some patients  antidepressant mirtazapine results in a significant increase in body weight.

Read More

Anaemia - The Diets that you should be taken care

Anaemia is a blood disorder characterized by a reduced red blood cell count, which makes it difficultfor the blood to carry oxygen to brain and other parts of the body.

Symptoms to look for are, 

1. Fatigue
2. Dizziness
3. Pale skin
4. Shortness of breath 
5. Headaches

Anaemia can be caused by various factors . Lack of iron or certain vitamins such as folic acid and vitamin B12 are the common factors that caused anaemia.

Iron-deficiency anaemia
The amount of iron that we need depends on your age and sex. The best sources of iron come from red meat. We get a good proportion of iron from non-animal sources too.

Sources of Iron include:

1. Red meat and offal - Eg: Beef, Lamb, Pork, Kidneys, Liver, Heart.
2. Fish and shellfish - Eg: Sardines, Pilchards, Crab, Shrimps, Mmussels.
3. Eggs.
4. Cereal and cereal products - Eg: Bread, Rice , corn flakes and Oatcakes.
5. Nuts and seeds - Eg: Hazelnuts, Macadamia nuts, Peanuts, Pecans, Walnuts, Sesame seeds, Sunflower seeds.
6. Green leafy vegetables - Eg: Broccoli, Spinach, Watercress
7. Beans and pulses - Eg: Baked beans, Peas, Lentils, Chickpeas, Black-eyed beans
8. Dried fruit - Eg: Raisins, Apricots, Prunes, Currants, Figs.

Folic acid-deficiency anaemia
As usual the cause is not eating enough foods which contain folic acid.

Sources of folic acid include:

1. Fresh, Raw Or Cooked Brussels Sprouts, Asparagus, Spinach, Kale, Broccoli, Spring Beans, Green Beans, Cabbage, Cauliflowe.
2. Cooked black-eyed beans 
3. Breakfast cereals (with folic acid added to them).
4. Liver (note, pregnant women should avoid liver).
5. Kidneys, yeast and beef extracts.

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Foods you shouldnot refrigerate

Many of us actually store some of the foods in the fridge, but they are really best when kept on the kitchen counter or in the pantry. In fact, storing certain foods in the refrigerator can change their flavor or texture, or speed up their deterioration and make them moldy

Cold can stop the ripening process of fruits, including the fruits which we consider as vegetables and sometimes the temperatures in the refrigerator can break down the cell walls in fruits or vegetables, turning them mealy. degrees is ideal - and prefer warmer rather than colder conditions, if you can't provide that ideal.

Here is your guide for foods that should not be refrigerated:

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