FIT MOM

Putting on weight after you give birth to your bundle of joy is inevitable. Use a little tact and you can easily become your slim self again.

Consume small frequent meals instead of three main meals. Eat something filling like a tall glass of milkshake, soup or a plate of fruits.

Cut caffeine intake. Instead opt for other liquids and drink gallons of water.

It is best to avoid fried food like salty chips, wafers but give your body essentail fats through nuts and olive oil.

Proteins from lean meat such as chicken and fish are good option for lactating mothers. For vegetarians, animal protein can come through yoghurt, milk and dairy products.

Keep awy from refined flours. Vegetables like spinach, gourd, pumpkin, mushroom etc are packed with fibre. Fibre improves digestion, controls sugar, promotes satiety and provides anti-oxidants and vitamins that are important post pregnancy.

For women who have undergone surgery it is best to stay away from exercise for six months after the delivery but exercise can begin 40 days after a normal delivery.

Brisk walking for 20 to 30 mins is good enough for a beginner.

Post pregnancy yoga is the best way to improve posture.

Dancing and working out with music is another way of shedding weight.

GYNAECOMASTIA

Abnormal enlargement of breast with palpable breast tissue in men is called gynaecomastia.It is very important to differentiate lipomastia in which there is deposition of adipose tissue in the breast from true gynaecomastia.For differentiating both of them mammography or breast ultrasound can be done.

If there is indeed a presence of true gynaecomastia it indicates an underlying health problem.In most cases some underlying endocrine issue needs evaluation.But here one thing is to be kept in mind that there are three physiological conditions like newborns,adolescence and aging in which gynaecomastai can be seen.

Most of the time the cause of gynaecomastia or growth of breast in men is due to the estrogen and disturbance in the ratio of androgen and the estrogen.The ratio of testosterone and estrogen in plasma is about 300:1.Now gynaecomastia may be visible when this ratio gets disturbed either due to decreased production of testosterone or enhanced production of estrogen or both process may also occur simultaneously.

Sometimes drugs can also cause gynaecomastia because they sometimes act like estrogens or increase the levels of estrogens in the body.Most commonly found agents are ketoconazole,spironolactone,cimetidine,diazepam,omeprazole,marijuana,heroin,ACE inhibitors.

Some pathological conditions in which the raised estrogen can be seen are the testicular tumors,carcinoma of lung.Decreased production of testosterone is seen in anorchia(absent testes),viral orchitis, trauma,castration,renal failure and some syndromes like the Klinefilters syndrome.

Diagnostic evaluation includes proper testicular exam,hormonal assay including plasma estradiol,HCG,testosterone,LH.

When the primary cause can be identified breast enlargement can be promptly corrected and it disappears.But if gynaecomastia is long standing then it is likely that breast tissue enlargement will not disappear.In those cases surgery is the only option.Rare instances of males with gynaecomastia turn into male breast cancers.

Gynaecomastia is really a matter of concern only if the drug history is negative,breast is tender and the breast mass is larger than 4cm in diameter.

CROHN'S DISEASE

Crohn’s disease is characterized by inflammation extending in all layers of the intestinal wall.

Clinical features:

The main clinical features of CD are fever, abdominal pain, diarrhea and fatigue.
Associated weight loss is often seen.
When colon is involved diarrhea and pain in the abdomen are the most common features.
Rectal bleeding is distinctly less.
Apthous ulcers are the most common oral symptom.

Diagnosis:

Sigmoidoscopy and radiologic studies of the bowel are most important in establishing the diagnosis
Air contrast barium enema examination of the prepared colon may disclose earliest mucosal changes in CD
Endoscopic examination of the colon is valuable in the diagnosis of CD.
Colonoscopic examination is indicated when CD appears only to involve the small bowel.
Rectal biopsy samples help in 5 to 15% of cases.


Systemic manifestations:

Weight loss
Anemia
Folate or Vitamin B12 deficiency
Arthritis and Arthralgia
Aphthous stomatitis
CD of buccal mucosa, gingiva, vagina


Management:

Sulfasalazine is effective in the therapy of active colonic disease.
Glucocorticoids must be used with caution and constant attention. It is difficult to achieve a clinical remission and to withdraw steroids completely.
Metronidazole shows marked improvement in patients with perineal fistulas with CD
Drugs like mercaptopurine or azathioprine decreases disease activity, causes fistulas to close, exerts a steroid sparing effect, decreases relapse rate if used as maintenance therapy.

Diet in CD:

Eat small and frequent meals.
Steamed or baked vegetables rather than raw vegetables.
High protein diets like fish, soy are good.
Fruits like apples, grape fruit, oranges, plums, blue berries, raspberries, strawberries are good.
Potatoes, avocados, brown rice and bananas are helpful.
Low fat pizza, low fat hamburger, turkey sandwiches are allowed
Milkshakes can be taken but if lactose intolerant avoid dairy products.

What food to avoid:

Avoid oily, spicy, refined foods such as white breads and pastas.

Avoid high fibre diet in flare up condition.

Avoid these during flare up and eat very little: nuts, corn, seeds, raw fruits and vegetables, sauces ,high sugar fruits like grapes, pineapple and watermelon

BIRTH CONTROL PILLS

Birth control pills are one of the most effective and reversible method of contraception.With the term reversible I mean to say the return of fertility.
Let us first know how they actually work to prevent a pregnancy.They inhibit ovulation,produce some changes in the endometrium,alter the character of the cervical mucus so that it becomes thick and prevents the sperm from entering and even probably alters the motility of the fallopian tubes.

The next question that arises is am I a fit case to take birth control pills.
Well,There are some absolute contraindications to the use of birth control pills meaning in no case this should be started if the person is having severe hypertension,hyperlipidaemia,focal migraine problems, valvular heart disease and liver diseases.

Birth control pills are a big no in cases of undiagnosed bleeding from vagina due to any reason and all estrogen dependent tumors like the breast cancers.

There are some relative contraindications in which after a proper evaluation by the doctor one can decide if birth control pills can be taken.These conditions are smoking, asthma, obesity,epilepsy.

Now let us talk about the beneficial effects of the birth control pills other than the prevention of pregnancy.It regulates the menstrual cycle,decreases incidence of pain in periods,reduces premenstrual syndrome.It has beneficial effects as it protects against some disorders like fibroid,endometriosis, acne,hirsuitism,and even some cancers like the ovary,endometrium.

Minor side effects after the intake of birth control pills are nausea,vomiting,breast pain,weight gain,chloasma.

Breast feeding

All the babies regardless of the type of delivery must be given early and exclusive breast feeding upto 6 months of age. Exclusive breast feeding means giving nothing orally other than colostrums and breast milk. Breast milk has an ideal composition for easy digestion .Proteins in the form of lactalbumin and lactglobulin is easily digestible. The mineral contents are balanced and do not overload the infants kidney as compared to the artificial milk. Vitamin D in it prevents occurrence of rickets.

Breast milk is readily available and in commercial terms we can say that it is directly available to the consumer from the producer. One important benefit of breast feeding which we cannot forget is breast feeding acts as a natural contraceptive.

There are many advantages of breast feeding other than these. It has a laxative action, no risk of allergy, establishes a baby and mother bonding. Initially babies may need to be fed every 2 to 3 hours and babies must always be fed on demand and not by the clock. If the baby is happy, sleeps between feeds and at night, does not vomit and passes urine at least 6 times in 24 hours it means that the baby is feeding properly.
HIV positive mothers are counseled as regards the risks and benefits and are helped to make an informed choice.

Some causes of inability to breast feed are low birth weight baby, temporary illness like respiratory tract infection, over distention of the stomach with swallowed air and congenital malformations like cleft palate etc.

Why the hue and cry on salt intake and health concerns

It is a much talked about topic on how much is good, what are the bad health effects and so on and on. Most of the organizations have recommended an intake of 1500 to 2400 milligrams of salt intake daily in an adult. If a person is above 50, black, or suffering from high blood pressure, chronic kidney disease or diabetes he is more sensitive to blood pressure effects of sodium. People who are sodium sensitive will retain sodium easily causing excess fluid retention and thus increase in blood pressure.

The three main sources of sodium are processed and prepared foods, sodium containing condiments and natural sources of sodium like meat, poultry, vegetables and dairy products.

One myth is that people think that food which tastes salty is full of salt and those which do not taste salty are not. Some food like the bagel doesn't taste salty but has a high sodium content.

So how do we identify the sodium content in food? Look for these in the product labels : Monosodium glutamate, baking soda, baking powder, disodium phosphate, sodium alginate , sodium nitrate etc.

Now the question is how can we cut the intake of sodium in daily diet.
Eat more fresh foods and fewer processed foods.
If you do buy processed foods, select those that have reduced sodium.
You can leave out the salt in many recipes, including casseroles, stews and other main dishes.
Avoid salad dressings, ketchups, dips, mustard etc
Start adding herbs, citrus juices to jazz up your meals
If you cannot eat without the taste of salt then a dietary potassium in food can be a substitute to the sodium
Remember excess of sodium in diet can be the cause of cardiovascular and kidney diseases.

Fish, Olive oil, nuts good for eyes too, studies say

More studies have revealed a lot of things on the vision. If you wish to keep your vision good as the time passes keep fish,olive oil and nuts in your menu but avoid the trans fats.Studies from two different teams published Monday in the Archives of Ophthalmology provide more evidence that these foods -- which contain healthy fats -- can reduce the risk of developing a retina-destroying condition known as age-related macular degeneration (AMD).AMD is one of the most common cause of blindness in people beyond 65years.Let me explain what is AMD. AMD occurs when blood vessels or cells in the macula, the central portion of the retina responsible for central vision and seeing sharp detail, begin to break down.In the early stages people will have yellow deposits in the the retina but only a few will progress to late macular degeneration. Major risk factors for its development are age,smoking,genes and the fat intake also.Eating the right kind of fat can decrease the risk like eating a handful of nuts will decrease the risk to 35%.Same as people who take a lots of olive oil in diet are less prone as compared to those who take less than 1ml of olive oil per week.Trans fat as said is bad for AMD and is commonly found in baked and fried food and commonly raises the bad cholesterol or the low density lipoproteins.Well, it makes sense to think that the omega 3 fatty acids will help protect the eye.So eat a plenty of salmon, sardines, mackerel and also nuts and green veggies.Those who are not able to take these must take supplements of fish oil or lutein