Category Archives: Health & Fitness

LET’S TAKE NUTRITION SERIOUSLY INDIA – THE NATIONAL NUTRITION WEEK (1ST TO 7TH SEPTEMBER, 2021)

“Let food be thy medicine and medicine be thy food”

-Hippocrates

Introduction

Gluten free, Keto free, Dairy free- these are a few “terms” trending all around us on our Instagram, Twitter and Facebook feeds. However, have you ever questioned yourself why there is a sudden surge in opting for these diets? Where did we all go wrong in making diet choices? Are these diets necessary for everyone? The answer is NO. 

Food and nutrition is indeed fuel for our body. However, our continuous ignorance in over or mis-consuming this fuel has led to a drastic shift in our health. Obesity, PCOS, Diabetes, Hypertension, High BP- all these conditions indicate, something is seriously wrong with our lifestyle choices.  Nutrition is health. To remember this truth and make citizens more aware of nutritional choices, India observes the National Nutrition Week every year from September 1 to September 7. The 2021 theme for National Nutrition Week is ‘feeding smart right from start’.

So, it all started in India? – The History

No. National Nutrition week first started in 1973 when an United States organization namely Academy of Nutrition and Dietetics [formerly known as the American Dietetic Association or ADA) announced- “Invest in Yourself—Buy Nutrition.” This campaign was targeted to educate people on importance of nutrition and nutritionists. Be it radio announcements, news coverage or pamphlets, the National Nutrition Week gained entire America’s attention and got upgraded to a month-long program from 1980.

Forward to 1982, India, on a similar intention launched the National Nutrition Week to educate its citizens on Nutrition.

Fast forward 2021: India and Nutrition

Though India’s fight for nutrition began way back in 1982, the rise of obesity, diabetes, polycystic ovary syndrome (PCOS) and other lifestyle diseases in 2021 clearly indicates that we have not reached the mark yet with nutritional choices being the primary culprit. This year’s theme ‘feeding smart right from start’ also highlights that not only us, but our younger generation also requires to make right nutritional choices.  

So how can we contribute?

Cut down on fats and sugar: Eating right involves choosing right. One of the best ways to do so is opting for healthier versions of daily food. Understanding the content of saturated fat is the key as they are responsible for increasing the cholesterol level. 

Stay away from junk food: Junk food does not serve your body’s nutritional requirements, rather hampers your body by causing digestive issues, fluctuation in blood sugar levels, depression, fatigue and weakness. The best idea is to switch to fresh food and leafy vegetables. They not only provide you the right nutrition but also increases your immunity

Drink water: May be your favourite beverage is Coffee, but let’s not forget the importance of drinking water. Water is the ultimate nutritional support. It aids in digestion, normalizes BP, stabilizes the heart beat and what not.

And last but not the least, Exercise.

“Invest in Yourself—Invest in your Nutrition.”

References

  1. eatright.org (2021) National Nutrition Month: A Brief History https://www.eatright.org/~/media/eatright%20files/nationalnutritionmonth/nnmhistory_032006jada.ashx
  2. Dixon, et al. 2007. Social science & medicine, 65(7), pp.1311-1323.
  3. Skerrett, P. J., & Willett, W. C. (2010). Essentials of healthy eating: a guide. 55(6), 492–501.

A SIMPLE GUIDE TO PCOD/PCOS

Introduction

Polycystic Ovary Syndrome (PCOS), also known as Polycystic Ovarian Disease (PCOD) is one of common hormonal syndrome that women blame for their weight gain. The cause of PCOS is still unknown, but studies have shown that it may involve a combination of genetic and environmental factors (like lifestyle, pollution). Normally ovaries have follicles which contain eggs, and one or more mature eggs are released during each menstrual cycle. In PCOS, eggs in follicles do not mature and are not released, instead form cysts. The ovaries also produce small amount of male hormones. However, the absence of ovulation in PCOS leads to an imbalance in the sex hormone levels.

The common symptoms PCOS patients present:

Acne, weight gain, irregular periods, extra hair on face and body

If untreated, can lead to:

Infertility (women having regular intercourse, but fail to conceive), heart diseases, breast cancer, endometrial and uterine cancer, diabetes, obesity

Influence of obesity on PCOS:

Obesity aggravates certain manifestations in PCOS and are more likely to have menstrual irregularities. It also increases the risk of infertility, higher probability of hair growth on face and body and complications during pregnancy.

CAN PCOS BE TREATED?

PCOS can be managed by improving insulin levels using metformin, commonly used to treat type 2 diabetes.

Irregular cycles can be treated by Oral Contraceptive Pills (OCPs).

Infertility can be treated by ovulation inducing drugs.

Consult your doctor before taking medicine.

Hair growth on body and face can be treated by laser and non-laser techniques.

However, nutrition and exercise play a major role in the management of PCOS.

Nutrition strategies:

Eating fresh food, wholesome food and eating in peace is important.

Avoid foods that are over-heated or microwave food.

Carbohydrates are extremely important to be included in the diet.

Eating wheat, rice, jowar (whole grains and carbohydrates make slow and steady rise of blood sugar) is very important.

Eating complete proteins is also vital (eggs, pulses, milk, paneer).

Essential fatty acids like ghee, oils, groundnut oil, sesame, sunflower, olive oil should be included in adequate amount.

Alpha-linolenic acid (ALA)-rich food like flax seeds, peas and nuts can also be incorporated in a regular diet.

Calcium-rich foods can help in reducing general fatigue and cramps during periods.

Exercise strategies

Regular workouts are the key to regular periods.

Seven days a month is a good start.

Weight training workouts are must at least twice a week.

Cardio is a great way to burn fat when associated with learning new movements or a skill.

Surya namaskar’ along with pelvic opening exercises are among the best.

Sleep strategies

Maintaining sleep-wake cycle with 8 hours of sound sleep.

Resources: DC Dutta’s textbook of gynecology, Shaw’s textbook of gynecology, The PCOD-thyroid book -book by Rujuta. Diwekar

Diabetes Mellitus & it’s Management

Diabetes Mellitus (DM) is an endocrine metabolic disorder, characterized by elevated blood glucose level. DM is sub-classified into following categories.

  1. Type 1 Diabetes mellitus, also called as insulin dependent diabetes mellitus.
  2. Type 2 Diabetes Mellitus, also called as non-insulin dependent diabetes mellitus.

Type 1 DM

In Type 1 DM, there is no secretion of insulin by Beta cells of Islet of Langerhans in the pancreas because of the auto-immune destruction. Hence, there is no proper secretion of insulin. Type 1 DM is mainly treated by insulin replacement therapy. Symptoms of Type 1 DM include excessive thirst and hunger, blurred vision and fatigue. Frequent urination and weight loss occur in short period of time.

Diabetic complications may lead to cardiovascular diseases, retinopathy, and skin problems like foot ulcer.

Diagnosis of Type 1 DM is usually conducted by following procedure:

  1. Fasting blood sugar >126 mg/dl on two separate tests.
  2. Random blood sugar >200 mg/dl.
  3. Haemoglobin, HbA1c> 6.5 on two separate tests.

Management of Type 1 DM:

Good glycaemic control in Type 1 DM requires insulin therapy and oral hypoglycaemic agents like metformin, pioglitazone.

Diet and exercise play a crucial role in the management of DM.

Type 2 DM

In Type 2 DM, body cells not able to respond to insulin which is produce by Beta cells of the pancreas and is not able to produce insulin anymore.

Gestational Diabetes:

Gestational Diabetes is a condition in which sugar level is elevated during pregnancy.

Narcolepsy – a revelation

There is a time for many words there is also time for sleep – Homer

Introduction

Sleep is an important part of our day-to-day life and everybody long for a good night’s sleep after a day’s work. But do you know why you sleep at night and are awake during daytime? Do you know we have a biological clock inside us? Do you know why some people fall asleep while talking or even while driving? If you want to know the answers to these questions, please read on.

Before delving into this topic, let us first discuss the sleep-wake cycle. In a day, most people are awake for 16 hours and asleep for 8 hours on average. This sleep-wake cycle is controlled primarily by parts of the brain called the brain stem and the hypothalamus. While the precise mechanisms of control are not fully understood, researchers have found out the various biochemical and physiological changes that take place in our brain during sleep.

Arousal signals in the form of neurotransmitters are sent from the brain stem and the hypothalamus to the cerebral cortex, which is the largest part of the brain. Neurons in specific regions of the cerebral cortex are activated by the neurotransmitters. Hypocretin, also known as orexin, is an example of such a neurotransmitter.

Apart from this mechanism, sleep and wakefulness are also regulated by our biological clock – a region of the brain comprising ~50000 neurons in the suprachiasmatic nucleus. This clock is activated by light signals from the eye and received through the optic nerve. So, we can sleep during the night as there is less light and this clock will also send powerful alerting signals to wake us up in the morning.

There are several sleep disorders which can present as either excessive sleepiness (hypersomnia) or lack of sleep (insomnia).

With this background knowledge, let me introduce you to the topic of narcolepsy.

What is narcolepsy?

Narcolepsy (narke – numbness lepsis – attack) belongs to a group of sleep disorders and is characterized by excessive and persistent sleepiness. It was not recognized till the French physician Jean-Baptiste Edouard Gelineau identified and named this condition in 1880.With the research happened in the field of sleep disorders now we have a better understanding of the brain changes leading to the manifestation of this condition. 

Narcolepsy is a neurological disorder that causes sudden, recurring, and uncontrollable urge to sleep during day time. It is an underdiagnosed condition which affects 3 million people worldwide. Both males and females are affected equally. It commonly starts in teenage and early 20s but can also affect children and older people.

The exact cause of this condition is unknown. However, scientists have discovered a link between the levels of hypocretin and narcolepsy .Hypocretin is a regulator of wakefulness as it increases activity of target neurons which release epinephrine, serotonin, and dopamine and hence involved in alertness. The hypothalamic neurons which produce hypocretin are destroyed by

     a) an autoimmune process

     b) infectious agents like streptococcus or influenza virus.

     c) head injury

     d) genetic defect

It is underdiagnosed due to unfamiliarity of the physicians with this condition and sometimes takes 10 years or more before the patient receives a correct diagnosis. Affected people are often mislabelled as simply lazy, depressed, epileptic, or schizophrenic.

Symptoms of narcolepsy

There are numerous ways in which this disorder presents itself and the severity also varies. The most common complaint is of course excessive daytime sleepiness (EDS).Narcoleptics can be likened to “Sleepy,” the famous Disney character in the fairy tale of Snow White and the seven dwarfs .Those affected may find it difficult to stay awake like him during day time and will fall asleep during routine activities like talking, driving, working etc. It will be more like a “sleep attack.”

Teachers may complain to parents that their child sleeps during the class. Narcolepsy can also present as hyperactivity, irritability, memory problems and brain fog.

The excessive sleepiness may also be associated with another neurological condition called cataplexy which leads to sudden loss of muscle tone or paralysis in the form of knee buckling, head dropping or collapsing, often triggered by strong emotions or excitement.

Thus, we can categorize narcolepsy into two types

Type 1– Narcolepsy with cataplexy

Type 2 – Narcolepsy without cataplexy

Symptoms of cataplexy can precede EDS and hence narcolepsy can be misdiagnosed as a seizure disorder.

Another important feature of narcolepsy is inadequate quality of sleep at night which is often referred to as fragmented sleep. Night time sleep will be interrupted several times and the person will often feel tired after sleeping.

At times, narcolepsy can coexist with sleep paralysis or hypnagogic hallucinations (vivid dream-like events). A brief inability to move the body or speak while falling asleep or waking up is called sleep paralysis.

 Fortunately, only ~25% of affected individuals will display the full set of symptoms. All these disabilities can negatively impact education, professional life, relationships, and even personal safety of affected individuals.

How is this condition diagnosed?

Because of the varied and nonspecific presentation, it may take several years for someone with narcolepsy to get diagnosed properly. Hence the treating physician need to take a detailed history and conduct a thorough medical examination.

The doctor will ask the patient to keep a sleep journal to record the time of sleep, symptoms experienced etc over a period of 2 weeks. Sleep specialists have devised two tests viz; Polysomnography (PSG) and Multiple Sleep Latency test to establish the diagnosis of narcolepsy.

Polysomnogram (sleep study) is a recording of breathing, eye movements and activity of brain and muscles during night.

Multiple sleep latency test – this test helps to determine how quickly a person falls asleep during day time.

How can it be managed?

Narcolepsy is a disease which can persist throughout life as there is no cure. However, symptoms can be successfully controlled by lifestyle changes and medications. Medicines like modafinil, antidepressants, and stimulants are the main stay of drug therapy. But medication alone will not be sufficient to maintain a normal state of alertness.

Patients need to be taught proper sleep hygiene to maintain a regular sleep schedule. Several support groups are available to help patients develop coping strategies and to offer emotional support. Even though it is an incurable disease, the advancements in the management of narcolepsy have enabled people to lead near normal life.

Points to remember!

  1. Narcolepsy is a sleep disorder which is characterized by excessive day time sleepiness.

2. It is caused by lack of a neurotransmitter called hypocretin in the brain.

3. It usually starts in teenage and early twenties.

4. It can be associated with another neurological problem called cataplexy.

5. It is often misdiagnosed and it might take several years for the affected person to get a proper diagnosis.

6. It is an incurable disease but affected people can lead a normal life by taking medicines and by following life style changes.

Pain and Recent Advances in Managing Pain

What is pain?

Pain can be a displeasing and uncomfortable experience associated with possible damage to the body. The word ‘pain’ is derived from Latin literature, ‘poena’ meaning penalty or punishment. The majority describe it as an irritating, overwhelming, unpleasant, and terrible phase to go through. Most of us can recall visiting a medical chamber with different kinds of pain.

Let us dwell deeper into pain, based on time, intensity, location, and types.

  1. Duration of time:

Pain can be acute or chronic.

Acute – It is sudden, momentary, or a short period of fewer than 3 months.

Example- Pinprick, minor injuries

Chronic – It usually lasts longer than 3 months and more resistant to medical treatment with time.

Example- Arthritic pain, migraines

2. Intensity:

The feeling of pain can be mild, moderate, and severe measured on a pain scale of 0-10.

Although, the perception of intensity may differ among individuals. Severe pain for one felt as moderate by another.

Example- Minor fall from the cycle, major brain trauma

3. Location:

It can differ in locations. It can be anywhere from top to toe.

Ex- Back pain, knee pain, stomach pain

4. Types:

Pain can be superficial, deep, or psychogenic.

Superficial – Direct irritation (chemical/ mechanical/thermal/electrical) of the peripheral nerve endings in the superficial tissue.

Deep – Due to irritation of deep structures like the muscles, the tendons, the bones, the joints, and the viscera.

Psychogenic – Pain attributed to the processing of thoughts, mental and emotional state, or other unknown behavioral causes.

Can the tip of my shoulder be hurting? What else could be the reason for my pain?

So, let us discuss a bit more about pain and then go into how one can free themselves from pain and tips to manage pain!

Pain can be originating elsewhere and felt elsewhere. Pain can radiate, refer, or migrate! Your pain can travel and move around! How is that possible? Through the brilliantly intricate nervous system, we possess!

Our body is unique in a way that no one can decipher it to 100%.

Not just yet!

The central role of controlling and managing pain is to release the stress and suffering associated with it on an everyday basis. Sometimes, pain can be extremely distressing, leading to mental disturbances in the long term. It can lead to anxiety, depression, loneliness, debilitating one’s life to the extreme side.

Therefore, it is wise to act and take control.

The evidence-based management of pain

Management of pain can be abled by using modern medicine or traditional techniques like acupuncture, homeopathy, physiotherapy, massage, yoga, meditation, physical therapies, psychological therapies, occupational therapies, etc.

On an individual level, leading an active lifestyle, changing to a nutritious diet and food, physical activity for 20 minutes a day 4-5 times a week can lead to an overall increase in quality of life and alertness levels of the body.

For minor injuries or falls, menstrual cycle pains, headaches, causing mild pain, the first reach out is the first aid kit, OTC (over the counter) drugs like paracetamol, aspirin, ibuprofen, and some prescribed antibiotics and topical ointments if infection presents.

How much freedom does a pharmaceutical drug intervention bring? That depends on the type of pain; chronic pains usually do not subside on taking drugs but need a combination of therapies.

Acute and sudden pain conditions can sometimes be fatal requiring urgent medical care and surgical treatment. For example, appendicitis, obstructed bile duct, acute pancreatitis, kidney stones, heart attack, head injuries, trauma, etc.

Chronic conditions eventually become resistant to the regular drugs and need stronger management pain regimes.

For example, arthritic knee joint pain, lower back pain due to slip disc or compression of nerves, nerve conditions like sciatica or neuralgias, cancer pains, constant headaches due to migraine, tension headaches, post-surgical pain, structural deformities like scoliosis & lordosis, psychogenic pain, etc.

Drug treatment – Analgesics or pain relievers like aspirin, Ibuprofen, Naproxen is usually the first-line treatment for mild to moderate chronic conditions.

Opioids are the last reserve when the pain is resistant and non-responsive to other lines of treatment.

OTC creams and ointments like lidocaine can be applied topically for relief 2-3 times a day or as told by the physician.

Anticonvulsants and nerve supplements are used to treat multiple chronic nerve conditions like injuries and diabetic neuropathy.

A newer class of drug under investigation is the monoclonal antibodies, which target the nerve growth factor (NGF), a peptide involved in the growth and survival of neurons that regulate how the body processes pain.

Nonpharmacological management

  • Mild exercise improves blood circulation and reduces mild to moderate pain. (Caution – Heart condition, Disability)
  • Physiotherapy is a new line of pain management with many advances for musculoskeletal disorders, nerve conditions causing chronic pain.
  • Physical heat/cold therapy – Icing and hot packs
  • Acupuncture, meditation, massages, aromatherapy, yoga are some other personal preferences of many.

Psychogenic pain- Mental well-being and counseling – Seeking psychiatric care for mental illness is the right of the brain, body, and well-being of the person in society.

Cognitive-behavioral therapy – Coping mechanisms and stress reduction techniques among the wide range of CBT methods

Antidepressants – Avoid self-medication and always seek professional help.

Genetic modeling is a newer science, which can strike a great deal in the way we perceive and manage pain. Science is all about optimism. Epigenetics, modification of gene expression, examples – like a fan switch or a remote button.

Neuroplasticity – the ability of the brain and spinal cord to adjust their activities in response to new changes.  For example – To compensate for injury and pain

Seeking professional medical care should be the first step for any kind of pain for assessment and evaluation.

However, one can do a self-assessment with the PQRST characteristics, Pain rating measurement scale ranging from 0 – 10, and quality of life.

  • P   Provocative factors: what intensifies the pain?
  • Q   Quality of pain: what kind of pain is it?
  • R   Radiation of pain: Is it at the same location or moving?
  • S   Severity of pain: how does it feel?
  • T   Temporal factors: Is the pain universal or comes and goes away?

One can take an informed decision and visit the nearest health center or pain clinic for the best care and treatment.

*Keep in mind the hazards associated with self-medication and combination of drugs without the right professional help*

Staying fit while working from home

Working from home comes with its own set of pros and cons. And staying fit while working from home is a challenge. Setting up a routine and breaking down the plan into feasible goals is all that is required.

Key points to stay fit while you work from home

  • Setting up a routine
  • Creating a workspace at home
  • Healthy eating habits
  • Adequate sleep
  • Physical activity
  • Mental health
  • Social interactions
  • Positive attitude and empathy

Setting up a routine

  • Start your day with a morning routine that includes yoga, jogging, or any physical activity. Make sure you keep aside a few minutes to plan your day.
  • Make plans so that you don’t mix up work and family time. Focussing on one thing will bring out the best in you.

Creating a workspace at home

  1. Create a quiet, well-lit workspace.
  2. A clutter-free desk with minimal things will reduce chaos and help you work effectively.
  3. Watch your posture while sitting on a chair.
  • Adjust the chair to support your back and arm.
  • Let your feet lie flat on the floor.
  • Maintaining the curve of the lower back (upper lordotic sitting) is one of the optimal position recommended by the physiotherapists.1

4. Computer vision syndrome is a group of symptoms that you experience when you sit in front of the computer monitor for a prolonged time in the same position.

Key points :

  • The monitor should be at the level of your eyes.
  • Keep the monitor at a distance of 53 to 72 cm from the eyes.2
  • Ideal positioning will reduce your neck discomfort.
  •  Use filters to reduce the screen glare.
  • Keep your eye moist by blinking frequently.
  • Take breaks while viewing the monitor and give your eyes some rest.
  • 20-20-20 rule: take a break once every 20 minutes and view things 20 feet away for 20 seconds.
  • You may have to change your eyeglasses or contact lenses if you are having discomfort.
  • Consult your doctor if the symptoms persist, and also schedule regular eye examinations.

Healthy eating habits

  1. Take frequent breaks from work to drink water (10-12 glasses in a day).
  2. Replace your fries, cookies, and muffins with fruit, nuts, and vegetables.
  • Healthy snacks bring down the calorie and have lots of benefits.
  • According to the Centre for Disease Control and Prevention (CDC), only 1 in 10 individuals consume enough fruits and vegetables in a day.
  • Fruits and vegetables help to protect you from heart disease, stroke, cancer, and overweight.3

3. Practice mindfuleating

  • Eat your meals slowly and enjoy the food; stay away from the distractions like television, phone, and so on
  • Mindful eating will help digestion and curb overeating.
  • Try eating mindfully at least once a day; it will benefit you in the long run.

4. Limit caffeine consumption in your diet

  • Coffee, tea, caffeinated soda, and energy drinks contain caffeine.
  • You should avoid replacing plain drinking water with caffeinated drinks.
  • Though caffeinated beverages are relatively safe, they can get addictive at times.
  • Too much caffeine may lead to insomnia, restlessness, digestive problems, high sugar level, and diuretic effect causing dehydration.4
  • Hence consume caffeine in moderation and always wean gradually from the habit.

5. Vitamin D

  • You may be lacking the sunshine vitamin; hence, make efforts to get the rays by keeping the windows open or taking a stroll on the balcony.
  • Include food rich in vitamin D such as milk, egg yolk, cod liver oil, and fortified grains in your diet.
  • Vitamin D is required for your bones’ growth and health; It is vital for the immune system that protects you from infections.

Sleep

  1. Adequate sleep has a lot of benefits.
  2. Sleeping well at night will help you focus and concentrate better; it affects your judgment and reaction time.
  3. Sleeping between 7-9 hours is ideal for you, and the duration varies depending on age.
  4. According to a study, people having around 7 hours of sleep/night are at a lower risk of developing overweight, hypertension, and diabetes (metabolic syndromes).5

Physical activity

Physical includes a spectrum of activities like exercise, household chores, and leisure activities; It improves your life quality. They have immediate and long-term benefits.

Benefits of exercise

  1. Regular exercise offers multiple health benefits.
  2. Exercise plays a significant role in treating obesity, lung disease, heart disease, diabetes, cancer, and low back pain.
  3. Recent studies suggest that exercise reduces your risk of developing long-term (chronic) health conditions like high blood pressure, diabetes, heart attacks, and stroke.
  4. Regular exercise will strengthen your bones and muscles; It helps you manage weight and reduce arthritis.
  5. According to recent physical activity guidelines, you can attain substantial health benefits by engaging in physical activity for 150 minutes a week.
  6. When you exercise, the body releases endorphins (feel-good hormones). Endorphins boost happiness; hence, they reduce stress and calms down your mind. You can sleep better too.

Mental health

Mental health is as important as physical health; It includes emotional, psychological, and social well-being. Mental health is all about how you handle the highs and lows; make choices, and keep calm amidst the chaos.

Yoga

  • Long-term stress and anxiety may increase the risk of developing heart disease, diabetes, cancer, and inflammatory conditions.
  • Studies have shown that yoga reduces stress hormone levels called cortisol (downregulation of hypothalamic-pituitary-adrenal axis) in your body; hence, it can ease stress and anxiety.
  • Yoga also has a beneficial effect on depression. It acts as an antidepressant.6
  • Practicing yoga as a routine will calm your nerves and bring peace of mind.
  • Pranayama includes breathing exercises. It offers a lot of health benefits, both physical and mental.
  • Practice yoga for a healthy body and mind.

Nurturing a hobby

  • Nurturing a hobby is very satisfying; it is right for your mental health.
  • It includes reading a book, gardening, dancing, games, and so on.
  • A hobby can lower stress levels and enrich your life.

Social interaction

  • Working from home shouldn’t limit your social life.
  • Spend quality time with your family and friends.
  • Make plans with your friends and meet them often.
  • Volunteering for a specific cause you believe in will create an opportunity to meet people and add value to your life.

Positive attitude

Being positive, grateful, and empathetic will impact your overall well-being.

Conclusion

Most of us are aware of all the steps mentioned to stay fit while working from home, but we still procrastinate. The best way to start is to set small achievable goals and gradually build them up. It’s never too late to make positive lifestyle changes. Stay fit, stay happy!

References:

  1. Korakakis V, O’Sullivan K, O’Sullivan PB, et al. Physiotherapist perceptions of optimal sitting and standing posture. Musculoskelet Sci Pract. 2019;39:24-31. doi:10.1016/j.msksp.2018.11.004
  2. Rempel D, Willms K, Anshel J, Jaschinski W, Sheedy J. The Effects of Visual Display Distance on Eye Accommodation, Head Posture, and Vision and Neck Symptoms. Hum Factors. 2007;49(5):830-838. doi:10.1518/001872007X230208
  3. CDC. Steps to Safe and Healthy Fruits & Vegetables. Centers for Disease Control and Prevention. Published December 10, 2020. Accessed December 15, 2020. https://www.cdc.gov/foodsafety/communication/steps-healthy-fruits-veggies.html
  4. Reyes CM, Cornelis MC. Caffeine in the Diet: Country-Level Consumption and Guidelines. Nutrients. 2018;10(11). doi:10.3390/nu10111772
  5. Smiley A, King D, Bidulescu A. The Association between Sleep Duration and Metabolic Syndrome: The NHANES 2013/2014. Nutrients. 2019;11(11). doi:10.3390/nu11112582
  6. Naveen GH, Varambally S, Thirthalli J, Rao M, Christopher R, Gangadhar BN. Serum cortisol and BDNF in patients with major depression-effect of yoga. Int Rev Psychiatry Abingdon Engl. 2016;28(3):273-278. doi:10.1080/09540261.2016.1175419

Working from home in pandemic: How yoga can be your best friend in this time?

It has been weeks and months since we have stopped counting days being in this pandemic-driven lockdown. There is a unique quality to this day-by-day pandemic despair; this quarantine depression is edging humans into physical and mental stagnation.  According to an article I read in the Hindu couple of days back, approximately  12.2 crore Indians lost their jobs during the coronavirus lockdown in April 2020 only, which makes COVID 19 pandemic much more stressful for people.

Not only for people who have lost their jobs, but also for people who are working from home in this pandemic and trying to juggle between their family and work without any house help and childcare services available, that this pandemic is proving more emotionally exhausting than the virus itself. With an official Microsoft TEAMS video call in my morning joggers or stirring the ladle in a cooking pot with my official call in my earpods and with my toddler in my arms, I too am acing at juggling! Watching this situation very closely for past couple of months now, I feel a more accepting and holistic approach to this fiasco is the need of the hour.

We all know that there is uncertainty & fear and we all are multitasking around for the past 4-5 months, but instead of getting bogged down, coping with stress in a healthy way will not only make us, but the people we care about and our community stronger. The best we can do is accept the situation and take care of our and our family’s mental and physical health. One way that I discovered and loved during this period, is a 40 minutes yoga routine with 10 minutes meditation, to reinforce my strength and potential. Every single day for past three months now: believe me these are the most blissful 60 minutes I have from my day! I feel that my mind is calmer and more focussed; I am able to do one thing at a time, that too perfectly and my productivity has increased like anything. I am following a very good book ‘Light on Yoga’ by BKS Iyengar and practicing yoga from the same.

It can be anything, as long as you are present in the moment mentally & physically and moving, stretching and doing basic pranayama initially for 10 minutes in a day and gradually increasing to half an hour or 40 minutes; but please follow the same with 10 minutes of mediation (just focussing on your breath with closed eyes) and you will feel a positive change in your day. You can even take breaks in between your office calls and stretch your arms, necks or legs for 2 minutes on the chair or your yoga mat.

On the occasion of International Yoga Day 2020, I am sharing some of basic yoga poses which I have been practicing and you can also start with them as a beginner in yoga journey:

Trianga Mukha Eka Pada Paschimottanasana: Keeping one knee folded, try to touch your nose to the other stretched knee. It gives a nice and long stretch to your tense back and can make you ready for a long office call.

Matasyasana: Matasyasana or  Fish pose is a reclining back-bending pose. It relieves tension in your neck, throat, and shoulders and stretches and tones the front of your neck and your abdominals. It could be proven beneficial for all the creative people who like to keep their neck in the laptop screens for better focus.

Dhanurasana: Dhanurasana or chakrasana or wheel pose or The Upper Facing Bow whatever you can call, it can help—and strengthen your arms, legs, abdomen, and spine. For this one, you bend your knees and place your heels as close to the hips as possible and then slowly raise your arms, bend your elbows by resting the palms beside your ears.Floating camel pose: an advance version of Utraasna. This one is little bit of an advance yoga pose and maybe you will be able to do it after a month’s practice but the benefits are for sure worth the pain in the process. It increases flexibility in the spine, stimulates the nervous system, opens the chest and shoulders, improves circulation and digestion, and stimulates the thyroid gland. It’s said to rejuvenate/increase energy levels, and lower blood pressure.Sirsasana or headstand: and finally the king of all the yoga poses, The headstand. This is definitely a very advance yoga pose but is known as the most relaxing and cooling posture. It helps you to draw your attention inwards, to concentrate more, to focus more. This posture is extremely helpful if you are having anxiety, stress, fear or otherwise worrisome thoughts. Combine headstand with long, slow breathing and you have a recipe for stress relief.

So happy International yoga day 2020 people and I would like to leave you with a very special quote from my favourite yogi BKS Iyengar, ‘Yoga is a light, which once lit, will never dim. The better your practice, the brighter the flame.’

Health Benefits of Nutraceuticals

Economic development of the people has improved their lifestyle. But the challenge that has arisen with this lifestyle change is increasing the prevalence of ‘lifestyle diseases.’ Lifestyle diseases refers to diseases associated with bad lifestyle choices including food habits. The increased trend of eating junk food is known to be the reason for several diseases (obesity, cardiovascular diseases) and nutritional deficiencies. Due to high cost of treatment of these diseases in the modern science, people have started looking for alternative or complementary treatment options. Thus, nutraceuticals came into focus and are being opted as they fulfill nutritional requirements and have therapeutic benefits.

The word “nutraceutical” was coined from “nutrition” and “pharmaceutical” by Stephen De Felice, founder and chairman of the Foundation for Innovation in Medicine in 1989. It is defined as “a food or parts of food that provide medical or health benefits, including the prevention and treatment of disease”.  Nutraceuticals are the pharmaceutically blended products that have both nutritional as well as the medicinal value. This type of product is designed to improve the physical health, and fight against day-to-day challenges such as stress, increase longevity, etc. It is a food supplement that plays a vital role in maintaining a healthy body and provides necessary supplements required for various metabolic processes to regulate body functions and thus protects the body from disease.

According to a Mordor Intelligence Report, the global nutraceuticals market is predicted to reach $671.30 billion by 2024.

Classification of nutraceuticals:

Nutraceuticals can be organized in several ways, depending upon its application and easier understanding. Some classifications can be based on academic instruction, clinical trial design, functional food development or dietary recommendations.

  • Based on food availability, they are divided into traditional nutraceuticals, obtained from nature directly, without any changes in the natural form and non-traditional nutraceuticals, foods enriched with supplements or biotechnologically designed crops to boost the nutrients
  • Based on mechanism of action, they are further classified with respect to specific therapeutic properties such as anti-microbial, anti-inflammatory, and antioxidants
  • Based on chemical nature, these are segmented depending upon their primary and secondary metabolite sources such as isoprenoid derivatives, phenolic substances, fatty acids, carbohydrates, and amino acid-based substances.

Nutraceuticals and their health benefits

Nutraceuticals are known to have therapeutics effects and physiological benefits. They are known to provide protection against various diseases including cardiovascular, obesity, diabetes, cancer, chronic inflammatory disorders, and degenerative diseases. Some of the food sources used as nutraceuticals and their therapeutic effects are discussed below:

  • Dietary Fibre– Dietary fibres are not hydrolysed by enzymes secreted by the digestive tract but by microflora in the gut. The benefits of consuming dietary fibres include the retardation of emptying of the gastric juices in the stomach thereby affecting the rate of digestion and the uptake of nutrients, and it improves glucose tolerance and lowers the risk of coronary heart disease, stroke, hypertension, diabetes, obesity and certain gastrointestinal (GI) disorders. Also, an increase in the intake of high fibre food improves serum lipoprotein values, lowers blood pressure level, improves blood glucose control for diabetes, and aids weight loss.
  • Probiotics– Probiotics are non-pathogenic, non-toxic anti-bacterial substances. These are resistant to gastric acid and adhere to gut epithelial tissues. Consumption of probiotics decreases the risk of systemic conditions like allergy, asthma, cancer, several infections of the ear and urinary tract. It is also used to treat GI conditions such as lactose intolerance, acute diarrhoea and antibiotic-associated GI side effects.
  • Prebiotics– It improves lactose tolerance, has anti-tumor properties, is capable of neutralizing toxins, stimulates the intestinal immune system, and helps reduce constipation, blood lipids and maintains safe blood cholesterol levels.
  • Polyunsaturated fatty acids (PUFAs) – These are very essential for all bodily functions and hence known as “essential fatty acids”. It can be only taken through diet. Omega-3-fatty acids are one on the best examples of PUFAs. The three major effects against cardiovascular diseases are anti-arrhythmic, hypolipidemic and antithrombotic. Its benefits are numerous, such as, it can help improve the health of pre-mature infants and patients suffering from asthma, bipolar and depressive disorders, dysmenorrhea and even diabetes. Infant formulas of omega-3-fatty acids nowadays contain docosahexaenoic acid (DHA) along with arachidonic acid, which closely mimic the breast milk. The FDA recommends a maximum of 3g/day intake of eicosapentaenoic acid (EPA) and DHA omega-3 fatty acids, with no more than 2g/day as a dietary supplement.
  • Antioxidant vitamins– Vitamins like vitamin C, vitamin E, and carotenoids are collectively known as antioxidant vitamins. These vitamins are self-sufficient and have synergistic effects. They prevent oxidative reactions leading to several degenerative diseases including cancer, cardiovascular diseases, cataracts etc.
  • Polyphenols– It has antioxidant, anti-inflammatory, anti-microbial, cardioprotective activities and plays a role in the prevention of neurodegenerative diseases and diabetes mellitus. Also, dietary polyphenols are believed (from in vitro studies) to affect numerous cellular processes like gene expression, apoptosis, platelet aggregation, intercellular signalling that can have anti-carcinogenic and anti-atherogenic implications.
  • Spices– These are responsible for lowering of blood cholesterol, prevention, and dissolution of cholesterol gallstones, protection of erythrocyte integrity in hypercholesterolemic condition, hypoglycaemic potential, amelioration of diabetic nephropathy. It also possesses antioxidant effect, anti-inflammatory and anti-arthritic effect, antimutagenic effect/cancer preventing, digestive stimulant action and antimicrobial activity.

People are trying to attain a healthier and a better quality of life by eating more vegetables, fruits, and other plant extracts, taking dietary supplements or nutraceuticals. The development of nutraceuticals and functional foods delivers unique products to the world at large and helps in enhancing consumer confidence. Nutraceuticals are substances that have physiological benefits or provide protection against chronic diseases. They are used to improve health, delay the aging process, prevent chronic diseases, increase life span, or support the structure or functions of the body.

Are you at the risk of Breast Cancer? Read this & find out.

Breast cancer is the most prevalent form of cancer in women. Though it also affects men, the incidence rate is quite low. Early detection (be it any type of cancer) increases the chances of survival in case of this deadly ailment.

For better and timely diagnosis, it is very important to detect the early signs of breast cancer. In this blog we will be discussing the signs of breast cancer.

Have you ever paid attention to your breasts?

How often do you check your breasts?

Ever noticed anything unusual around that area?

These questions are very crucial when it comes to determining the signs and symptoms of breast cancer. Start with having a look carefully at your breasts.

How to check your breasts?

You don’t need any special training to check your breasts. Each woman has a different set of breasts and you should know how your breasts normally feel like or look like. When you know this, you will easily be able to spot anything unusual in your breast area.

Check the whole area around your breast including your armpits & upper chest and if you notice anything unusual, get yourself checked by a doctor.

What to check?

Check for any lumps around your breast area, upper chest or even around armpits. Lumps can be the primary symptom of breast cancer. Pain in breast can also be a sign of breast cancer but usually it is not in most cases. Pain in your breast can be due to other reasons as well but if an unexplained pain prevails over some time, it is advisable to get it checked by a doctor.

Checking your breasts for any signs of breast cancer follows a simple formula: TLC: Touch, Look, Check

  • Lumps are not visible, but they can be felt. Look for any lump or swelling in your breast, armpits and upper chest.
  • Check for any changes in shape or texture of your breasts. A change in size or shape of your breasts might be an indicator of something fishy, for instance one breast appearing larger than the other one.
  • Have a look closely at the texture of your breasts. Look for any puckering or dimpling of the breast skin.
  • Closely examine the color of the breasts. If you notice any redness or inflammation on your breasts, get it checked by a doctor.
  • Notice whether your nipples look different than usual. A change like inversion of one of the nipples if present (these are usually pointed outwards), then consult a doctor.
  • If there is any unusual discharge from your nipples, immediate action is required.
  • Check for any rashes or crusting on your nipples or the areas nearby.

If you notice any of the above symptoms (also presented in Figure 1), then go and see a doctor. It is not necessary that having any of these symptoms is the sign of breast cancer, but it is always safe to have a breast screening post consulting with a doctor. Doctor would examine and if further check-ups required, he will refer you to the specialists accordingly.

Are you at the risk of Breast Cancer? Read this & find out.

Figure 1: Symptoms of breast cancer in women

Do you need to check your breasts often?

Well, as a precautionary step or rather say to be on the safer side and to be aware of this disease you can check your breasts at regular intervals. You can check them monthly or bi-monthly or how often you feel like.

Once you start checking them regularly you will be able to identify even the slightest change taking place in them, be it due to age or at various times of a month. Your breasts can feel sore or heavy before or during your periods, heavier and bigger during pregnancy and you might notice this change if you know your breasts well.

In the similar way if anything is odd with them, it would be noticeable when you are aware of the normal/usual appearance of your breasts.

Breast cancer in men:

Men also have breast tissue, but they are very much less developed as compared to the ones of women. This is also the reason why breast cancer in men is a rare phenomenon.

But, still, we cannot feign ignorance to the fact that men too, are affected by breast cancer.

 

Signs & symptoms of breast cancer in men:

If someone in your family had breast cancer, you have some chances of getting it, but again it’s not definite that you will. Regularly checking your breast is a wise option especially if you have a genetic record of Klinefelter’s Syndrome (history of breast cancer in family).

The breast tissues in men are mostly behind the nipple area & the pigmented region known as areola. Breast cancer in men usually appears around the nipple area as a lump (Figure 2).

Are you at the risk of Breast Cancer? Read this & find out.

Fig. 2: (a) Shows changes in the look of the nipple or areola (direction change in nipple); (b) shows discharge from nipple or nipple ulcers; (c) Shows lump formation around nipple or armpit

If you find any of these symptoms, go and consult a doctor. In case cancer is detected, you can get an early diagnosis, ensuring better and faster recovery. If not, then, any other problem might also get solved in time.

Turacoz Healthcare Solutions requests every men & women to pay close attention to these specific parts of their body and help themselves in early detection of breast cancer, if present.

An early detection increases your chances for better treatment and recovery.

Importance of Good Oral Health

Oral health is an integral part of our general health, yet is the most neglected one. The Indian Dental Association (IDA), in a National Oral Health Survey, 2005, highlighted that 95% of the Indian population suffers from gum diseases and only 50% of the population use a toothbrush. The survey also noted that, only 2% of the population visit the dentist.

A good oral health plays an important role in overall health improvement, improving quality of life, boosting of self-confidence and performance enhancement at workplace. However, the irony lies in the factthatmost people remain unaware of the benefits of maintaining a good oral health. Further, individual’s lack of knowledge, a neglecting attitude, and inadequate oral hygiene practices adds to the oral health problems.

Pyorrhea (periodontitis), tooth decay/ cavities, misaligned teeth, and oral cancer are amongst the most common oral health problems affecting people worldwide as well as in the India. It has also been proved by researchers and has been widely accepted by doctors/ dental professionals worldwide that oral and general/systemic healthshare a two-way relationship between them. This means that oral diseases especially,pyorrhea may predispose an individual to different systemic diseases such as uncontrolled blood sugar levels/ diabetes, hypertension, heart diseases and many more. The implications of poor oral health have been shown in Figure 1. Similarly, systemic diseases especially diabetes may also lead to/ worsen oral diseases especially, pyorrhea/ periodontitis. Thus, to keep ourselves healthy, it is very important to maintain an adequate oral health.

Figure 1 : The implications of poor oral health

IMRAD in Original Research Articles

IMRAD is nothing but the acronym used for the 4 basic sections of an original research article, namely Introduction, Methods, Results, and Discussion. Any original article must include these 4 essential parts. Diagrammatic representation of IMRAD is depicted in Figure 1. Each of these sections are designed to answer certain questions as described below.

Introduction – Why was the study carried out? What is the specific question to be answered? What is already known, and what is being sought? What is the specific objective?

Introduction must be written in present tense. It must start with broad topics and gradually narrow down to the precise study topic. Thus, this section must provide the background information, set the stage for the article, and build-up the reader’s interest. It must highlight how the study intends to fill-in the existing gaps and what it will add to the current knowledge that already exists.

                                                                                          Figure 1. Diagrammatic Representation of IMRAD

Methods – When, where, and how was the study conducted?

Methods must be written in past tense. This section must clearly describe how the study was designed and carried out, what was the sample, and how it was collected. Procedures conducted must be described comprehensively in a chronological order. The methods section must describe the outcomes being evaluated in the order of their relevance to the research question. Statistical analysis methods used must also be described here. Methods must be presented such that the process could be reproducible.

Results – What was found?

Results must be written in past tense. This is the most important part of any research article as it provides answers to the questions asked in introduction section. Results must be presented in a simple structured way so that they are easy to read and understand. Tables and figures must be included to present the results. If required, results can be organized in subsections. All outcomes must be reported in this section in the same order in which they have been mentioned in the methods section of the article. Results must be only reported in this section and not interpreted or discussed. Specific statistical data such as p-values must be included.

Discussion

What do the results mean? How do the results compare with the existing published literature? What are the implications and future directions?

Discussion must be written in both present and past tense. Established knowledge must be written in past tense and discussion of current results must be written in present tense. This is the most difficult section to write as the author must put everything together in a comprehensive way and should attempt to draw conclusions from the results obtained. Results must be discussed here with an emphasis on the most significant observations. These observations must then be compared with previously published similar studies. Strengths and limitations of the study must be mentioned. Some speculative discussion can be included, which can serve as the source for future research.

Discussion section can be followed by conclusion section where the overall findings can be summarized succinctly.

We, at Turacoz Healthcare Solutions (THS), provide customized medical communication support. Our wing, Turacoz Skill Development Program (TSDP), provides training solutions in various forms to help the healthcare and pharma professionals improve their skills. Although medical writing is a skill and one gets better at it only by practice, equipping oneself with certain basic tools would be a very good start. Here, we share the basic concept of IMRAD in original research articles, which will help budding writers to understand the importance of following this structure while developing manuscripts.

 

World Health Day: Let’s Talk About Depression

World Health Organization (WHO) celebrates 7th of April every year, as World Health Day to mark the anniversary of WHO founding. This day provides us with an opportunity to spread awareness about a specific health topic of concern amongst people all over the world and take some action towards it.

Depression: The Theme for 2017

Depression is characterized by persistent sadness and a loss of interest in activities that a person normally enjoys, along with an inability to carry out daily activities. In addition, people with depression normally experience the following symptoms:

  • Anxiety
  • Lack of energy
  • Loss of appetite
  • Changes in sleeping patterns and habits
  • Decrease in concentration
  • Restlessness
  • Feelings of worthlessness or hopelessness
  • Thoughts of self-harm or suicide

 

Depression may affect people from all walks of life, irrespective of their age group, gender and ethnicity or geographical location. Depression causes mental anguish and inhibits people’s ability to do the simplest tasks in day-to-day life. It may sometimes lead to devastating consequences for relationships with family and friends, and affect the livelihood of a person causing financial damage. At worst, depression can develop suicidal tendency in a person, making it the second leading cause of death among teenagers and young people.

Depression has spread its pangs into our society and grown into a worldwide problem. Looking at the gravity of this psychosocial disorder, the theme of 2017 World Health Day campaign is “Depression: Let’s Talk”.

 

It’s Okay to Talk About Depression and Seek Help

Talking about depression is the first step towards its treatment. Aim of this WHO campaign is to:

  • Make people more informed about depression, its causes and possible consequences, and what help can be given for prevention and treatment
  • Motivate people with depression seek help
  • Support and help family, friends and colleagues of people having depression

It is most important to make the people with depression feel that they are not alone, and that you care for them. Without having this intention and will, one can never help their friends or loved ones get out of depression. People who are facing this problem need great courage and moral support to cope up with this condition.

The more distant one gets from the family, the closer they get to depression. So, it is important to break the silence and speak about it. Let everyone be a part of the war against this mental illness. Turacoz Healthcare Solutions extends its support and cooperation to all those who are fighting depression.

To Eat, or Not to Eat : Is Mediterranean Diet Good for All?

A lot of talking about Mediterranean food and its benefits has been doing the rounds for quite some time now. Indeed, there are many advantages of planning for such a healthy diet. But first, we should know about the so-called ‘Mediterranean food’.

What is Mediterranean Diet?

The food habits followed in the countries around the Mediterranean Sea is referred to as the Mediterranean diet. This diet-plan emphasizes on eating fresh fruits and vegetables, fish, food prepared in extra virgin olive oil, herbs and spices, and minimal use of salt. A typical Mediterranean diet includes lots of vegetables, fruits, beans, whole grain cereals and cereal products. It also contains moderate amounts of fish, white meat and some dairy produce.

What Are Its Benefits on Health?

Mediterranean diet is a combination of different elements that seem to bring health benefits. It includes healthy fats in the form of monounsaturated fats from olive oil and polyunsaturated fats from seeds, nuts, and fish oil. Such a diet plan is good for people who have:

  • Type 2 diabetes mellitus
  • High blood pressure
  • High blood cholesterol
  • Cardiovascular disorders

How to Start With?

The most important thing to do is to visit your healthcare provider or a registered dietician for a diet plan. Always seek expert advice from your dietician or healthcare provider before you set to take up a new diet plan.You will know about what to eat and what to avoid. In general, few things one should know about the foods included in Mediterranean diet:

  • Bing on fresh fruits- and vegetable salads
  • Cook food in extra virgin olive oil
  • Have about 100-125 grams fish at least twice a week
  • Have1-3 servings of dairy products daily (one serving equals 1 cup of milk /yogurt or 28 grams of cheese)
  • Include nuts, legumes and sprouted grains(wholegrain bread, pasta and brown rice)
  • Incorporate fermented grains (like, sourdough) for easier digestion and better nutrient absorption
  • Add herbs and spices to your food for taste enhancement
  • Reduce intake of salt
  • Include green tea with mint for antioxidant intake

Why Should we Think Twice Before Starting the Mediterranean Diet?

Mediterranean diet plan is based on the traditional food of the people residing in countries around the Mediterranean Sea which have maritime climate and Mediterranean vegetation. Though it has a lot of health benefits, it has some negative effects also.

  • Risk for Hypertensive patients– Mediterranean diet may not be healthy for all the hypertensive patients. Prefer having a diet which is suitable for your body-type and the place where you reside. Besides, food allergies can make this diet plan unsuitable for you.
  • Not cost-effective-Mediterranean food is not easily available in all countries and the cost of the food is also high. It is also not very easy to obtain the food items at places which have a different climate, or at places where seasonal fruits and vegetables are more easily available.
  • Only Mediterranean diet is not enough– Follow a healthy lifestyle to be fit. Regular physical exercise, staying away fromsmoking and alcohol consumption, and having an overall healthy diet is important for good health.
  • Increased intake of olive oil is unhealthy– Mostly people start with an increased consumption of olive oil in the form of fried food. Overeating of snacks which are deep fried in olive oil is definitely not a healthy way to gain the benefits of olive oil.

 

Turacoz Healthcare Solutions wants to make you aware of the health benefits and risks associated with Mediterranean diet. Mere following a new health trend and a new diet chart is not enough. You should know what kind of foods are suitable for your body. We hope to share more facts on healthcare in times to come.

DASH it for Hypertension

Know About the DASH Plan

“DASH” or the Dietary Approaches to Stop Hypertension (DASH) is an eating plan which can reduce the risk of developing high blood pressure, and also manage existing hypertension.

  1. The first DASH diet research showed that it could lower blood pressure as efficiently as the first line anti-hypertensive medications, even with a sodium intake of 3300 mg/day.
  2. Other than hypertension, DASH diet reduces the risk of many diseases like stroke, heart disease, heart failure, kidney stones, diabetes, and even some kinds of cancer.
  3. It can be considered as an Americanized version of the Mediterranean diet, and owing to its specific guidelines it is easier to follow.

 Advise to Follow the DASH Plan

  1. Seek Advice From Experts: The number of servings that is right for you may vary, depending on your caloric need. Hence, it is advisable to consult a nutritionist before adopting DASH diet.
  2. Track Your Diet Plan: A good way to start with the DASH eating plan is to keep a diary of your current eating habits to track down the time where you tend to eat high-fat food, or when you skip meals. Later, make necessary changes in your diet.
  3. Go Slow: Increase your servings of fruits, vegetables, and grains gradually, as DASH diet is high in fibre, and may temporarily cause bloating and diarrhoea.
  4. Know What’s Best for Your Tummy: If you have trouble digesting dairy products, try lactase enzyme pills or drops, or buy lactose-free milk or milk with lactase enzyme added to it.
  5. Look Before You Leap: Carefully read the food labels to compare fat content in packaged foods, as items marked low-fat or fat free are not always lower in calories than their regular versions.
  6. Beat Sugar Cravings: Limit foods with lots of added sugar, such as pies, flavoured yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.
  7. Eat it Right: Instead of snacking on chips or sweets, eat unsalted pretzels or nuts, raisins, low-fat and fat-free yogurt, frozen yogurt, unsalted plain popcorn with no butter, and raw vegetables.

“DASH”is a dietary plan which is clinically proven to reduce blood pressure, and the risk of developing hypertension. We, at Turacoz Healthcare Solutions, consider it our corporate social responsibility to share the dietary approaches that can save you from the pangs of hypertension and many other diseases associated with it. Know how to manage hypertension with the DASH plan.

Desktop Workers! Eat it Right!

Desktop dining has now become a common phenomenon with approximately 65% of working professionals typically having lunch at their desks on a regular basis. Pizzas, burgers, sandwiches, muffins, momos, and doughnuts are the most preferred meals of this group of busy workers who generally, in order to clock-in extra working hours, avoid extra spends and get hooked to these high fat, sugar and salt diets because of lack of options. This increasing trend of consuming quick-tasty-junk at desk when combined with compulsive snacking, caffeine overdose, and minimal water intake plays a massive havoc on our body.

This unhealthy food habit in sedentary office life is a risk factor for several lifestyle diseases such as:

  • Obesity
  • Cardiovascular diseases
  • Stroke
  • Lipid disorders
  • Depression
  • Anxiety

Since our body switches-off the fat-burning process when sitting for a longer period of time, we really need to mind the calories and correct our eating habits while at work.Though we require less calories during this period of minimal physical activity, our body needs a well-balanced and proper nutritional diet to function optimally and prevent malnutrition.

The initial area of focus should be on giving our diet a complete makeover by planning in advance for healthy meals and snack options for the entire week. This proactive planning would limit our urge of compulsive binging and thus,help in controlling the habit of going for unhealthy meal options.

Foods to Include in Daily Diet:

  • Complex carbohydrates (whole grains, cereals, pulses, beans, legumes, fruits, vegetables etc.)
  • Good protein sources (eggs, lean meat, poultry without skin, fish and low fat dairy products)
  • Healthy forms of fat (yogurt, cheese, skimmed milk, nuts, olive oil etc.)
  • Dietary fibers and nutrients (dry fruits, sunflower and pumpkin seeds, granola bars etc.)
  • Sufficient quantity of water

Foods to Avoid in Daily Diet:

  • Processed foods (white flour bread and pastas, chips, candies, processed meat, canned food etc.)
  • Food with high-cholesterol content (egg yolk, bacon, butter, seafood, red meat, sausages, cheese, cakes, pies, and cookies)
  • Unhealthy fat (foods rich in saturated fats like beef, lamb, pork, coconut oil, palm oil etc.)
  • Empty calories (foods with no nutritional content like sweets, soft drinks, and high fat salad dressings)

A nutritious and balanced meal gives us a sustained energy flow and optimizes brain oxygen level without getting too hard on our digestive system. This provides fuel to our brain and energy to our body, improves our cognition, and helps us stay focused – all of which increase our productivity and performance at work.

Turacoz Healthcare Solutions understands the need to make smarter diet choices while sitting for longer working hours. We aim to increase awareness about the negative health impact of unhealthy eating and suggest the ways to healthy eating. Let’s improve our eating quotient and make the right choice.

Triclosan and Memory Loss in Children

What is Triclosan?

Triclosan is commonly used as a disinfectant or an antiseptic to reduce and control the bacterial contamination. It is an organic compound with a slight phenolic smell. It is a very well-known biocide for over 40 years. Although its main application is in cosmetics (maximum allowed concentration 0.3%), triclosan is also ubiquitously usedinanti-bacterial soaps and toothpastes (even upto the concentration0.46%). About 75% of liquid anti-bacterial soaps and 30% of bars use triclosan as an active ingredient. The drug, which was originally used strictly in hospitals and healthcare centres, was adopted by manufacturers of soaps and other home products in course of time.

Triclosan Causes Memory Loss

Triclosan is believed to cause endocrine disruption; even low levels of triclosan may disrupt thyroid function. Poor thyroid function, in turn, may lead to depression, weight gain, fatigue, and memory loss. Also, triclosan degrades to dioxins in the body, which can destroy brain cells. As a result, neurological disorders and emotional distress might happen.

Triclosan attaches itself to the receptor molecules on the surface of brain cells and leads to increased calcium levels inside the cells. As a result, cells become over-excited, leading to cellular death. Over-excitation of brain cells may lead to developmental delays and autism in children.

The United States Food and Drug Administration (US FDA) research, along with countless independent studies, have shown that triclosan does not provide any health benefits as compared to the old-fashioned soaps. Using triclosan-containing anti-bacterial soaps does not give any added advantage over triclosan-free normal soaps in providing antimicrobial protection.

The U.S. FDA has issued a proposed rule requesting additional scientific data to support the safety and effectiveness of such active ingredients used in topical antiseptic rubs (including hand sanitizers) marketed over-the-counter (OTC).

How to Reduce Exposure to Triclosan

Anti-bacterial soaps and hand-sanitizers mostly contain triclosan, which is harmful for children. However, you must ensure that children clean theirhands before eating. A few tips can help you to avoid exposure to triclosan:

  • Choose a safer soap or liquid hand soaps which do not contain triclosan.
  • Encourage washing hands with soap and water, the best way to reduce the number of microbes in most of the situations.
  • If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Exposure to triclosan can disrupt normal brain function and cause memory loss in children. We, at Turacoz Healthcare Solutions, consider it our corporate social responsibility to raise awareness for the minimal use of triclosan-containing antibacterial hand sanitizers, especially in children. Protect your children from the toxic effects of triclosan.

Health Hazards of Being a Medical Writer

Being a medical writer has a lot of allure, particularly if you are having a flexible work schedule, competitive salary package, and assured growth as a professional. However, having these advantages doesn’t insulate you from some of the hazards that you may face as a medical writer. Medical writing, being a sedentary job, requires sitting behind a desk for long hours, which over a period of time can take a toll on your health.

The Risks

  • Metabolic Diseases 
    Medical writers spend their maximum awake time sitting and working. Sedentary lifestyle and reduced physical activity contribute to the excessive body fat around the waist and abnormal cholesterol levels, which are major risk factors for certain diseases like obesity, hypertension, and diabetes.
  • Cardiovascular Diseases
    The sedentary lifestyle attributes to abnormal cholesterol level which is a major risk factor for cardiovascular diseases like atherosclerosis, stroke, angina, and heart attack. It is found that the risk of heart disease is increased by 50 per cent in a sedentary worker (who sits for 11 hours or more a day) even if exercise is performed regularly.
  • Posture Problems
    Due to the nature of work, a medical writer usually works in a ‘static posture’ throughout the day that results in a faulty ergonomics. Rotator cuff disease, chronic pain in the neck, shoulder, back or hand, ruptured disks, and pulled or strained muscles/ligaments are the few disorders that might occur due to static posture. Several studies have reported that there is an increased risk of physical injuries if a worker maintains a static posture throughout working hours.
  • Bone and Joint Disorders
    Spending daily 8 hours or more working on a desktop/laptop without any significant movement of the joints and muscles of limbs may result in loss of muscle mass, loss of muscular flexibility, carpal tunnel syndrome, and hand/wrist tendinitis.
  • Eye Problems
    Prolonged working on a desktop or laptop and gazing the screen for hours expose eyes to undue effects of brightness of the screen that later results in eye strain, temporary blurred vision, headaches, and migraines.
  • Psychological Problems
    In today’s competitive world, analogous to any other professional, medical writers also experience several psychological problems like stress, anxiety, exhaustion, depression, and disordered sleep.

 

The Remedies

Overall, being more physically active is the basic remedy to reduce the chances of all the potential health problems that are associated with the sedentary nature of the work of a medical writer. It is recommended that a sedentary worker (e.g. a medical writer) should spend a minimum of 10 minutes in moderate- or vigorous-intensity aerobic exercise to improve circulation of blood and burn calories. Additionally, there are a few health tips which a medical writer should follow:

  • Take regular breaks during the working hours. After every couple of hours, stand up from the desk and move around.
  • After every 30 minutes of desktop work, do basic stretching exercises at your desk. This will help in maintaining flexibility of the muscles.
  • Avoid getting locked into a static posture. Change your posture frequently by adjusting the angles of your hips, knees, ankles, and elbows while sitting.
  • Be more active: take stairs instead of the lift, prefer public transport or cycle to work.
  • Eat smart. Avoid binging and unhealthy eating habits.
  • Keep your body well hydrated by drinking enough amount of water.
  • Don’t eat while you work. Ensure you eat lunch away from your desk.
  • Adjust the brightness of the screen of your laptop/desktop. Don’t gaze the screen fora long Take regular breaks to relax your eyes.
  • Ensure that you spend at least an hour each week in outdoor sport or leisure activity of your choice.
  • Don’t work hard, work smart.Plan well before you start to work, divide all major tasks into sub-tasks and organise your work schedule. This will help to reduce the chances of having stress and anxiety.
  • Don’t be a workaholic! Make sure you spend a reasonable amount of time with your family and friends, which is important for your mental and emotional well being.

Being sedentary is the root-cause of most of the health problems. Making appropriate lifestyle changes in your daily work schedule may reduce your risk of having these health problems. As a medical communication company, we at Turacoz Healthcare Solutions always encourage our medical writers and everyone to exercise daily and lead a physically active, healthy life.

Keep Your Skin Healthy: Prevent Seasonal Ailments

As the cool showers of monsoon bring relief after the torrid summers, the warm humid weather also brings numerous skin problems in trail. Some common skin problems which may cause trouble in this season are:

  • Heat rash: Heat rash is a red pimply eruption caused by sweating that leads to choking or blockage of skin pores.
  • Eczema: It is aterm applied to variety of skin conditions that result from inflammation of the skindue to external and genetic factors.
  • Acne:It is a common skin problem during the rainy season, mainly for youngsters. Itresults from bacterial overgrowth on the face, especially due to exposure to a lot of rainwater.
  • Ringworm and folliculitis: These are bacterial or fungal infections that result from excessive sweating, dehydration, photo-toxic effects of the sun, and humidity.
  • Nail infection: Infections can occur due to long nailsthat attract muck, and can make nailsdiscolored, brittle and dull.
  • Athlete’s foot:It is an itchy painful infection on the feet with well defined, scaly patches caused by common fungi called Candida. The toe nails may get discolored or brittle.

 

Tips to Keep Your Skin Healthy

Some easy skin-care tipscan protect your skin from having bacterial and fungal itches during the rainy season:

  • Control sweat: The ideal way to avoid skin problems is to keep it clean and avoid excessive perspiration. Take regular and more frequent baths. Use anti-bacterial soaps, talcum powder and face wash to keep yourself clean.
  • Quick-wash after rain-wash: Children are highly prone to fungal infections during the monsoons. An immediate bath after playing in the rain and application of an anti-bacterial soap is important. Avoid using public toilets, where due to lower hygiene you are exposed to infections.
  • Natural skin-care: Use anti-fungal cream or powder for nail-itches. Calamine lotion is a good option to ease skin-itching. Natural and home-made remedies such as aloe-vera, rosewater and milk can keep your skin fresh.Apply moisturizers to keep your skin hydrated.
  • Check what you wear: Wearcomfortablyloose cotton and linen clothing. Wear slippers and flip-flops as they allow your feet to breathe. Avoid wearing plastic shoes, leather or canvas ones. Wash your feet regularly, and apply anti-fungal powder in shoes and socks.Wear washed cotton socks daily and keep feet clean and dry. One must never stay in wet socks for long hours.
  • Watch your diet: Since the chances of infection increases during the rainy seasons, increase vitamin Cintake as it is an effective immunity-booster.Keep yourself well-hydrated with at least 6 to 8 glasses of water daily. Add the juice of a lemon to a glass of warm water and have it first in the morning. Fresh fruits, salads, sprouts, whole grains and curd must be included in daily diet.
  • Skin care for diabetics: People with diabetic diseases are more prone to skin infections. They must go for a check-up when symptoms like skin rashes or redness appear lest they leave scars and turn untreatable.

Several skin ailments are the result of our ignorance and a care-free attitude towards monsoon—borne microbial infections. These infections may grow into serious problems, if not nipped in the bud. Turacoz Healthcare Solutions wants to share some basic skin-care tips this season. So stay healthy, keep your skin monsoon-proof and enjoy the rains.

Transient Smartphone Blindness: Dark Side of Bright Screens

Disturbed sleep and strained red eyes seem to take a back seat as we stand face-to-face with a much more alarming side-effect of the endless smartphone usage, scientifically termed as ‘transient smartphone blindness’. Cradling your smartphone and gazing at it late at night or early in the morning, while lying in bed, leads to this unusual phenomenon of temporary vision loss.

The problem: A recent report published in the New England Journal of Medicine1 outlined the case studies of two women who suffered from impaired vision for months after regularly using their smartphones in the dark.

  • The first case was of a 22-year-old woman with right eye vision loss at night.
  • The second case was of a 40-year-old woman with recurrent monocular visual impairment on waking, lasting up to 15 minutes.

Investigation of both the cases revealed that these patients used smartphone for quite some time in the dark with just one eye while lying in bed and that the symptoms were always in the eye opposite to the side on which the patient was lying.

The Cause: Lying on one’s side while using the smartphone in the dark leads to differential bleaching of the retinal pigments, making the viewer eye light adapted while the other eye, being closed or covered by a pillow, becomes adapted to dark.2 The eye staring at the bright screen is always the one to be temporarily blind when the smartphone is put down because it takes time for the phone eye to catch up with the dark adapted eye.

The Fix: Till now the long-term effect of this strange condition is not documented but viewing screens binocularly i.e. with both eyes, is a quick and simple solution recommended by ophthalmologists.

The global smartphone user-base is exponentially increasing each day with more people going to bed with their phones which puts them at a higher risk of transient smartphone blindness. Luckily enough, the condition is temporary and probably more distracting than dangerous.

 

Turacoz Healthcare Solutions is a medical writing organization which provides assistance in publication of research articles and clinical research documents. We consider it our corporate social responsibility to raise awareness about transient smartphone blindness. The best vision is insight!

 

References:

  1. Alim-Marvasti A, Bi W, Mahroo OA, Barbur JL, Plant GT. Transient Smartphone “Blindness”. N Engl J Med. 2016;374(25):2502-4.
  2. BEC CREW. Science alert. 2016. Available at: http://www.sciencealert.com/smartphone-users-experience-temporary-blindnss-after-looking-at-their-screens-in-bed. Accessed on: 2nd Aug 2016.

Dehydration and Importance of Oral Rehydration Salts

Introduction

Dehydration is a condition where free water loss exceeds free water intake. Around 2/3rd of the human body is composed of water, and helps in various functions such as lubrication of the joints and eyes,digestion, flushing out of wastes and toxins, and maintaining the balance of minerals (salts and sugar) in our body. Dehydration may occur due to exercise or diseases, high environmental temperature, not drinking enough fluids, persistent vomiting and diarrhea, sweating due to fever etc.

Causes for Dehydration

There are different conditions which may cause dehydration. Some of them are as follows:

  • Gastrointestinal: Diarrhea and vomiting due to gastroenteritis, cholera, yellow fever or infection of the gastrointestinal tract leads to dehydration as well as an electrolyte imbalance.
  • Sweating:Excessive sweating due to vigorous exercise, sports, fever, heavy manual work, climatic conditions etc. results in fluid loss and dehydration.
  • Alcohol intake: Alcohol is a diuretic and stimulates urination resulting in dehydration.
  • Diabetes: In diabetes, kidney removes extra glucose along with water, which in turn may result into dehydration.
  • Blood loss: Excessive loss of blood can also result in dehydration.

People can tolerate 3-4%decrease in total body water without any difficulty. But 5-8% decrease can cause fatigue and dizziness and above 8% can prove to be dangerous.

Signs and Symptoms

The early signs of dehydration include feeling thirsty and lightheaded, dry mouth,tiredness,having dark colored face, strong smell in urine, passing urine less often than usual etc.

Remedies and Treatments

  • Drink plenty of fluids such as water, squash or fruit juice and avoid caffeinated beverages and fizzy drinks.
  • In illnesses such as vomiting or diarrhea, it is difficult to maintain optimum water level in our body. In such cases, it is better to have small sips of water or other fluids.
  • Infants and children who are dehydrated or having diarrhea should be given oral rehydrated salts (ORS)as recommended by World Health Organization (WHO) instead of water.This is because water can dilute the already low levels of electrolytes and minerals in the body. ORS is a mixture of electrolytes and sugars mainly given to restore imbalance of body fluids. It is very helpful in adults suffering from dehydration, vomiting, and diarrhea.

Importance of ORS

  • ORS is a special combination of dry salts (electrolytes) that are mixed with water. It can help to replace the fluids lost due to diarrhea and vomiting.
  • ORS is important because it helps to rehydrate the body with essential electrolytes, especially sodium and potassium.
  • In severe case of dehydration, when fainting or unconsciousness occurs, ORS can be given through intravenous injections for replenishment of necessary electrolytes and water.
  • In mild dehydration, an oral rehydration can be given which is less painful, and less expensive as compared to ORS given through intravenous route.
  • ORS can be prepared at home by simply mixing 6 level teaspoons of sugar and 1/2 level teaspoon of salt in 1 liter of clean water.
  • ORS is the best treatment option for dehydration

Turacoz Healthcare Solutions is engaged in spreading awareness among people regarding any healthcare issues. We consider it our responsibility to create awareness about any health-related issues in the general public.

Sedentary Lifestyle: A Threat to your Good Health!

Humans were designed to move around and stay physically active. However, over the period of time, we evolved technologically and the levels of our physical activity steeply declined. Our environment at work, schools, homes, and public places were gradually engineered in such a way which restricted our daily physical activity and compelled us to assume a non-exercising behaviour. Steadily, we adapted the non-exercising behaviour in our lifestyle and became sedentary or negligibly active.Parallel with this major change in our lifestyle, several pieces of evidence emerged which identified sedentary behaviour as a novel risk factor for cardiometabolic diseases and all-cause mortality. Studies showed that the mediocrity begins the precise moment when we swap activity with sedentary behaviour. Therefore, it is important to understand the health risks associated with sedentary lifestyle and take timely action.

What is a sedentary lifestyle?

A sedentary lifestyle can be defined as sitting, lying down, and expending very little energy (approximately 1.0-1.5 metabolic equivalents [METs]) in a day. Due to limited physical activity and associated health risks, asedentary lifestyle is also termed as a “sitting disease”.

Who is expected to have a sedentary lifestyle?

With changing nature of our work and leisure activities, an average adult is likely to spend more than 70% of the waking time in a day being sedentary or minimally active. The levels of inactivity tend to increase with growing age, and women are more prone to inactive lifestyle as compared to men. However, recent trends have shown a surge in sedentary behaviour among children.

Health risks associated with sedentary lifestyle

Lack of physical activity has clearly been shown to be a risk factor for several physical, mental and psychological disorders. Individuals having a sedentary lifestyle are at greater risk of having cardiovascular diseases, hypertension, pulmonary embolism, diabetes, and obesity. Increased adiposity (excessive weight gain) due to sedentary lifestyle also increases the risk of certain cancers like endometrial cancer, colon cancer and breast cancer. Additionally, non-exercising behaviour also results in several bone and muscle disorders like osteoporosis, back or neck pain, and muscle degeneration. An overall poor health of a sedentary individual is later accountable for developing psychological stress, depression and anxiety disorders. Worrisome is the fact that lack of physical activity and its associated conditions account for about 3.2 million deaths a year across the globe.

Tips to overcome sedentary lifestyle

Sedentary lifestyle can be easily avoided by making few smart choices at work and leisure, such as:

  • Go NEAT (non-exercise activity thermogenesis), i.e. set an alarm after each couple of hours which reminds you to stand up and go on your feet. This can include simple stretching, taking a walk around the office, or a 10-minute brisk walk. It is an ideal option for those who can’t manage to go to the gym after work.
  • Walk n Work:Schedule walking meetings with your team, walk while having a telephonic conversation, pick up your lunch instead of ordering delivery, walk to the market for picking up daily grocery, and take stairs instead of elevator whenever permissible.
  • Rearrange the workplace: Install treadmills or stationary cycles to encourage physical activity at work, schedule regular exercise sessions at workplace for your team, and relocate water coolers and trash cans so that people have to move from their workplace to use them.
  • Commute differently:If possible, try to commute with public transport or use cycle instead of personal vehicles.
  • Exercise:Try to engage yourself in a physical activity, exercise or sport of your choice. Make sure you spend at least a day each week exercising.

Being physically active is necessary for having a physical and mental well-being. A sedentary lifestyle is a root cause for most of the modern day diseases and it can be easily avoided by making healthy choices for you and your family. Turacoz Healthcare Solutions always tries to encourage its employees and everyone to exercise daily and lead a physically active, healthy life.

Physical activity should be adopted as a behaviour in daily life, and one should remember to ‘get up and move’!

Novel Therapeutic Advances for Management of Diabetes Mellitus

Diabetes mellitus (DM) has become one of the most challenging health problems in the 21st century. It is a serious public health problem globally, but the good news is that various advances are being made in prevention, detection, and treatment of diabetes. Though prevention is always better than cure, yet sometimes prevention is not possible and the cure seems to take ages. The interest to find a possible cure for diabetes has eventually led to exploration of various new scientific areas of research.

Volanesorsen

Volanesorsen (formerly ISIS-APOCIIIRx)is an antisense drug in development intended to treat patients with severely high triglycerides either as a single agent or in combination with other triglyceride-lowering agents.Elevation in triglycerides has always increased the risk of cardiovascular disorders as well as type 2 diabetes mellitus (T2DM). Researchers from the University of Pennsylvania have found the therapeutic effect of lipid-lowering medication sin improving insulin sensitivity in people with T2DM. Volanesorsen is an oral medication that can help to control the blood sugar levels. Itis believed to improve the insulin sensitivity and significantly decrease the patients’ overall glycated hemoglobin (HbA1c). After taking the medication for 12 weeks, researchers found that adult T2DM patients receiving volanesorsen experienced 69% reduction in triglycerides, and 57% improvement in whole-body insulin sensitivity.Researchers concluded that decrease in triglycerides was strongly related to improved insulin sensitivity and improved HbA1c.

PEGylated Lispro

PEGylated lispro (LY2605541) has been developed by the addition of polyethylene glycol (PEG) to insulin lispro, leading to its extended half-life. Early phase evaluations of PEGyalted lispro confirm its non-inferiority to glargine with a potential weight advantage when used in T2DM. Since insulin therapy is anabolic and its initiation is commonly associated with weight gain, an insulin preparation associated with a beneficial weight profile would represent a particularly valuable therapeutic entity.

Pre-clinical studies indicate that LY2605541 has low mitogenic potency, exerting a preferential hepatic effect on glucose homeostasis. However, LY2605541 appears to cause elevated transaminases and derangement of lipid profiles. On the basis of these initial observations, LY2605541 requires further extensive clinical evaluation to fully assess its risk/benefit profile in the management ofdiabetes.

Islet Transplantation

A novel technology has been developed to help treat type 1 diabetes mellitus (T1DM) and potentially negate the need for insulin injections. Islets are organoids that produce multiple hormones, including insulin, and donated islets are already treating severe cases of T1DMeffectively. Islet transplantation can transform the lives of T1DM patients, and may result in long-term freedom from insulin injections with excellent glucose control.

Natural Products

Plants possessing antidiabetic properties may be suitable as an adjunct to the existing therapies or as a prospective source of new hypoglycemic compounds. Many new bioactive drugs isolated from plants demonstrate antidiabetic activity equal to known oral hypoglycemic agents such as tolbutamide and chlorpropamide. Several plant species with terpenoids, flavonoids, phenols, coumarins, and other bioactive constituents have shown their potency in reducing blood glucose levels. Plants likeAllium sativum(Liliaceae),Gymnema sylvestre(Asclepiadaceae),Murraya koenigii(Rutaceae),Allium cepa(Liliaceae),Withania somnifera (Solanaceae), andFerula foetida (Umbelliferae) have exhibited antidiabetic properties when assessed in experimental models of diabetes. These traditional approaches might prove to bebeneficial in treatment of diabetic complications.

Great strides have been made clinically in the management of diabetes. Extensive research may lead to discovery of newer and better options for diabetes. With new technologies revolutionizing the treatment possibilities, the search for an effective medication is not far ahead.

Turacoz Healthcare Solutions aims to create awareness for such healthcare issues like diabetes mellitus which pose a serious threat to people, irrespective of race, gender, or age. We consider it our corporate responsibility to share the knowledge related to therapeutic research and development, and keep you updated with the recent medical advancements in the healthcare industry.“Being aware of a disease and its deleterious consequences”is the first-step towards its prevention. So stay healthy and stay long.

Ramadan: Healthy Foods for a Healthy Fasting

It’s again Ramadan time. Millions of Muslims fast during this period and abstain from eating and drinking. However, two main meals are taken during Ramadan: ‘Suhur’ which is served before dawn and ‘Iftar’ which is taken after sunset. It is very important that Suhur comprises of a healthy meal to provide you energy for the whole day, and Iftar is a light meal to avoid weight gain.One should take foods that are rich in complex carbohydrates and protein, fruits or vegetables, and plenty of water to maintain a healthy fasting. Here are the few tips:

  • Incorporate brown rice, wholemeal bread or wholegrain noodles in diet which take longer more time to digest, and help in sustaining energy levels longer
  • When preparing rice, noodles and other grains, season with herbs, spices and broths
  • Include high-calcium low-fat dairy products in your diet to maintain strong bones
  • Lactose intolerant persons can choose lactose-free milk or calcium-fortified soybean milk
  • Eat fish as it contains the healthy fat- omega-3fatty acid
  • Prefer white meat over red meat and choose from low fat meat options (like veal, chicken and fish)
  • Add herbs, sliced lemon or lemon juice to white meats and fishinstead of spices and salt
  • Add favorite fruits, dates, and honey to the desserts to include more fiber and make the food vitamin-rich
  • Replace sweets with stuffed dates, which are rich in fibre and are healthy
  • Use home-made cream for the qatayef stuffing, which cuts down almost three-quarters of the calories

When deciding what to eat during Ramadan, one must remember that consuming the right food is very important. Turacoz Healthcare Solutions is passionate to spread the awareness on such social or healthcare related issues as a part of their Corporate Social Responsibility (CSR) activity. We consider it our responsibility to share the healthy way of fasting.

Surya Namaskar: A Complete Health Guide for Recent Times from Ancient India

Surya Namaskar or sun salutation is a way of saluting sun, the ultimate source of energy and life on earth. Our solar plexus or second brain which is located in the central part of the body, i.e. behind navel, is assumed to be connected to the sun. This rationale must be behind the gurus and rishis of ancient and current times who recommend Surya Namaskar regular practise to increase one’s creativity and intuitive abilities.

The 12 postures of Surya Namaskar are in sync with the sun’s cycles which run at twelve-and-a-quarter years. In addition to having the known health benefits, performing Surya Namaskar also makes your body ready to vibrate and breathe with the natural solar cycle.

According to Sathguru, young women are already in sync with the smallest natural cycle i.e. lunar cycle. Now if women do Surya Namaskar also every day, they will be synced to both solar and lunar cycles, and that gives a lot of energy.Probably that is why God gave the privilege to propagate the race to the women.

The 12 steps of Surya Namaskar are:

  1. Pranamasana or Prayer pose
  2. Hastauttanasana or Raised arms pose
  3. Hasta Padasana or Hand to foot pose
  4. Ashwasanchalanasana or Equestrian pose
  5. Dandasana or Stick pose
  6. Ashtanganamarkara or Salute with eight parts/points
  7. Bhujangasana or Cobra pose
  8. Parvatasana or Mountain pose
  9. Ashwasanchalanasana or Equestrian pose
  10. Hasta padasana or Hand to foot pose
  11. Hastauttanasana or Raised arms pose
  12. Tadasana

Some quick facts:

  • Twelve sets of Surya Namaskar is equivalent to 288 poses and can be done in only 12 minutes.
  • One round of Surya Namaskar can burn upto 14 calories for an average weighing person.
  • The sets can be increased up to 108 in a day.

Surya Namaskar is a complete exercise of body and soul. Including it in our daily routine can help us enjoy better life and be more productive.

One of the pillar of Turacoz Healthcare Solutions is our people and we always try to inculcate healthy habits and life style modifications to attain a comprehensive health, enjoy the life, and God’s creations. On this #InternationalYogaDay, Turacoz team pledges to inculcate healthy habits in their lifestyle and spread the awareness as a part of their corporate social responsibility.

Ramadan Fasting and Diabetes Management

Ramadan is a holy month for Muslims in which consumption of food and drinks, medications, and smoking is forbidden between dawn and dusk. During Ramadan, millions of Muslims fast during the daylight hours. People generally consume only two meals per day during this month, one after sunset (Iftar) and the other before dawn (Suhur). However, this can lead to metabolic changes in the body and can give rise to various health complications, especially in diabetic patients. Although any person who is ill or has some medical condition like diabetes can choose not to fast, it becomes a personal decision. In casediabetic patients choose to fast, they should consult their doctors before starting fasting during Ramadan.

Diabetes is characterized by high blood sugar levels in the body due to insulin deficiency or inability of the body to use insulin properly. Long fasting and fluid restriction during the day can lead to dehydration and fluctuations in sugar levels. These patients can experience any one of the following:

  • Hypoglycemia (lowering of blood sugar levels) due to long fasting hours leading to seizures and loss of consciousness
  • Hyperglycemia (increased blood sugar levels) due to increased food/sugar intake during Iftar and abstaining the use of antidiabetic medications
  • Diabetic ketoacidosis (a life-threatening situation) in patients having high blood glucose levels and taking reduced dosage of insulin during Ramadan
  • Dehydration leading to volume and electrolyte depletion and causing syncope, falls, and injuries

 

Managing Diabetes During Diabetes:

It is very important that patients with diabetes make a personal choice of fasting during Ramadan only after considering their health condition and proper consultation with their physicians. They should be aware of the associated risks and adhere to the doctors’ recommendations in order to have a safe fasting. Diabetic patients should monitor blood glucose levels regularly during Ramadan. If the blood glucose falls below 70 mg/dL, the fast needs to be ended. Checking blood glucose is very important and does not mean breaking the fast. Secondly, dosage of antidiabetic medications need to be modified during Ramadan. That doesn’t mean that a person has to stop taking his medications. Only the doses will be altered based on his sugar levels and current condition.

During Suhur, a diabetic patient should go for healthy breakfast including starchy carbohydrates and some proteins to slow down the digestion and maintaining the feeling of fullness. Breakfast can include: whole grain cereals, some lentils, and low-fat milk. During Iftar, one should drink plenty of fluids, but avoid caffeine and sugar containing beverages. One should not overeat during Iftar and have small meals. Fried food, sweets, and excessive sugar containing foodsshould be avoided.

With proper management plan and regular glucose monitoring, diabetic patients can experience a healthy living and maintain their religious beliefs during the month of Ramadan.

 

HAVE A HAPPY AND HEALTHY RAMADAN!

Turacoz aims to spread the awareness on various healthcare related issues as a part of their Corporate Social Responsibility (CSR) activity. Our medical writing team is well-versed with recent advances in various therapeutic areas. We provide support in publication writing, clinical research and regulatory writing, medical advisory board meetings and medical marketing services.

Sexual and Reproductive Health Awareness

February 12 is declared as Sexual and Reproductive Health Awareness Day annually. This day provides an opportunity to raise awareness about sexual and reproductive health issues and educate to reduce the spread of sexually transmitted infections (STIs). STIs are one of the major public health concerns. Hence,

Sexual and Reproductive Health Awareness Day is therefore an annual health promotion event which focuses on the importance of sexual health issues. Also these health awareness events create publicity for health issues and aims to improve the condition and help save lives, sometimes these events encourage preventative action against conditions becoming more serious.

Sexual health is a broad area that encompasses many inter-related challenges and problems. Key issues and concerns are human rights related to sexual health, sexual pleasure, eroticism and sexual satisfaction, diseases (HIV/AIDS, STIs, RTIs [reproductive tract infections]), violence, female genital mutilation, sexual dysfunction and mental health related to sexual health.

The objectives of this awareness include:

  • Improving the acceptability of safer sex behavior;
  • Decreasing the prevalence of STIs within the community;
  • Providing sexual health information, education and resources ; and
  • Improving health seeking behaviour to increase testing and treatment for STIs.

The goal of having an awareness week is to encourage people to consider the importance of maintaining reproductive health and talking about healthy decision-making with the people they care about.

 

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Screening tests may help find diseases or conditions early when they are easier to treat. It is also important that each of us is aware of our own bodies so if changes occur that don’t seem normal they can be checked by a health-care provider.

 

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The National Population Stabilisation Fund (Jansankhya Sthirata Kosh) has started a helpline to provide confidential counseling services and immediate answers to queries on sexual and reproductive health problems. For authentic telephonic information on Reproductive Health, Family Planning and Infant Health, Call 1800-11-6555. This helpline operates daily from 9am to 11pm. A team of health executives and doctors answer questions about sexual health concerns, sexually transmitted infections, contraception, pregnancy, infertility, abortions, menopause and puberty and can explain the functioning of the reproductive systems of males and females.

The helpline will also work towards removing popular misconceptions about sex, important in a country such as India where the subject is still socially taboo. When experimented with in schools, confidential information services have been shown to be in high demand. They can help in providing objective advice from a respected source rather than peers, the Internet and word of mouth, increase public knowledge of their rights and trust in public facilities, and can reduce the bridge between users and services.

Education can provide the social vaccine needed, offering a real chance at a productive life. Not only is education essential for preventing HIV, preventing HIV is essential for education.

 

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The role of air purifier to combat air pollution

Air pollution is the introduction of chemicals, particulate matters or biological materials in air, for a sufficient time that causes harm or discomfort to humans or other living organisms or damages the natural environment. Clean air is considered as a basic requirement of human because it determines the health of the lungs as well as other organs. In order to extract 420 litres of oxygen that is crucial for human survival and function, a total of 10,000 litres of air enters the lungs every day. However, air pollution is continuously rising and responsible for significant threat to health worldwide. According to the World Health organization (WHO) report, around 7 million people died in 2012 as a result of air pollution exposure confirming that air pollution is now the world’s largest single environmental health risk.

There are different types of air pollutants, which affect the living organism as well as climate in different ways, depending on their specific properties and ultimately effect the living organisms. Air pollutants mainly consists of gas and particle contaminants that are present in the atmosphere. Gaseous pollutants includeSO2, NOx, ozone, carbon monoxide (CO), volatile organic compounds (VOCs), certain toxic air pollutants, and some gaseous forms of metals whereas particle pollution (PM2.5 and PM10) includes a mixture of compounds.

Various scientific studies have associated with air pollution to a number of health problems, which include: (1) diminished lung function; (2) precipitation of respiratory symptoms such as difficulty breathing and coughing; (3) worsening of respiratory and cardiovascular disease; (4) increased susceptibility to respiratory infections; (5) adverse effect on nervous system, including the brain, such as Intelligence quotient (IQ) loss and impacts on learning, memory, and behaviour; (6) cancer; and (7) premature death.

While air quality regulations can reduce air pollution at a societal level, but individuals can also play important role to improve the air quality especially in their house. With a better understanding of indoor pollutants (e.g., dust mites, household pets, cockroaches, mould, environmental tobacco smoke, wood smoke, volatile organic compounds), a new and effective measures i.e. air filters have evolved. Indoor air filtration can also be provided by whole house filtration via the home’s heating, ventilation, or air conditioning system, by portable room air cleaners.

Currently available air purifiers usually have a multilayer filter system composed of a pre‑filter, a carbon filter, an antibacterial filter, and a HEPA (High-efficiency particulate arrestance) filter. The HEPA filters, which were traditionally used in hospitals, has indeed been a significant inclusion to home air purifiers. A HEPA filter uses mechanical filtration to remove airborne particles. A HEPA filter is standardized at a minimum 99.97% efficiency rating for removing particles greater than or equal to 0.3μm (1/83,000 of an inch) in diameter. This means that for every 10,000 particles that are 0.3μm in diameter, 3 will pass through the filter, and the rest will be trapped by the filter.

Although air pollution remains a worldwide epidemic and need multi-tiered prevention strategy, use of air filter which efficiently remove particulate matter, may result in significant health benefits to patients of asthma and cardiovascular disease. Besides, children, the elderly, and women will also be benefited, if indoor air quality is good because they spend more time in the home environment.

#AIDS:IndianStatistics

It is believed that around 1920, a deadly virus crossed species from chimpanzees to humans in Kinshasa (Africa), and led to the beginning of an era full of illness, fear, and discrimination. The deadly virus was called human immune-deficiency virus or HIV. Over decades, the virus slowly spread to other parts of the world, and a large number of people became infected. Depressed immunity, huge number of infections, and high mortality rates were observed. In 1982, Centers for Disease Control and Prevention (CDC) used the term acquired immunodeficiency syndrome (AIDS) for the first time. AIDS was defined as “a disease at least moderately predictive of a defect in cell mediated immunity, occurring in a person with no known case for diminished resistance to that disease.” Soon, the disease became an epidemic and engulfed the whole world.

As per UNAIDS, the number of people living with HIV increased from 9 million in 1990 to 36.9 million in 2014. AIDS-related deaths also increased drastically from 320,000 in 1990 to 2 million in 2004-05. However, this led to emergence of global actions for management of AIDS and with more people receiving treatment, improvements could be seen. As a result, the number of deaths has been estimated to decrease to 1.2 million in 2014.

WHERE DOES INDIA STAND?

Globally, 15 countries account for nearly 75% of the people living with HIV, with the top 3 countries being South Africa (18%), Nigeria (9%), and India (6%). Being a densely populated country with a large number of people under poverty line, living in unhygienic conditions, or lacking awareness, AIDS is a major health concern in India. By 2013, 2.1 million people were estimated to be living with HIV in India. Out of this, there were approximately 140,000 children aged 0 to 14; 750,000 women aged 15 and above; and 1.9 million adults aged 15 years and above. The prevalence rate in adults was noted to be 0.3.

Let’s look at the regional variations: The distribution of HIV is heterogeneous throughout the country. As per National AIDS Control Organization (NACO), the highest prevalence has been noted in Nagaland (0.88%), followed by Mizoram (0.68%), Manipur (0.64%), Andhra Pradesh (0.59%), Karnataka (0.53%). Chhattisgarh (0.51%), Gujarat (0.50%), Maharashtra (0.40%), Delhi (0.40%), Punjab (0.37%), Bihar (0.33%), Rajasthan (0.32%), and Odisha (0.31%).

Who all are affected?

In India, female sex workers, men who have sex with men, transgender, and people who inject drugs have been identified as the core high-risk groups. They are at high risk of HIV infection and play a significant role in the HIV transmission to general population through sexual networks. Besides them, truck drivers and migrant workers can transmit infection as they have mobile working jobs and are more likely to come in contact with the high-risk groups like female sex workers.

Population National prevalence in 2011
Female sex workers 2.8%
Men who have sex with men 4.43%
Transgender 8.82%
People who inject drugs 7.14%
Migrant workers 0.99%
Truck drivers 2.59%
Source: NACO Annual Report, 2014

The sad part: Unfortunately, 64% of these people living with HIV were found to have no access to the treatment in 2013. This led to approximately 130,000 AIDS-related deaths in India, which accounts for 8% of the AIDS-related deaths in the world and 51% in Asia.

Looking at the brighter side: Even though AIDS is a major concern in India, the number of people living with AIDS has decreased from 2.4 million in 2005 to 2.1 million in 2013. Also, the estimated number of new infections has decreased from 160,000 in 2009 to 130,000 in 2013 (19% decline). A 38% decline has been noted in AIDS-related deaths between 2005 (210,000 deaths) and 2013 (130,000 deaths). Overall, the epidemic is slowing down in India.

And the credit goes to: Various prevention and treatment interventions launched by Government of India under the National AIDS Control Programme (NACP) have played an important role in fighting with AIDS. Its main objective has been to reduce new infections and provide care, support, and treatment to people with HIV or those who are in need. The number of centers providing antiretroviral (ART) treatment has increased from 25 in 2005 to 425 in 2014, and the number of patients receiving first-line ART has increased from 6,845 in 2005 to 768,000 in 2014. HIV counseling and testing services have also scaled-up in India: from 4,567 Integrated Counseling and Testing Centres in 2007-08 to 15,606 in 2013-14. Resources allocation through states has also increased from Rs. 733.04 crores in 2008-09 to Rs. 931.00 crores in 2013-14.

The road ahead: Although improvements have been seen, it is a long way ahead to attain an AIDS-free country. Fast-track targets have been established to secure ZERO new infections, ZERO discrimination, and ZERO AIDS-related deaths in the future. The global consensus is to aim for 90-90-90 by 2020, i.e. 90% of people living with HIV know their HIV status, 90% of people who know their status receive treatment, and 90% of people on HIV treatment have a suppressed viral load so that their immune system remains strong and they are no longer infectious.

By 2020 90-90-90 treatment, ZERO discrimination
By 2030 95-95-95 treatment, ZERO discrimination

Let’s just hope that the occurrence of AIDS keeps on dipping, and we attain ZERO infections!

Sources: NACO and UNAIDS

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing. 

# VaccineHesitancy

As described by the WHO, immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease. In simpler terms, vaccination is your best shot for health. Therefore, for a healthier life it is recommended that everyone should be vaccinated according to schedule advised by their family doctors.

Despite knowing the importance of immunization and easy accessibility of vaccines, people often refuse or deny to vaccinate themselves or their children. “Vaccine hesitancy” is, therefore, the biggest challenge faced by the healthcare system in achieving optimal immunization among masses. It is evident that vaccine hesitancy negatively impacts on vaccine uptake rates and the performance of national immunization programs of the country. The UN health agency reported that globally, one in five children still do not receive routine life-saving immunizations, and an estimated 1.5 million children die each year of diseases that could be prevented by vaccines.

 As per the WHO, denying or refusing vaccination against any disease not only increases the vulnerability of an individual for that particular disease, but it also widens the immunization gap in the population. Vaccine hesitancy is a complex issue that is influenced by multiple factors such as misinformation, complacency, convenience, confidence, and fear of needles. Myths associated with vaccines such as vaccination of women leading to infertility is also a major reason for denying vaccinations, particularly among the rural population.

To overcome these issues, WHO, in the recently published editorial recommended the healthcare organizations to focus on increasing the understanding of vaccine hesitancy, its determinants, and challenges among the lay population. The recommendations also focused on usage of evidence-based practices that are required in dealing with the structures and organizational capacity to decrease hesitancy and increase acceptance of vaccines at the global, national and local levels. Sharing of lessons learned and effective practices from various countries and settings as well as the development, validation and implementation of new tools to address hesitancy were also recommended.

This World immunization day, it is suggestive that pro-active measures should be taken by various health care organizations for increasing acceptance of vaccines, such as:

  • Using effective communication to dispel fears among people
  • One‑on‑one or group interaction between health‑workers and people to resolve their doubts, and myths related to vaccination
  • Organizing number of immunization session for generating awareness about health benefits of vaccination
  • Bringing together interactive activities that engage groups of members and society members to give the guidelines related to immunization
  • Spreading awareness among people about new vaccine availability, its benefits
  • Encouraging people to bring their children for detailed check-up and give vaccine
  • Involving staff members and nurses of health care institutions, primary centers, family‑clinics to maintain the immunization record of the patients and provide them when needed

Immunization is one of the most important preventive health measures, responsible for saving millions of lives. Hence, addressing the concerns of vaccine-hesitancy must be a priority for all the stakeholders of the healthcare industry. So, this world immunization day, each one of us should take it as our moral responsibility to spread awareness among people about the vaccine and to debunk fear/myths associated with vaccination.

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing. 

Diabetes Tech Advancemnents

Over the years there are many technological advancements that came into light in the treatment of diabetes. These technological advancements in diabetes care helped from the discovery, production of insulin till the development of less painful ways to deliver it to the patients.

Technological developments will continue and probably even increase, as the epidemic of diabetes continues to grow rapidly. Advances in medical technology can help control diabetes with ease, a more convenient, and a more accurate tool for everyone.

Echo Therapeutics

These are non-invasive, wireless, transdermal continuous glucose monitoring (tCGM) systems for diabetic patients. These provide reliable data continuously, conveniently and in a cost-effective way. Also reduce the dependence on periodic finger stick testing.

Omnipod

These are wireless systems that help in delivering insulin. OmniPod is discreet and durable. Wireless and waterproof, the Pod holds and delivers insulin without tubes or shots. This also programs the personalized insulin delivery, calculates suggested doses, and has a convenient style.

Mobile Devices and Social Media Tools

These help in connecting with others and the healthcare physician. Social media also helps in the maintenance and monitoring of diabetes and helps the diabetic patients connect each other. These websites of diabetes can not only clarify the doubts but also support the patients’ problems. Also mobile devices help in tracking the data and send test results directly to the doctor.

Artificial Pancreas

This is helpful and provides relief for type 1 diabetics. An automated system used to disperse insulin based on changes in blood sugar levels. This is a wearable device acting as an artificial pancreas, the system will enable people living with type 1 diabetes to better maintain blood sugar levels within a target range with minimal effort.

High-Tech Tattoo Sensor

This is again a substitute for the finger-sticking method. This includes a sensor that changes color with rising blood sugar levels. This high-tech tattoo contains a special kind of ink that reacts with glucose and is injected into the outermost layer of skin.

Technology continues to develop and help patients with diabetes with much convenient and easier methods.

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing. 

Diabetes Management and Ramadan: What does ADA say?

Ramadan is a lunar based fasting month for Muslims. Muslims who fast during this time should refrain from eating, drinking, use of oral medications and smoking from predawn to post sunset, with no restrictions on food or fluid intake between sunset and dawn. Muslims with diabetes insist on fasting during the holy month, thus creating challenge for themselves and their health care providers. In this article we enumerated some risk factors associated with diabetic patients and how to manage diabetes in Ramadan, according to the ADA recommendations shared in 2005.

Risk associated with fasting in patients with diabetes.

Hypoglycemia: Reduced food intake is a well-known risk factor for developing hypoglycemia. The effect of fasting during Ramadan on hypoglycemic rates is not well known. But, in a study conducted it was observed that fasting during Ramadan increased the risk of severe hypoglycemia by 4.7 fold in patients with type 1 diabetes and 7.5-fold in patients with type 2 diabetes. In addition, the risk of severe hypoglycemia was more common in patient in whose dosage of oral hypoglycemic agents or insulin was changed as well as those who reported a significant change in their lifestyle.

Hyperglycemia: Glycemic control deteriorated, improved, or showed no change in patients who fasted during Ramadan. A study conducted showed 5 fold increase in the incidence of severe hyperglycemia (required hospitalization) for patients with type 2 diabetes and 3 fold increase in the incidence of severe hyperglycemia with or without ketoacidosis in patients with type 1 diabetes. This can be attributed to excess reduction in medication dose for preventing hypoglycemia. Patients with reported increase in food and/or sugar intake had higher rates of severe hyperglycemia.

Diabetic ketoacidosis: Patients with type 1 diabetes fasting during Ramadan have a greater risk of developing diabetic ketoacidosis, especially if their diabetes is poorly controlled. The risk is increased even further because of excessive reduction of insulin dose as food intake too is relatively reduced during that time.

Dehydration and thrombosis: Fluid intake limitation during the fast if prolonged, leads to dehydration (becomes severe in hot and humid climates and in patients who perform physical labor).

Hyperglycemia causes an osmotic diuresis, adding to the volume and electrolyte depletion. In patients with preexisting autonomic neuropathy orthostatic hypotension may be developed. Syncope, falls, injuries, and bone fractures may occur from hypovolemia and the associated hypotension. Blood viscosity may be increased due to dehydration, which may enhance the risk of thrombosis and stroke.

Managing diabetes in Ramadan

  1. Frequent monitoring of glycaemia: especially important for patients with type 1 & 2 diabetes requiring insulin.
  1. Nutrition: Have a well-balanced diet. Avoid large amount of food rich in carbohydrates and fats at sunset. Foods having complex carbohydrate ((slow digesting foods) should be had as a predawn meal and must be eaten as late as possible before start of daily fast. Fluid intake must be increased during non-fasting hours.
  1. Exercise: Normal physical activity may be maintained. Avoid excessive physical activity, which can lead to higher risk of hypoglycemia, especially during few hours before sunset meal.
  1. Breaking the fast: Fast must be broken if
  • Feeling hypoglycemic (blood glucose of 60 mg/dl). Blood glucose may drop further if treatment is delayed.
  • Blood glucose reaches 70 mg/dl in first few hours after start of sunset and especially if insulin, sulfonylurea drugs, or meglitinide are taken at predawn.
  • Blood glucose exceeds 300 mg/dl.
  • Avoid fasting on sick days
  1. Pre-Ramadan medical assessment: should be undertaken 1–2 months before Ramadan. During this time, appropriate blood studies need to be done and evaluated. Individualized advice must be provided if there is any potential risk to the patient. In addition, necessary changes in diet or medication regimen should be made.
  1. Ramadan-focused structured diabetes education: Healthcare professionals need to be trained to deliver structured diabetes education during Ramadan, which should include:
  • Glucose monitoring importance during fasting and nonfasting hours.
  • When fast should not be done or stopped.
  • Planning of meal if feeling hypoglycemic and dehydrated during long fasting hours.
  • Timing and intensity of physical activity during fasting.
  • Importance of diabetes-related medications and its risk during fasting.
  1. Managing of patients with type 1 diabetes
  • Close monitoring and frequent insulin adjustments are essential for avoiding hypo- or hyperglycemia in patients with type 1 diabetes.
  • Continuous subcutaneous insulin infusion (pump) management can also be done, but is substantially expensive.
  1. Managing of patients with type 2 diabetes:
  2. Diet-controlled patients : there is a potential risk for occurrence of postprandial hyperglycemia in type 2 diabetic patients. In such cases:
  • Spreading calories over 2 to 3 smaller meals during the nonfasting interval may help in preventing excessive postprandial hyperglycemia.
  • Intensity and timing of physical activity may be modified e.g.,2 h after the sunset meal.
  1. Patients treated with oral agents: choice of oral agents should be individualized.
  2. Patients on metformin : have limited possibility of severe hypoglycemia and may fast safely. However, dose timing should be modified so as to provide 2/3rd total daily dose with the sunset meal and the 1/3rd before the predawn meal.
  3. Use of sulfonylurea’s: is unsuitable for use during Ramadan as it posses inherent risk of hypoglycemia. Use of these drugs should be done with individualized with caution. Chlorpropamide use is contraindicated during Ramadan due to risk of prolonged and unpredictable hypoglycemia.
  4. Short-acting insulin secretagogues: could be taken two times daily before the sunset and predawn meals.
  5. Incretin-based therapy: drugs such as Exenatide in particular, can be given before meals to minimize appetite and promote weight loss. Due to its short half-life of 2 hrs, it’s not associated a substantial effect on fasting glucose.
  6. Patients treated with insulin: To maintain necessary levels of basal insulin and preventing fasting hyperglycemia, use of intermediate- or long acting insulin preparations and short acting insulin need to be given before meals. Also, injecting long-acting or intermediate-acting insulin can give adequate coverage in few patients as long as dosage is appropriately individualized.
  7. Insulin Pumps: Frequent glucose monitoring is needed due to failure of the pump infusion site can result in severe deterioration in control over a few hours. Patients with type 1 diabetes must be fully educated and facile about the use of an insulin pump. Before Ramadan, they should receive adequate training and education with respect to self management and insulin dose adjustment. Also, how to adjust their infusion rates as per results of frequent home blood glucose monitoring must be taught.
  1. Pregnancy and fasting during Ramadan: Women with presentational or gestational diabetes are at increasingly high risk and should be strongly advised not to fast during Ramadan. However, if they insist to fast, then special attention must be given to their care. Pre-Ramadan evaluation of their medical condition should be carried out that includes, preconception care with emphasis on achieving near-normal blood glucose and A1C values, counseling regarding maternal and fetal complications associated with poor glycemic control, self management education skills. These patients should be managed in high-risk clinics having obstetrician, diabelogists, a nutritionist, and diabetes nurse educators. Appropriate diet and intensive insulin therapy should be given to pregnant patients. In addition, frequent monitoring and insulin dose adjustment is necessary.
  1. Management of hypertension and dyslipidemia: Dehydration, volume depletion, and tendency towards hypotension may occur with fasting during Ramadan, especially if fasting is extended for long and is also linked with increased perspiration. Therefore, dose and/or type of anti-hypertensive medications should be adjusted for preventing hypotension. Further, proper counseling need to be given and agents previously given for managing elevated cholesterol and triglycerides should be continued.

Key messages

Fasting by diabetic patients should be done after prolonged discussion with their health care provider so as to discuss the risks involved. Patients, who insist on fasting in Ramadan, must undergo pre-Ramadan assessment and receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and dosage and timing of medications. Newer pharmacological agents have lesser hypoglycemic potential and can be specifically useful during Ramadan. Similarly, insulin pump therapy can give greater safety in Ramadan setting.

Read more at

Al-Arouj M,Assaad-Khalil S, Buse J, Fahdil I, Fahmy M, Hafez S, et.al, Recommendations for Management of Diabetes During Ramadan. Diabetes Care; 2010.33 (8), 1895-1902.