TTIMES WORLD: Today's News Report

Wednesday, September 22, 2021
Washington, DC, USA


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Surgeries Most Commonly Performed By Plastic Surgeons
Both Children and Adults

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The work of plastic surgeons encompasses different parts of the body. They work with both children and adults.

1. Reconstructive surgery: It is the main job of a plastic surgery specialist and includes head & neck reconstruction, burns and trauma surgery, skin and soft tissue, breast reconstruction, cleft lip and palate surgery, and more.

2. Aesthetic Surgery: Aesthetic procedures are carried out on both men and women and much of this work is done privately. Some of the aesthetic surgeries include otoplasty, breast augmentation, eyelid surgery, liposuction and facelifts.


3. Augmentation Mammoplasty – Various surgical processes are adopted to give new shape to the breasts. The fat is transformed to breasts from different areas of the body.

4. Robot-Assisted Surgery – Robot-assisted surgery helps in performing complex surgeries with more flexibility, precision, and control. Results achieved are minimally invasive!!

5. Craniomaxillofacial Surgery – This type of surgery is used in treating diseases, injuries, and defects in the head, neck, face, and jaws. It is a globally acclaimed surgical specialty.

6. Liposuction – It is an attempt to transform the shape of the body. In such type of treatment excess fat is removed from the body with the help of surgery.

Do You Get Frequent Severe Shoulder Pains?
You May Have This Condition

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THORACIC OUTLET SYNDROME

Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck and numbness in your fingers.

TREATMENT – Treatment for thoracic outlet syndrome usually involves physical therapy and pain relief measures. Many people show signs of improvement with these approaches or improve completely. However, in some cases, the doctors might end up recommending a surgery.

SYMPTOMS OF THORACIC OUTLET SYNDROME

Severe Shoulder Pain - Main symptom of this condition, often severe, may subside on its own.

WASTING IN THE THUMB – When the patient suffers from neurogenic thoracic outlet syndrome, often they experience wasting in the fleshy base of the thumb. 

NUMBNESS IN THE HANDS AND FINGERS – experience numbness in hands and fingers because of reduced blood flow to the extremities. 

DISCOLORATION OF THE ARMS N HANDS – When the arteries and veins of the shoulder get compressed, This poor circulation can also result in a weakened or even absent pulse in the arm.



Countries with Improved Healthcare System in Africa 2020
Countries with Improved Healthcare System in Africa 2020-Nigeria

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Top 10 Countries with Improved Healthcare System in Africa 2020

African countries lose millions of US Dollars yearly in medical tourism.

Top 10 Countries with Improved Healthcare System in Africa 2020


Health Systems in India
India

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Health systems in India


Background

Report on the Health Survey and Development Committee, commonly referred to as the Bhore Committee Report, 1946, has been a landmark report for India, from which the current health policy and systems have evolved.1 The recommendation for three-tiered health-care system to provide preventive and curative health care in rural and urban areas placing health workers on government payrolls and limiting the need for private practitioners became the principles on which the current public health-care systems were founded. This was done to ensure that access to primary care is independent of individual socioeconomic conditions. However, lack of capacity of public health systems to provide access to quality care resulted in a simultaneous evolution of the private health-care systems with a constant and gradual expansion of private health-care services.2

Although the first national population program was announced in 1951, the first National Health Policy of India (NHP) got formulated only in 1983 with its main focus on provision of primary health care to all by 2000.3 It prioritized setting up a network of primary health-care services using health volunteers and simple technologies establishing well-functioning referral systems and an integrated network of specialty facilities. NHP 2002 further built on NHP 1983, with an objective of provision of health services to the general public through decentralization, use of private sector and increasing public expenditure on health care overall.4 It also emphasized on increasing the use of non-allopathic form of medicines such as ayurveda, unani and siddha, and a need for strengthening decision-making processes at decentralized state level.

Due to the India's federalized system of government, the areas of governance and operations of health system in India have been divided between the union and the state governments. The Union Ministry of Health & Family Welfare is responsible for implementation of various programs on a national scale (National AIDS Control Program, Revised National Tuberculosis Program, to name a few) in the areas of health and family welfare, prevention and control of major communicable diseases, and promotion of traditional and indigenous systems of medicines and setting standards and guidelines, which state governments can adapt. In addition, the Ministry assists states in preventing and controlling the spread of seasonal disease outbreaks and epidemics through technical assistance.5 On the other hand, the areas of public health, hospitals, sanitation and so on come under the purview of the state, making health a state subject. However, areas having wider ramification at the national level, such as family welfare and population control, medical education, prevention of food adulteration, quality control in manufacture of drugs, are governed jointly by the union and the state government.

Public health-care infrastructure in India

India has a mixed health-care system, inclusive of public and private health-care service providers.6 However, most of the private health-care providers are concentrated in urban India, providing secondary and tertiary care health-care services. The public health-care infrastructure in rural areas has been developed as a three-tier system based on the population norms and described below.7 The urban health system is discussed in the article on Urban Newborn.

Sub-centers

A sub-center (SC) is established in a plain area with a population of 5000 people and in hilly/difficult to reach/tribal areas with a population of 3000, and it is the most peripheral and first contact point between the primary health-care system and the community. Each SC is required to be staffed by at least one auxiliary nurse midwife (ANM)/female health worker and one male health worker (for details see recommended staffing structure under the Indian Public Health Standards (IPHS)). Under National Rural Health Mission (NRHM), there is a provision for one additional ANM on a contract basis.

SCs are assigned tasks relating to interpersonal communication in order to bring about behavioral change and provide services in relation to maternal and child health, family welfare, nutrition, immunization, diarrhea control and control of communicable diseases programs. The Ministry of Health & Family Welfare is providing 100% central assistance to all the SCs in the country since April 2002 in the form of salaries, rent and contingencies in addition to drugs and equipment.

Primary health centers

A primary health center (PHC) is established in a plain area with a population of 30 000 people and in hilly/difficult to reach/tribal areas with a population of 20 000, and is the first contact point between the village community and the medical officer. PHCs were envisaged to provide integrated curative and preventive health care to the rural population with emphasis on the preventive and promotive aspects of health care. The PHCs are established and maintained by the State Governments under the Minimum Needs Program (MNP)/Basic Minimum Services (BMS) Program. As per minimum requirement, a PHC is to be staffed by a medical officer supported by 14 paramedical and other staff. Under NRHM, there is a provision for two additional staff nurses at PHCs on a contract basis. It acts as a referral unit for 5-6 SCs and has 4-6 beds for in-patients. The activities of PHCs involve health-care promotion and curative services.

Community health centers

Community health centers (CHCs) are established and maintained by the State Government under the MNP/BMS program in an area with a population of 120 000 people and in hilly/difficult to reach/tribal areas with a population of 80 000. As per minimum norms, a CHC is required to be staffed by four medical specialists, that is, surgeon, physician, gynecologist/obstetrician and pediatrician supported by 21 paramedical and other staff. It has 30 beds with an operating theater, X-ray, labor room and laboratory facilities. It serves as a referral center for PHCs within the block and also provides facilities for obstetric care and specialist consultations.

First referral units

An existing facility (district hospital, sub-divisional hospital, CHC) can be declared a fully operational first referral unit (FRU) only if it is equipped to provide round-the-clock services for emergency obstetric and newborn care, in addition to all emergencies that any hospital is required to provide. It should be noted that there are three critical determinants of a facility being declared as a FRU: (i) emergency obstetric care including surgical interventions such as caesarean sections; (ii) care for small and sick newborns; and (iii) blood storage facility on a 24-h basis.

Schematic diagram of the Indian Public Health Standard (IPHS) norms, which decides the distribution of health-care infrastructure as well the resources needed at each level of care is shown in Figure 1.

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Indian Public Health System. Reprinted with permission from National Rural Health Mission, Ministry of Health and Family Welfare, Government of India.21

On the basis of the distributional pyramid, currently there are 722 district hospitals, 4833 CHCs, 24  049 PHCs and 148 366 SCs in the country.

National rural health mission: strengthening of rural public health system

NRHM, launched in 2005, was a watershed for the health sector in India. With its core focus to reduce maternal and child mortality, it aimed at increased public expenditure on health care, decreased inequity, decentralization and community participation in operationalization of health-care facilities based on IPHS norms. It was also an articulation of the commitment of the government to raise public spending on health from 0.9% to 2-3% of GDP.8

Seeking to improve access of rural people, especially poor women and children, to equitable, affordable, accountable and effective primary health care, NRHM (2005-2012) aimed to provide effective health care to the rural population throughout the country with special focus on 18 states having weak public health indicators and/or weak infrastructure. Within the mission there are high-focused and low-focused states and districts based on the status of infant and maternal mortality rates, and these states are provided additional support, both financially and technically. Gradually it has emerged as a major financing and health sector reform strategy to strengthen the state health systems.

Major initiatives have been undertaken under NRHM for architectural correction of the rural health system—in terms of availability of human resources, program management, physical infrastructure, community participation, financing health care and use of information technology. Some of these activities are tabulated below (Table 1).

Table 1

Glimpse of activities under the National Rural Health Mission (2005–2013)
Human resources (new providers)931 239 Accredited social health activists
 27 421 Doctors at PHCs, 4078 specialists at CHCs*
 40 119 Staff nurses
 72 984 ANM
Human resources (program management)618 District Program Managers and 633 District Accounts Managers deployed
AmbulanceMore than 30 000 ambulances deployed nation wide
Community participation structure499 210 Village level Health Sanitation and Nutrition Committees (VHSNCs) created
 29 063 Patient Welfare Committees created at public facilities
Web-based mother and child tracking systemTracking 105 million mother–baby dyads
Finances providedA total of 21 billion USD invested (2005–2015) by the central government
OtherBetween 2009 and 2013, graduate medical capacity increased by 54% and post graduate medical seats by 74%

Abbreviations: ANM, auxiliary nurse midwives; CHC, community health centers; PHC, primary health center.

Source: Adapted from Quarterly NRHM MIS reports: National Executive Summary9 and Rural Health Statistics*.10

The mission emphasized on increasing health-care delivery points as well as facilities available at the health-care delivery points. It not only focused on increasing the number of physicians, specialists, staff nurses, as well as ANMs, but also gave importance to increasing the production capacity of medical colleges at graduate and post graduate levels. Physical infrastructure was enhanced by creating more health centers, newborn care units and renovating existing centers, which increased the capacity of health systems to treat more mothers and children. Special efforts were made to strengthen community participation through the formation of health committees at the village level and patient welfare committees at public health-care facilities. Information technology was used to track delivery of services to the mother and child. And all this has been an outcome of increased financial assistance by the central government and increased rates of utilization. During the period 2005-2013, the total investment by the central government equalled nearly 17 billion USD.


National programs and initiatives for newborn health

In India, major policies and national programs are planned and implemented during the 5-year planning phase. Despite the fact that no explicit programs on newborn care have been designed in the past, various programs and the 5-year plans in the country had focused on provision of services for mothers and children.111213141516171819 The launch of the CSSM program in 1992, for the first time included an essential newborn care component, and specifically integrated newborn care in the maternal and child health program. Thereafter, newborn care started receiving more attention and resources in the subsequent programs and initiatives.

Under NRHM, newborn health received unprecedented attention and resources with the launch of several new initiatives aimed at reducing the burden of maternal and newborn mortality and morbidity.

In February 2013, the government launched the strategic approach, reproductive, maternal, newborn, child and adolescent health (RMNCH+A),20 to accelerate actions for equity, harmonization and improved coverage of services. Although the RMNCH+A approach recognized that newborn health and survival is inextricably linked to women's health, across all life stages, it also clearly emphasized interlinkages between each of the five life stages with adolescent health as a distinct life stage, and connected community, outreach- and facility-based services. On the basis of this approach, the central government has taken vital policy decisions to combat major causes of newborn death, providing special attention to sick newborns, babies born too soon (premature) and too small (small for gestational age).

Specific interventions for the newborn included under the RMNCH+A strategy include:

  1. Delivery of antenatal care package and tracking of high-risk pregnancies;

  2. Skilled care at birth, emergency obstetric care and postpartum care for mother;

  3. Home-based newborn care and prompt referral;

  4. Facility-based care of the sick newborn;

  5. Integrated management of common childhood illnesses (diarrhea, pneumonia and malaria)

The strategy identifies the roles to be played at each level of care and the service provision and health systems requirement in terms of manpower and commodities for each of them. (Figure 1)212223 SCs and PHCs are designated as delivery points; CHCs (which are the FRUs) and district hospitals have been made functional 24 × 7 to provide basic and comprehensive obstetric and newborn-care services. Only those health facilities are designated as FRUs that have the facilities and manpower to conduct a caesarean section. Moreover, the strategic document identifies the required capacity building efforts for which NRHM has produced manuals. So far out of 116 capacity building manuals, 10 are dedicated to newborns. The document also has the guidance for reaching remote inaccessible areas to ensure maternal and child Health care.

One of the key aspects of the document and one that certainly contributes to its comprehensive nature is the involvement of various stakeholders in its development. Apart from the core drafting team of the Ministry of Health and Family Welfare, the technical support team is represented by the development partners, academic partners, practitioners, nationally and internationally. This has proved to be an important step for wider adaptation of processes and is crucial for implementation success.


Conclusion

India has been focussing on providing comprehensive care to mother and child. It has framed policies that allow the design and implementation of programs on newborn care in an inclusive manner. However, looking at the pace of achievements of the targets so far and future targets, it needs to focus more on framing of the policies in terms of building capacity of existing human resources, enhancing further allocation of finances dedicated toward newborn care, identifying areas through operational research, which can enhance quantity and quality of care for newborn care in India. The path is set and we need to operationalize and move forward.

Diabetes: Treatment, Diagnosis and Prevention
What Diabetes Mellitus is About?

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Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high. Persons with diabetes have too much sugar in their blood. There is no cure for diabetes. People with diabetes need to manage their disease to stay healthy.
It is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood.

Persons with diabetes have too much sugar in their blood. This problem can start when a person is young (Type 1 diabetes) or older (Type 2 diabetes). Type 1 diabetes is usually more serious, this can only be control by insulin (drug/Injection).
Diabetes is a serious complex condition which can affect the entire body. Diabetes requires daily self care and if complications develop, diabetes can have a significant impact on quality of life and can reduce life expectancy. While there is currently no cure for diabetes, you can live an enjoyable life by learning about the condition and effectively managing it. It often referred to by doctors as diabetes mellitus.

Types of Diabetes Mellitus
There are three major types of diabetes:
Type 1 diabetes
The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. Type 1 diabetes is usually more serious and young people need a medicine called insulin to control it. This problem can start when a person is young or older
Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. We do not know what causes this auto-immune reaction. Type 1 diabetes is not linked to modifiable lifestyle factors. There is no cure and it cannot be prevented.

  • Occurs when the pancreas does not produce insulin
  • Represents around 10% of all cases of diabetes and is one of the most common chronic childhood conditions
  • Onset is usually abrupt and the symptoms obvious
  • Symptoms can include excessive thirst and urination, unexplained weight loss, weakness and fatigue and blurred vision
  • Is managed with insulin injections several times a day or the use of an insulin pump.

Type 2 diabetes
The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). Most people with diabetes have Type 2, starting after age 40.
The most common form of diabetes is called type 2, or non-insulin dependent diabetes.
This is also called “adult onset” diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes. 
People with type 2 are able to produce some of their own insulin. Often, it’s not enough. And sometimes, the insulin will try to serve as the “key” to open the body’s cells, to allow the glucose to enter. But the key won’t work. The cells won’t open. This is called insulin resistance. 
Often, type 2 is tied to people who are overweight, with a sedentary lifestyle. 
Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

Gestational diabetes/Pregnant Diabetes
This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.
High blood glucose is caused because the mother can’t produce enough insulin (a pregnant woman’s insulin needs are two to three times that of normal).
There are two reasons why the mother needs more insulin:
Because pregnancy causes certain types of hormones (that are made by the placenta) to be released., These hormones make it harder for insulin to do its job because the growth demands of the foetus (developing baby) increases the mother's need for insulin

Unlike type 1 and type 2 diabetes, gestational diabetes is only temporary and usually disappears after pregnancy. However, a woman who has had gestational diabetes has an increased risk (50-60%) of developing type 2 diabetes in the future; therefore they should be tested for type 2 diabetes each year.

What you need to know about diabetes

  • Diabetes is a long-term condition that causes high blood sugar levels.
  • In 2013 it was estimated that over 382 million people throughout the world had diabetes (Williams textbook of endocrinology).
  • Type 1 Diabetes - the body does not produce insulin. Approximately 10% of all diabetes cases are type 1.
  • Type 2 Diabetes - the body does not produce enough insulin for proper function. Approximately 90% of all cases of diabetes worldwide are of this type.
  • Gestational Diabetes - this type affects females during pregnancy.
  • The most common diabetes symptoms include frequent urination, intense thirst and hunger, weight gain, unusual weight loss, fatigue, cuts and bruises that do not heal, male sexual dysfunction, numbness and tingling in hands and feet.
  • If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life.
  • Type 2 patients need to eat healthily, be physically active, and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.
  • As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.
  • As smoking might have a serious effect on cardiovascular health, diabetics should stop smoking.
  • Hypoglycemia - low blood glucose - can have a bad effect on the patient. Hyperglycemia - when blood glucose is too high - can also have a bad effect on the patient.
Causes of Diabetes Mellitus
Causes of type 1 diabetes
  • Heredity plays an important part in determining who is likely to develop type 1 diabetes.
  • What is known is that your immune system — which normally fights harmful bacteria or viruses attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.

Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what many of those factors are is still unclear.

  • Environmental Factors

Causes of type 2 diabetes
In pre-diabetes — which can lead to type 2 diabetes  and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it's needed for energy, sugar builds up in your bloodstream.
Exactly why this happens is uncertain, although it's believed that genetic and environmental factors play a role in the development of type 2 diabetes. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.
Causes of gestational diabetes
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin.
Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your cells and too much stays in your blood, resulting in gestational diabetes.
 Symptoms/Signs of Diabetes Mellitus
Early signs of diabetes: Later, more serious signs:

  • Always hungry
  • Always thirsty
  • Always tired
  • Frequent vaginal infections
  • Itchy skin
  • Loss of consciousness (in extreme cases)
  • Periods of blurry eyesight
  • Some loss of feeling in hands or feet
  • Sores on the feet that do not heal
  • Urinates (pees) often and a lot
  • Weight loss


Diabetes

How to diagnose Diabetes Mellitus
In order to find out whether a person has diabetes, test her urine to see if there is sugar in it. Diabetes and pre-diabetes are diagnosed with a fasting plasma glucose test, oral glucose tolerance test, or random plasma glucose test. One way to test the urine is to taste it. If it tastes sweet to you, have 2 other persons taste it. Have them also taste the urine of 3 other people. If everyone agrees that the same person’s urine is sweeter, she is probably diabetic.
Another way of testing urine is to use special paper strips (for example, Uristix). If these change color when dipped in the urine, it has sugar in it.
If the person is a child or young adult, he should be seen by an experienced health worker or doctor.

To diagnose GDM
Get tested. During your doctor’s visit, you will likely be tested for GDM through an “initial glucose challenge test” and/or a follow-up “glucose tolerance testing.”
In the “initial glucose challenge test,” you’ll be asked to drink a syrupy, sugar solution and then, after an hour has passed, your blood will be tested to measure your sugar levels.

How to Prevent Diabetes
Tips to help you reduce your risk of type 2 diabetes

  • Type 1 diabetes cannot be prevented. But to some extent Type 2 diabetes can be delayed or prevented by making simple changes in our everyday lives.
  • In Type 1 diabetes, the body's immune system destroys the insulin-producing cells, but currently the cause remains uncertain.

Tips to help you reduce your risk of type 2 diabetes

  • Check your risk of diabetes. Take the Life! risk assessment test and learn more about your risk of developing type 2 diabetes. A 12+ score indicates that you are at high risk and may be eligible for the Life! program - a free Victorian lifestyle modification program that helps you reduce your risk of type 2 diabetes and cardiovascular disease, or call 13 RISK (13 7475).
  • Manage your weight. Excess body fat, particularly if stored around the abdomen, can increase the body’s resistance to the hormone insulin. This can lead to type 2 diabetes.
  • Exercise regularly. Moderate physical activity on most days of the week helps manage weight, reduce blood glucose levels and may also improve blood pressure and cholesterol.
  • Eat a balanced, healthy diet. Reduce the amount of fat in your diet, especially saturated and trans fats. Eat more fruit, vegetables and high-fibre foods. Cut back on salt.
  • Limit takeaway and processed foods. ‘Convenience meals’ are usually high in salt, fat and kilojoules. It’s best to cook for yourself using fresh ingredients whenever possible.
  • Limit your alcohol intake. Too much alcohol can lead to weight gain and may increase your blood pressure and triglyceride levels. Men should have no more than two standard drinks a day and women should have no more than one.
  • Quit smoking. Smokers are twice as likely to develop diabetes as non-smokers.
  • Control your blood pressure. Most people can do this with regular exercise, a balanced diet and by keeping a healthy weight. In some cases, you might need medication prescribed by your doctor.
  • Reduce your risk of cardiovascular disease. Diabetes and cardiovascular disease have many risk factors in common, including obesity and physical inactivity.
  • See your doctor for regular check-ups. As you get older, it’s a good idea to regularly check your blood glucose, blood pressure and blood cholesterol levels.

Tips to help you reduce your risk of GDM

  • Get a family history. The first step in preventing GDM is determining your risk factors for developing it. If it turns out that you are at high risk, then you and your doctor take steps towards lowering your risk and keeping you and the baby healthy.
  • Have your blood sugar tested as early as 3 months before you plan to become pregnant in order to establish your baseline levels and to if you fall in a normal range.
  • Plan to lose any excess weight before pregnancy. Weight loss is not advised during pregnancy, so if you are overweight and concerned about this increasing your risk for GDM, try to lose the extra weight (between 5% to 7% of your body weight if you are overweight) before you become pregnant
  • Meet with your doctor (gynecology) early on in your pregnancy, and frequently throughout, in order to ensure the health of you and your baby
  • Let your doctor know that you are particularly concerned about GDM, either because of your family history or other personal risk factors. Ask if they recommend any special diet, exercise, or testing plans for you to follow during your pregnancy.
  • Eat more fiber. It is important to maintain steady blood sugar levels if you are at risk of gestational diabetes. Fiber will help you stabilize your sugar levels. In a study of the diets of women before they got pregnant, those who increased their daily fiber intake by 10 grams reduced their risk of GDM by 26%. Try to include more high-fiber foods to lower your risk.
  • Take more of portentous food
  • Lean meats, such as chicken, are good sources of protein and safe for pregnant women to consume. Avoid fish as a lean protein source, as its high mercury levels can be dangerous for pregnant women
  • Keep an eye on portion sizes and try to eat several small meals frequently throughout the day to maintain your blood sugar levels.[17] For example, you could eat a 300 to 400 calorie meal once every three hours during the day so that you consume a total of five meals totaling between 1,500 to 2,000 calories.
  • Take more fresh fruit: Fruits are good for you, but sugary fruit juices should be avoided. Fruits are high in natural sugars which in and of itself is not a bad thing, but one small glass of orange juice can contain the juice of as many as 10 oranges and there may also be added artificial sweeteners.
  • Exercises Daily. Safe exercises to participate in during pregnancy typically include low impact exercises, such as walking and swimming. Avoid doing any type of exercise that is high impact or that has a higher potential for injuries, such as contact sports.

Treatment for Diabetes Mellitus

All types of diabetes are treatable. Diabetes type 1 lasts a lifetime, there is no known cure. Type 2 usually lasts a lifetime; however, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet and body weight control.
When a person gets diabetes after he is 40 years old, it can often be best controlled without medicines, by eating correctly and getting plenty of exercise. The diabetic person’s diet is very important and must be followed carefully for life.
The major goal in treating type 1 and type 2 diabetes is to control blood sugar (glucose) levels within the normal range, with minimal excursions to low or high levels.
Type 1 diabetes (T1D) is treated with:

  • Insulin
  • Exercise

Type 2 diabetes (T2D) is treated:
First with weight reduction, a type 2 diabetes diet, and exercise
Oral medications are prescribed when these measures fail to control the elevated blood sugars of type 2 diabetes.
If oral medications become ineffective treatment with insulin is initiated.

The diabetic diet:

Fat people with diabetes should lose weight until their weight is normal. Diabetics must not eat any sugar or sweets, or foods that taste sweet.It is important for them to eat lots of fresh vegetables and high fiber foods, such as whole grain breads. But diabetics should also eat some other starchy foods, like beans, rice, and potatoes, and also foods high in protein.

Diabetes in adults can sometimes be helped by drinking the sap of the prickly pear cactus (nopal, Opuntia). To prepare, cut the cactus into small pieces and crush them to squeeze out the liquid. Drink 1 ½ cups of the liquid 3 times each day before meals.
To prevent infection and injury to the skin, clean the teeth after eating, keep the skin clean, and always wear shoes to prevent foot injuries. For poor circulation in the feet (dark color, numbness), rest often with the feet up. Follow the same recommendations as for varicose veins

Diabetes Home Remedies/Home Cure

  • Whole sum diet: Diet which is a combination of vegetables and fruits get a rich array of antioxidants such as vitamin C. Antioxidants prevents the oxidation and damage of artery walls, which otherwise can lead to plaque build-up and heart disease.
  • Basil leaves: Basil leaves have power to lower blood sugar levels. Basil leaves contain potent antioxidants that relieve oxidative stress; it's this stress that compounds problems in diabetics.
  • Bitter Gourd: Bitter gourd, also known as bitter melon, can be helpful for controlling diabetes due to its blood glucose lowering effects. It tends to influence the glucose metabolism all over your body rather than a particular organ or tissue. It helps increase pancreatic insulin secretion and prevents insulin resistance. Thus, bitter gourd is beneficial for both type 1 and type 2 diabetes. However, it cannot be used to entirely replace insulin treatment. Drink some bitter gourd juice on an empty stomach each morning. First remove the seeds of two to three bitter gourds and use a juicer to extract the juice. Add some water and then drink it. Follow this treatment daily in the morning for at least two months.

Also, you can include one dish made of bitter gourd daily in your diet.

  • Cactus juice and flax seeds: Cactus juice from is also helpful. Cactus juice can help decrease and stabilize blood glucose and insulin levels. Consuming flax seed reduces postprandial sugar level by 28 per cent.
  • Exercise: Exercise has the potential to control the diabetes by nonmedical means. It reduces the severity of the disease and significantly reduces the risk of long-term complications. The energy needed for exercise can help people to lose weight which helps to take some of the risk related to central obesity. Exercise is known to increase insulin sensitivity which essentially helps to tackle the root cause of type 2 diabetes. Also, regular exercise can also help to reduce cholesterol levels and help people to reduce high blood pressure. Even a little extra activity each day can help.
  • Moringa leaves: Also called Drumstick, the leaves of this plant are best known for their ability to boost one’s energy. In the case of diabetics, the moringa leaf increases satiety and slows the breakdown of food and lower blood pressure.

Tip: Take a few drumstick leaves, wash and crush them to extract their juice. Now take about 1/4th cup of this juice and drink it on an empty stomach, every morning to keep your sugar levels under control.

  • Green Tea: Unlike other tea leaves, green tea is unfermented and is high in polyphenol content. Polyphenol is a strong antioxidant and hypo-glycaemic compound that helps control the release of blood sugars and helps the body use insulin better. Read more 10 types of flavoured green tea that have 20 health benefits.

Tip: Steep a bag of green tea in hot water for 2-3 minutes. Remove the bag and drink a cup of this tea in the morning or before your meals.

  • Holy Basil (tulsi) leaves: The leaves of holy basil are packed with antioxidants and essential oils that produce eugenol, methyl eugenol and caryophyllene. Collectively these compounds help the pancreatic beta cells (cells that store and release insulin) to function properly and increase sensitivity to insulin. An added advantage is that the antioxidants present in the leaves help beat the ill effects of oxidative stress.
  • Indian blackberry (Jamun): A glycoside present in the seeds of Indian blackberry prevents the conversion of starch to sugar. It lowers blood sugar and helps prevent insulin spikes. Jambul also has properties that can protect you from heart diseases and other vascular disorders.

Tip: Eat around 5 – 6 jamuns in the morning to control your blood sugar levels. Alternatively, you can also add a spoonful of jamun seeds powder to a glass of warm water or milk and drink this daily for better control of diabetes.

  • Leaves of bilberry plant and cinnamon: The leaves of the bilberry plant are known to lower blood sugar levels. Also, 1gram cinnamon in the diet for a month lowers the blood sugar levels
  • Mango Leaves: The delicate and tender mango leaves can be used to treat diabetes by regulating insulin levels in the blood. They can also help improve blood lipid profiles. Soak 10 to 15 tender mango leaves in a glass of water overnight. In the morning, filter the water and drink it on an empty stomach.

You can also dry the leaves in the shade and grind them. Eat one-half teaspoon of powdered mango leaves two times daily.

  • Neem: Found abundantly in India, the bitter leaf has a number of amazing medicinal properties. Neem enhances insulin receptor sensitivity, helps improve blood circulation by dilating the blood vessels, lowers blood glucose levels and reduces one’s dependence on hypoglycaemic drugs.  Here are more health benefits of neem.

Tip: Drink the juice of the tender shoot of neem leaves on an empty stomach for best results

  • Meditation: Meditation lowers the insulin resistance in our body. Stress hormones such as cortisol, adrenaline and noradrenalin intensify the production of insulin and glucose levels. Reducing these neurohormones through the Transcendental Meditation technique helps to balance glucose and insulin in the blood. This helps to normalize metabolic syndrome and diabetes.


Diabetes

Complications of Diabetes Mellitus
Type 1 Complications

  • Anxiety
  • Ear Damage
  • Eye damage
  • Fingers, toes, and lips damage
  • Headache
  • Heart disease
  • Seizures
  • Sleepiness
  • Slurred speech
  • Rapid heartbeat
  • Sweating
  • Whiteness of skin

Type 2 Complications

By keeping your blood glucose level in a healthy range through meal planning, physical activity, and medications, you can avoid long-term complications of diabetes.
These complications develop over many years and they all relate to how blood glucose levels can affect blood vessels. Over time, high blood glucose can damage the body’s blood vessels, both tiny and large.
Damage to your tiny blood vessels causes microvascular complications; damage to your large vessels causes macrovascular complications.
Microvascular Complications: Eye, Kidney, and Nerve Disease
You have small blood vessels that can be damaged by consistently high blood glucose over time. Damaged blood vessels don’t deliver blood as well as they should, so that leads to other problems, specifically with the eyes, kidneys, and nerves.
Eyes: Blood glucose levels out of range for a long period of time can cause cataracts and/or retinopathy in the eyes. Both can cause loss of vision.
To avoid eye problems associated with diabetes, keep your blood glucose within range and have yearly eye check-ups that include a dilated eye examination with an eye doctor to monitor your eye health.

Cardiovascular disease: affects the heart and blood vessels and may cause fatal complications such as coronary artery disease (leading to heart attack) and stroke. Cardiovascular disease is the most common cause of death in people with diabetes. High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications.

Kidney disease (diabetic nephropathy): caused by damage to small blood vessels in the kidneys leading to the kidneys becoming less efficient or to fail altogether. Kidney disease is much more common in people with diabetes than in those without diabetes. Maintaining near normal levels of blood glucose and blood pressure can greatly reduce the risk of kidney disease.

Nerve disease (diabetic neuropathy): diabetes can cause damage to the nerves throughout the body when blood glucose and blood pressure are too high. This can lead to problems with digestion, erectile dysfunction, and many other functions. Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations. People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. However, with comprehensive management, a large proportion of amputations related to diabetes can be prevented. Even when amputation takes place, the remaining leg and the person’s life can be saved by good follow-up care from a multidisciplinary foot team. People with diabetes should regularly examine their feet.

Eye disease (diabetic retinopathy): most people with diabetes will develop some form of eye disease (retinopathy) causing reduced vision or blindness. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy. It can be managed through regular eye checks and keeping glucose and lipid levels at or close to normal.

Pregnancy complications: Women with any type of diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. To prevent possible organ damage to the fetus, women with type 1 diabetes or type 2 diabetes should achieve target glucose levels before conception. All women with diabetes during pregnancy, type 1, type 2 or gestational should strive for target blood glucose levels throughout to minimize complications. High blood glucose during pregnancy can lead to the foetus putting on excess weight. This can lead to problems in delivery, trauma to the child and mother, and a sudden drop in blood glucose for the child after birth. Children who are exposed for a long time to high blood glucose in the womb are at higher risk of developing diabetes in the future.

Complications of gestational diabetes
Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.
Complications would affect the mother and the baby and the could cause this for the baby:
Excess growth. Extra glucose can cross the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to require a C-section birth.
Low blood sugar. Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.

 Death: Untreated gestational diabetes can result in a baby's death either before or shortly after birth.

As for the mother complications can include:
Preeclampsia: .This condition is characterized by high blood pressure, excess protein in the urine, and swelling in the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and baby.
Death: Untreated gestational diabetes can result to death during labour or after birth.

 

What Causes Dark Circles Under Your Eyes?
Dark circles under the eyes

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Dark circles under the lower eyelids are common in men and women. Often accompanied by bags, dark circles can make you appear older than you are. To make matters worse, they can be difficult to get rid of.

Though they can affect anyone, dark circles are most common in people who:

While fatigue may seem like the most logical explanation for this condition, there are a number of factors that can contribute to dark circles under the eyes. In most cases, they are no cause for concern and do not require medical attention. 


There are a number of contributing factors for dark circles. Some common causes of include:

Fatigue

Oversleeping, extreme fatigue, or just staying up a few hours past your normal bedtime can cause dark circles to form under your eyes. Sleep deprivation can cause your skin to become dull and pale, allowing for dark tissues and blood vessels beneath your skin to show.

Lack of sleep can also cause fluid to build underneath your eyes, causing them to appear puffy. As a result, the dark circles you see may actually be shadows cast by your puffy eyelids.

Age

Natural aging is another common cause of those dark circles beneath your eyes. As you get older, your skin becomes thinner. You also lose the fat and collagen needed to maintain your skin’s elasticity. As this occurs, the dark blood vessels beneath your skin become more visible causing the area below your eyes to darken.

Eye strain

Staring at your television or computer screen can cause significant strain on your eyes. This strain can cause blood vessels around your eyes to enlarge. As a result, the skin surrounding your eyes can darken.

Allergies

Allergic reactions and eye dryness can trigger dark circles. When you have an allergic reaction, your body release histamines as a response to harmful bacteria. Other than causing uncomfortable symptoms — including itchiness, redness, and puffy eyes — histamines also cause your blood vessels to dilate and become more visible beneath your skin.

Allergies can also increase your urge to rub and scratch the itchy skin around your eyes. These actions can worsen your symptoms, causing inflammation, swelling, and broken blood vessels. This can result in dark shadows beneath your eyes.

Dehydration

Dehydration is a common cause of dark circles under your eyes. When your body is not receiving the proper amount of water, the skin beneath your eyes begins to look dull and your eyes look sunken. This is due to their close proximity to the underlying bone.

Sun overexposure

Overexposure to the sun can cause your body to produce an excess of melanin, the pigment that provides your skin with color. Too much sun — particularly for your eyes — can cause pigmentation in the surrounding skin to darken.

Genetics

Family history also plays a part in developing dark circles under your eyes. It can be an inherited trait seen early in childhood, and may worsen as you age or slowly disappear. Predispositions to other medical conditions — such as thyroid disease — can also result in dark circles beneath your eyes.

At-Home treatments

Treatment for dark eye circles depends on the underlying cause. However, there are some home remedies that can help manage this condition. Some of the more common methods include:

  • Apply a cold compress. A cold compress can help reduce swelling and shrink dilated blood vessels. This can reduce the appearance of puffiness and help eliminate dark circles. Wrap a few ice cubes in a clean washcloth and apply to your eyes. You can also dampen a washcloth with cold water and apply it to the skin under your eyes for 20 minutes for the same effect. Repeat this process if the cloth becomes warm or if the ice melts.
  • Get extra sleep. Catching up on sleep can also help reduce the appearance of dark circles. Sleep deprivation can cause your skin to appear pale, making the dark circles more obvious. Allow yourself seven to eight hours of rest to prevent dark circles from appearing.
  • Elevate your head. While sleep deprivation can play a part in producing those dark bags under your eyes, sometimes it’s how you sleep. Elevate your head with a few pillows to prevent fluid from pooling under your eyes which can make them look puffy and swollen.
  • Soak with tea bags. Applying cold tea bags to your eyes can improve their appearance. Tea contains caffeine and antioxidants that can help stimulate blood circulation, shrink your blood vessels, and reduce liquid retention beneath your skin. Soak two black or green tea bags in hot water for five minutes. Let them chill in the refrigerator for 15 to 20 minutes. Once they’re cold, apply the teabags to your closed eyes for 10 to 20 minutes. After removing, rinse your eyes with cool water.
  • Conceal with makeup. While makeup and cosmetics do not cure dark eye circles, they can help to camouflage them. Concealers can cover dark marks so they blend in with your normal skin color. However, as with any topical treatment or makeup product, use proper care. Some products can cause your symptoms to worsen and may trigger an allergic reaction. If you begin to experience irregular symptoms from any topical treatment, stop use immediately and schedule a visit with your doctor.

Medical treatments

For a more effective and permanent solution, some medical treatments are available to reduce the appearance of dark circles. Some of the more common methods include:

  • chemical peels to reduce pigmentation
  • laser surgery to resurface the skin and enhance skin tightening
  • medical tattoos to inject pigment into thinning skin areas
  • tissue fillers to conceal blood vessels and melanin that are causing skin discoloration beneath your eyes.
  • fat removal to remove excess fat and skin, revealing a smoother and more even surface
  • surgical implants of fat or synthetic products

Before deciding on any cosmetic procedure, discuss your options with a doctor. Invasive medical treatments can be expensive, painful, and often require a long recovery time.

Diet for Hyperthyroidism:
Foods to Embrace and Avoid

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HYPERTHYROIDISM, also known as an overactive thyroid, is a medical condition that can cause a variety of symptoms in sufferers. So what foods should people with hyperthyroidism embrace and avoid for a healthy lifestyle?
Hyperthyroidism is a condition that is usually treatable and there are several medical treatments available. According to the NHS website, the main treatments for hyperthyroidism are medicine, radioactive iodine treatment or surgery.
What diet should people with hyperthyroidism follow?
People diagnosed with hyperthyroidism will usually be advised by a doctor on the best medical treatments for their circumstances. According to the British Thyroid Foundation (BTF), there isn't a specific diet people with hyperthyroidism should follow. But people with hyperthyroidism need to eat a variety of healthy foods to help them stay as healthy as possible.
As per the BTF website, based on the NHS Eatwell guide, a healthy diet includes:
Eating at least five portions of a variety of fruit and vegetables every day
Basing meals on higher fibre starchy foods like potatoes, bread, rice or pasta
Having some dairy or dairy alternatives
Eating some beans, pulses, fish, eggs, meat and other protein
Choosing unsaturated oils and spreads, and eat them in small amounts
Drinking plenty of fluids (at least six to eight glasses a day)
A doctor or pharmacist may recommend specific supplements or vitamins for people with hyperthyroidism.
People with Graves' disease or other types of autoimmune thyroid disorder may be sensitive to side effects from iodine.
So a doctor may recommend keeping to a diet that avoids large amounts of iodine.
The National Institute of Diabetes and Digestive and Kidney Diseases in the US explains on its website: "Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism.
"Taking iodine supplements can have the same effect.

"Talk with members of your health care team about what foods you should limit or avoid, and let them know if you take iodine supplements.
"Also, share information about any cough syrups or multivitamins that you take because they may contain iodine."
Anyone suffering from hyperthyroidism should address any concerns about their diet or lifestyle with their doctor.
What are the common symptoms of an overactive thyroid?
Anyone who has symptoms or signs of an overactive thyroid is advised to take note of their symptoms and speak to a GP.
According to the NHS website, symptoms of an overactive thyroid include:
nervousness, anxiety and irritability
hyperactivity – you may find it hard to stay still and have a lot of nervous energy
mood swings
difficulty sleeping
feeling tired all the time
sensitivity to heat
muscle weakness
diarrhoea
needing to pee more often than usual
persistent thirst
itchiness
loss of interest in sex
Common physical signs of an overactive thyroid also include:
a swelling in your neck caused by an enlarged thyroid gland (goitre)
an irregular and/or unusually fast heart rate (palpitations)
twitching or trembling
warm skin and excessive sweating
red palms of your hands
loose nails
a raised, itchy rash – known as hives (urticaria)
patchy hair loss or thinning
weight loss – often despite an increased appetite
eye problems, such as redness, dryness or vision problems (see complications of an overactive thyroid) 

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