Call for your Health

Breast Cancer Surgery

A biopsy specimen that proves to be malignant means radical surgery - that is, complete removal of the breast, and of adjacent lymph nodes near the armpit and collarbone, and sections of the arm and chest muscles beneath the breast. The surgeon cannot take chances. He must get all of the malignancy to save and prolong his patient’s life.

In the two to five-hour operation, the surgeon usually makes an elliptically­shaped incision and removes the breast and surrounding tissue in a single bloc. This technique is considered less likely to disturb and spread loose cancer cells and it also entails less disfigurement than some of the older procedures.

With sutures and skin grafts, the surgeon is able to close the “window” or incision with a minimum of scarring. As in other surgery, the pink lines of incisions become smoother and paler with the passage of time.

It would be fatuous to minimize the seriousness or complexity of this operation. Patience, delicacy, and great skill are essential. But let the apprehensive woman realize that it constitutes the removal of an external organ only, one which she can forfeit without major organic change or injury to her health or general well-being. The operation is literally superficial (by definition, “on the surface”). No major cavity of the body is invaded or affected .

After Surgery

Following the operation, most surgeons advise treatment of the chest area with x-rays, or one of the new anti-cancer drugs, or both. The purpose of this is to kill any stray cancer cells that might be too deep-seated to be discoverable by any sort of inspection. The whole area where the tumor existed is suspect and no chances are taken.

The so-called “magic bullet” which could destroy cancer cells wherever they hide without harming the normal cells of the body is still a hope of the future. But we do possess drugs which show heartening results against some cancers, notably of the prostate, uterus, and breast . Female breast cancer is classified as a “hormone dependent” type - that is, the rate of growth of existing breast cancer is affected by female hormones, although this is not to say that hormones incited the cancer in the first place. Similarly, cancer of the prostate is affected by male sex hormones. Use of antagonistic hormones (male hormones in breast cancer, female hormones in prostate cancer) or hormone doses and removal of hormone producing organs by castration, has proved to be of considerable palliative benefit in appropriate cases, but is not to be looked upon as a cure, and never as an alternative to recommended surgery.

Unhappily, there are cases of “inoperable” breast cancer disease so far advanced or so widespread that surgery cannot be curative. But even in these cases, drugs now available can usually relieve pain, delay cancer spread, prolong comfortable and useful life. Among such drugs are nitrogen mustard, thiotepa, 5-fluorouracil, and a number of others well known to doctors, and promising new ones emerge from time to time from a vast cancer chemotherapy research program which to date has screened more The left side of the drawing shows lymph channels of the breast area with lymph nodes in the armpit, neck, inner and upper chest areas. The right side of the drawing shows directions of drainage that may carry cancer cells to other parts of the body if treatment of localized breast cancer is delayed. than 75,000 anticancer compounds in animal cancer experimentation.

In some cases, one or another of available drugs has made possible the more effective use of surgery and radiotherapy. Medical journals are filled with case history reports of marked improvement when certain drugs are used with certain

breast cancer patients. Each patient’s needs are of course different and meticulous medical teamwork is necessary in order that the individual patient may have the best therapies in the light of present knowledge.

Height/weight chart has been given in earlier pages which should be gone through. Weight of an individual is dependant largely on following factors:-

1. Age of an individual- as in infancy, childhood, adolescence, middle age and, finally, in advance age.
2. Climatic effect on food habits.
3. Capacity to purchase and financial constraints.
4. Amount of labour put in, while discharging one’s professional job and the calories, actually required and expended.
5. Suitable balanced diet in health, as also in disease.
6. Nature of job of a person.

It is held that weight should be according to one’s height. But, conversely, certain classes of people do not or fail to gain weight, in spite of the fact that they take a balanced and nutritive diet. There is another myth that taller parents have taller children. In general observance, it is the reverse case, in most of the cases, so to say. Because parental factor is not so important as other factors like growth pattern, eating habits, mental and physical status, climate effects and outdoor games and/or physical exercises, resistance to or susceptibility of infections, amount of food properly digested etc. Some people talk of genetic effects also. The fact of the matter remains that parental care, carefree approach and disease less health state, provision and utilisation of reasonable avenues and facilities provided, acquired nutritive values in the food taken, burden of studies and other worries and cares of life, congenial at mosphere and environs are some of generally said causes and determining factors, for the growth of a person, Mental health plays an important part in the height factor.

Food is, in fact, one of factors that accounts for gaining height, and it is an important factor, Howsoever nutritious food one may take but, if the mind is under stress, turmoil and tension, family atmosphere is agitative and when even normal study is taken as a burden, there is some fear psychosis, growth process is bound to be adversely affected.

In all fairness to growing children and to ensure that they gain good or reasonably good height, let their caretakers provide congenial atmosphere as a first prerequisite. Children of working classes of those who have sparse and limited resources look heal their, better, taller and carefree whereas children of affluent parents are fed on pseudo fads and allurements. If parents wish their children to grow rich (not in wealth) in health, height and studies they should be nourished with proper requisite and timely parental care (not a pampered treatment), congenial atmosphere and other growth avenues, Never burden your child with worries and cares of modern life’s compulsions and demands. Let them enjoy and relish what is offered to them. Help him in feeling that he/she is a well looked after child, but not a pampered and spoiled child. All these factors contribute a lot in gaining normal growth. He should be given to eat what suits him, and not what is the best food item. Children should never be forced to eat, when they do not have an urge therefore. Emphasis should bean quality and nutritive values, and not on how costly the diet is. Avoid exposed foods, beverages, juices, fast foods, spicy and unhygienic foods. Rely more on nature.

Proper and requisite coordination between body, mind and intellect is a pre-requsite ot good health. A person is called healthy when the said three disciplines work in perfect unison and harmony, to enable a person to discharge his normal chores and any fact, contrary to a normal function, calls for proper investigations. Food is Nature’s vehicle to nurture the body which, in turn, rejuvenates various body organs, restoring and sustaining its expended energy. Various organs of body do need a sustained amount or energy to discharge various functions and food is the only item which helps body in that direction. How food metabolises in the body has already been explained in earlier a nut-shell. Food denotes all the edibles and drinks which have been provided to all living beings but the quality and quantity thereof depend on one’s individual requirement as total acceptance and reaction to a particular food item will depend on physical status, age, sex, profession, regional foods, food habits, availability and the purchasing capacity of a person. A healthy person’s diet will differ from that of an ailing person because dietary intake will depend, largely, on the said factors.

Kinds Of Food: As already mentioned, Nature has ever been kind to grow and provide in plenty, various types of vegetations which suit population of a particular area to meet their various requirements of body. But, here, we are referring to foods that are regularly required by all, as would be clear by the following subdivisions.

Vegetables : Beet root, cabbage, carrot, onion, garlic, potato, tomato, cucumber, fenugreek, ginger, spinach, radish, lady’s finger, bitter gourd, french beans, mint, coriander, amaranth, asparagus etc., including other green and leafy salads and vegetables

Fruits : Apple, Apricot, Avocado, Banana, Date, Fig, Grape, Grape Fruit, Indian Gooseberry, Jambul Fruit, Lemon, Lime, Mango, Orange, Papaya, Pomegranate, Raisins, Guava etc.,

Ceraals : Barley, Maize, Rice, Wheat, Green gram, Soyabcau, Porridge, Beaten Rice, Oat, Millet, Parched Rice, Paddy etc.

Pulses: Lentil, Kidney bean, Urad, Rajmah, Black gram, Bengal Gram, Gram Dal, Pigeon Pea etc.

Spices & Condiments : Aniseed, asafoetida, cinnamon, cloves coriander seeds, cumin, fenugreek, pepper, saffron, dried ginger etc.

Dry Fruits : Almond, Cashew Nut, Coconut, Peanut, Walnut, Apricot (dried), Chhoara (dried dates)

Milk And Its Products : Whole milk, skimmed milk, toned milk, khoya, curd/yoghurt, butter, clarified butter, whey etc.

Oils : Coconut oil, Mustard oil, Sunflower oil, Groundnut oil, Soya oil, Castor oil etc.

Teas (Herbal) : Chamomile, Sage, Thyme, Yarrow.

Meats : Fish, Poultry products (like eggs), Beef, Mutton, Pork, Venison, various sea and water animal’s meat.

Some Other Fruits : Bael, Cherry, Oran berry, Kiwi, Prune, Strawberry, Cheeku, Apricot.

Misc Vegetables : Artichoke, Brinjal, Broccoli, Turnip, Brewer’s Yeast, Mustard and Brussel Sprouts.

Spruts : Prepared from various cereals and pulses.

Juices : Cane sugar juice and juices of orange, lime, coconut water, tomato, carrot, beet root, mint, mango, bitter-gourd etc.

Some of the edible foods might have been left untouched, the reason being that their list is too exhaustive to mention.

Behavioral explanations of obesity can be placed into two categories: excessive caloric intake (overeating) and lack of physical activity (hypokinesis).

The basic laws of nature require that calories must be consumed before energy can be stored as excess weight. The body cannot make energy on its own. For the obese and overweight therefore, caloric intake is an important issue.

Do obese people eat more than normal-weight people? This has been a controversial question and researchers are divided in their answer. Numerous studies show that obese people eat no more and sometimes eat less than normal-weight people. These researchers would suggest that blaming obesity on a lack of willpower is inaccurate and an over simplification of the facts. They maintain that the body of the obese person is simply more efficient at converting calories to adipose cells for reasons beyond his or her control, such as genetic predisposition or higher set point for fatness. Stated another way, obese people may not eat more than normal weight people; they just consume more calories than are required by their bodies.

Other researchers claim that obese people do eat more than normal-weight people; the problem is a discrepancy in accurately reporting food intake. In one study obese subjects underestimated food intake by about 50% and overestimated physical activity by 33%. In another study obese women were found to expend and therefore eat about 400 to 500 calories more on average each day than normal-weight women.

Whereas researchers are divided on the issue of overeating, they tend to agree that the abundance of food high in fat and calories is a major factor in the prevalence of obesity in the United States. In his review of the literature on obesity-a review that included 284 citations from the scientific literature Knifeman stated: “Of all the current theories attempting to explain the epidemic of obesity in most Western societies, the high dietary fat intake hypothesis is most widely accepted by experts. Overweight people tend to eat a higher-fat diet than people of normal weight. Ounce for ounce, fat yields more than double the number of calories as protein or carbohydrates . This energy difference partially explains the relationship between dietary fat intake and weight gain. It is not a complete explanation because in studies that hold the total number of calories constant and more calories are consumed than needed, a person eating a high-fat diet tends to store more excess calories as body fat than someone eating a lower-fat diet. Your body is more sensitive to excess carbohydrates than excess fat. Studies conducted in laboratory-type settings (for example, in a respiratory chamber where oxygen is measured, burning calories requires oxygen, more to burn fat, less to burn carbohydrates) show that once the glycogen stores are filled, the body burns carbohydrates first and then stores the fat. We use fat for energy, especially between meals. The brain uses exclusively glucose for energy, but other tissues use fatty acids. Right after meals, all tissues burn glucose.

Excess carbohydrates are converted to glycogen in the liver and muscle. The body can only store a limited amount of glycogen. This is not true for fat. Fat cells are distributed throughout the body. Whereas carbohydrate storage is carefully regulated, fat storage is not, allowing a high degree of expansion. After a large meal, a bit of glucose and amino acids are left over, some of which are used to make fatty acids. This is why the American population has an increasing incidence of obesity on diets high in carbohydrates and excessive in calories. The body’s capacity to make and store fat may have served a useful purpose in earlier times when humans faced the constant threat of famines and an energy reserve meant survival. But now with the sedentary lifestyles of most Americans, glycogen stores are rarely exhausted. The reality for too many people is that they burn carbohydrates and store fat.

Dietary fat also has less of a thermogenic effect than does carbohydrate or protein and can thus be easily stored as adipose tissue. The thermogenic effect of food (TEF) represents the amount of energy required by the body to digest, absorb, metabolize, and store nutrients. The body expends only 3 calories of energy to process 100 calories from fat compared with 25 calories to process 100 calories from carbohydrates. Between 7% and 10% of total body energy goes to support the TEF. For example, after a meal containing 1000 calories, the body uses 70 to 100 calories just to process the meal. The TEF helps to explain why studies consistently show that when adults and children overeat and consume high amounts of dietary fat, they tend to gain weight. Conversely, when the intake of dietary fat is low and the intake of carbohydrate and fiber is high from nutrient-dense foods, desirable body weight is more readily achieved. Cross cultural comparisons confirm the dietary fat-obesity relationship. For example, Americans eat more than twice as much fat as the Chinese, yet the Chinese consume 20% more calories and there is little obesity in China.

Because the energy in carbohydrate stores (glycogen) is very small in relation to that in fat stores, the glycogen can be depleted quickly and frequently. The glucose requirement of the brain, other cells of the nervous system, and a few other tissues provides a stimulus for carbohydrate ingestion. The higher the proportion of fat in the diet, the more total food must be consumed to obtain enough carbohydrates to fill glycogen stores in the muscle and liver.

The high-fat theory of obesity leads to an important question: can a person lose weight by simply focusing on fat calories? In highly controlled studies in which food intake is carefully monitored, researchers found that subjects whose diets contained no more than 20% fat calories lost weight even when there were no restrictions on how much food was eaten. But was the weight loss the result of eating less fat or less calories? The answer seems to be that both fat and calories matter. In controlled studies, when people concentrate on eating less fat they also

Dietary fat promotes fat storage in the body. The body expends only 3 calories to convert an extra 100 calories of dietary fat to storage fat. Fat storage is accelerated if dietary fat is combined with simple sugar in the same meal, such as a ham­burger with a sugared cola drink. Sugar triggers the release of extra insulin. Insulin activates fat cell enzymes that promote movement of fat from the blood to the fat cells. On the other hand, the ingestion of an extra 100 calories of complex carbohydrates requires that the body expend 25 calories to convert it to fat for storage. The conversion process for carbohydrates is more costly than that for fats and provides another reason for reducing fat consumption and increasing carbohydrate consumption.

consume fewer calories and lose weight. This is due to the consumption of mainly nutrient dense foods. Does the same thing happen in real life? Apparently not. Studies of the eating habits of both men and women who consume low-fat products reveal that they often compensate by eating more snack and dessert foods high in sugar but low-fat so the use of low­fat foods becomes an excuse to eat more. The idea that people can eat as much as they want as long as it’s fat free appears to be more fantasy than fact. Although some researchers believe that fat is the main culprit associated with obesity; other experts emphasize that calories count. This helps to explain why Americans are getting heavier with each passing year, even though they are consuming a lower proportion of fat. Increased consumption of low-fat foods by itself does not result in weight loss. Whereas eating low-fat foods is good for health and weight control, eating them in buffet-sized portions isn’t.

Yes, in many instances they do. They also control. Suppose you are undergoing treatment by x-rays for a painful shoulder, shingles, or a similar benign illness. The x-ray tube from which the x-ray beam comes is centered over the affected area and the machine turned on. The treatment may be repeated a number of times, depending on how quickly the condition clears up.

Patients with thyrotoxicosis (an overactive thyroid gland) often are treated to an “atomic cocktail” by the radiologist. The “cocktail” is a carefully determined amount of radioactive iodine. The thyroid gland takes up iodine. When radio­active, this iodine gives off a continuous stream of beta and gamma rays. These rays slow down the overactive thyroid cells and the gland returns to its normal working condition.

Suppose someone you know has a cancerous growth. If his trouble has been discovered in the early stages he has a good chance of being cured. First, the radiologist will learn the patient’s history by talking with the patient and his referring doctor. He also will do his own examination of the patient. Then he will review the report on the tissue, or actually go over the microscope analysis of the small bit of tissue which has been taken from the growth (the biopsy) with the pathologist.

He then develops the plan of radiation treatment best suited for the patient. He maps out a schedule of treatment fit­ting the radiation to the particular growth. He must decide how many treatments given within a certain number of days will deliver the amount of radiation necessary to destroy or control the growth. In many instances, by using many small treatments, it is possible to bombard the growth and the area around it with a large dose of radiation with­out permanently damaging the healthy tissues. This allows them to recover with the least discomfort to the patient.

What do Radiation Treatments Feel Like

There is no sensation during the time the x-rays or gamma rays are being ad­ministered. After two or three weeks of therapy the patient may notice that his skin appears to be sunburned over the treated area. Actually, his “sunburn” is very similar to that which develops from over-exposure to the sun. This reaction in the skin is part of the treatment and will gradually disappear. Perhaps at the same time the patient may also complain of nausea and loss of pep. This is called “radiation sickness.” Fortunately, most patients do not experience this condition. If it does occur, it can be readily controlled. In any event, it will disappear as soon as the series of treatments are over.

The set point theory of weight control also reflects the role of genetics. Proponents of this theory suggest that the body works to maintain a certain weight. More specifically, each person has an internal set point for fatness, sometimes called the a dipostat, that the body seems to regulate by adjusting hunger, appetite, food intake, and energy expenditure. Re­searchers have demonstrated that human and animal subjects who have been put on low calorie or high­calorie diets lose and gain only to a certain level. When the diet ends, food consumption increases and they return to their approximate original weight.

How the body determines its set point is not known. One hypothesis is that the body is able to adjust its energy expenditure by varying how efficiently muscles burn calories. Researchers at New York’s Rockefeller University discovered that a dieter’s metabolism slows down after losing weight, so that doing the same amount of exercise at the new weight burns fewer calories. The researchers found that after losing 10% of their body weight, newly slimmer patients expended 15% less energy than expected for someone of similar size and body composition. The system also works in the other direction; when patients gained weight, their metabolism increased 16%. After a quick weight gain, the metabolism speeds up to make muscle activity burn more calories, quickly bringing the body back to its normal weight-its set point. Whatever direction a person’s weight goes, up or down, losing weight or gaining weight, the body tends to resist that change.

Can a person change his or her set point? Proponents of the set point theory think that the set point does shift over time in response to behavioral factors: eating a high-fat diet tends to raise the set point for fatness and regular physical activity tends to lower it. This shift may be so slight and gradual as to go unnoticed for years.

Some proponents of the set point theory suggest that because some people are genetically programmed to have unwanted pounds, efforts to eliminate fat with diet, exercise, or both are doomed. The body can shut down its calorie-losing mechanism by lowering metabolism and can stimulate appetite to the point that a person must have food.

Other proponents of the set point theory argue that vigorous regular exercise lowers the set point and thereby lowers the level of fat the body will accept and defend. Exercise induces the body to stabilize at a lower body weight, which is precisely what dieters are trying to do. Unfortunately there is no formula for calculating that a specific amount of exercise will result in the loss of a certain number of pounds. Individual response to exercise varies in ways similar to the differences in response to dieting. Still, exercise seems to be the best way to over power the body’s set point. This is a classic case of a genetic inclination being modified through appropriate lifestyle behavior. It supports the idea that heredity (that is, obesity) is not destiny. Living a healthy life-through regular exercise and sound nutritional habits cannot negate heredity, but it can modify it.

In one sense, all laboratory tests are used as a guide to treatment, since they promote accurate diagnosis. In this section, however, reference is made to the use of laboratory tests to select the type of treatment to be used, to determine how much treatment is required, to confirm that the desired effect is being obtained, and to avoid harmful side effects of treatment. The need for tests of this type is greatest in those chronic diseases where treatment must be continued for a long time, perhaps for life.

Tests of Antibiotic Efficacy

In a dangerous infection such as meningitis, it is extremely important to obtain an optimum therapeutic effect without delay. Since meningitis may be due to different bacteria, and each of these may respond differently or not at all to the various antibiotic drugs, it is common practice to test the various antibiotic drugs directly against the bacteria that are present in the particular case. This can be done in the following way:

Spinal fluid from the patient is mixed with melted agar in a sterile dish and the warm mixture is allowed to cool and solidify. Tiny paper disks, each of which has been impregnated with a different antibiotic, are dropped onto the surface of the agar and the dish is set aside for several hours in an incubator. The bacteria that were present in the patient’s spinal fluid begin to multiply and form “colonies” in the medium, except that where they are in contact with the paper disks their growth may be modified by the antibiotic.

If all bacterial growth is suppressed about the paper disk saturated with tetracycline, but growth is abundant about the disk saturated with penicillin, it is clear that tetracycline is a better drug than penicillin to use in the treatment of this particular patient with meningitis. The test is a combination of spinal fluid culture and antibiotic sensitivity.

Dosage Regulation

Probably the oldest use of laboratory tests to regulate drug dosage is in the diabetic patient. Some diabetics have a different requirement of insulin from day to day, depending upon appetite, diet, exercise, colds and the like. If the regular dose of insulin is sufficient, the urine test for glucose will be negative. If it is insufficient, the test may give a green, yellow or red color, depending upon the amount of glucose present. The doctor teaches the patient how to test his own urine and to regulate the dose of insulin depending upon the color of the urine test. From time to time the diabetic patient must also have a glucose test on blood, so as to avoid over dosage of insulin.

The following are other examples of the use of laboratory tests to guide treatment. After an attack of coronary thrombosis, many patients are given drugs to reduce the clotting tendency of their blood. The effect must be precisely controlled by coagulation tests, since overdose of the drug could cause a tendency to hemorrhage.

X-rays, radium and drugs used in the treatment of cancer sometimes destroy blood cells as well as cancer cells; occasional counts must be taken of white cells, red cells and platelets to make sure that this harmful effect is avoided. Some drugs used in the treatment of high blood pressure produce in some patients a condition resembling a special form of sensitivity disease known as lupus eurhythmics,. special blood examinations (”LE prep”) can anticipate this effect.

Transfusions

Of life-saving importance in certain diseases is the use of blood transfusions. However, different people have different types of blood and it would be extremely dangerous to give a patient blood of a type different from his own. To detect these types and determine compatibility between donor’s and recipient’s blood, blood group and Rh tests must be carried out meticulously.

Similar tests (blood group and Rh) are of importance in determining whether the blood of an unborn baby is compatible with that of its mother. If incompatibility is present, it may be necessary to give the baby an “exchange transfusion” immediately after birth.

Frozen Section

The surgeon often calls upon the pathologist to help him decide whether a lump in the breast should be simply removed or whether the whole breast and the nearby lymph nodes should also be removed. This test, known as the “frozen section,” is performed while the patient is under anesthesia. The surgeon removes the lump and passes it to the pathologist who freezes a portion of it in a jet of carbon dioxide gas. Once frozen, a very thin slice or section is cut, stained with a dye, mounted on a glass slide and examined under the microscope. If cancer is present, as determined by the pathologist, the surgeon will normally remove the entire breast and related tissue so as to “get around” the cancer. If the pathologist determines that the lump is benign, the surgeon ordinarily does not remove the remainder of the breast

Behavioral explanations of obesity can be placed into two categories: excessive caloric intake (overeating) and lack of physical activity (hypokinesis).

The basic laws of nature require that calories must be consumed before energy can be stored as excess weight. The body cannot make energy on its own. For the obese and overweight therefore, caloric intake is an important issue.

Do obese people eat more than normal-weight people? This has been a controversial question and researchers are divided in their answer. Numerous studies show that obese people eat no more and sometimes eat less than normal-weight people. These researchers would suggest that blaming obesity on a lack of willpower is inaccurate and an over simplification of the facts. They maintain that the body of the obese person is simply more efficient at converting calories to adipose cells for reasons beyond his or her control, such as genetic predisposition or higher set point for fatness. Stated another way, obese people may not eat more than normal weight people; they just consume more calories than are required by their bodies.

Other researchers claim that obese people do eat more than normal-weight people; the problem is a discrepancy in accurately reporting food intake. In one study obese subjects underestimated food intake by about 50% and overestimated physical activity by 33%. In another study obese women were found to expend and therefore eat about 400 to 500 calories more on average each day than normal-weight women.

Whereas researchers are divided on the issue of overeating, they tend to agree that the abundance of food high in fat and calories is a major factor in the prevalence of obesity in the United States. In his review of the literature on obesity-a review that included 284 citations from the scientific literature Knifeman stated: “Of all the current theories attempting to explain the epidemic of obesity in most Western societies, the high dietary fat intake hypothesis is most widely accepted by experts. Overweight people tend to eat a higher-fat diet than people of normal weight. Ounce for ounce, fat yields more than double the number of calories as protein or carbohydrates . This energy difference partially explains the relationship between dietary fat intake and weight gain. It is not a complete explanation because in studies that hold the total number of calories constant and more calories are consumed than needed, a person eating a high-fat diet tends to store more excess calories as body fat than someone eating a lower-fat diet. Your body is more sensitive to excess carbohydrates than excess fat. Studies conducted in laboratory-type settings (for example, in a respiratory chamber where oxygen is measured, burning calories requires oxygen, more to burn fat, less to burn carbohydrates) show that once the glycogen stores are filled, the body burns carbohydrates first and then stores the fat. We use fat for energy, especially between meals. The brain uses exclusively glucose for energy, but other tissues use fatty acids. Right after meals, all tissues burn glucose.

Excess carbohydrates are converted to glycogen in the liver and muscle. The body can only store a limited amount of glycogen. This is not true for fat. Fat cells are distributed throughout the body. Whereas carbohydrate storage is carefully regulated, fat storage is not, allowing a high degree of expansion. After a large meal, a bit of glucose and amino acids are left over, some of which are used to make fatty acids. This is why the American population has an increasing incidence of obesity on diets high in carbohydrates and excessive in calories. The body’s capacity to make and store fat may have served a useful purpose in earlier times when humans faced the constant threat of famines and an energy reserve meant survival. But now with the sedentary lifestyles of most Americans, glycogen stores are rarely exhausted. The reality for too many people is that they burn carbohydrates and store fat.

Dietary fat also has less of a thermogenic effect than does carbohydrate or protein and can thus be easily stored as adipose tissue. The thermogenic effect of food (TEF) represents the amount of energy required by the body to digest, absorb, metabolize, and store nutrients. The body expends only 3 calories of energy to process 100 calories from fat compared with 25 calories to process 100 calories from carbohydrates. Between 7% and 10% of total body energy goes to support the TEF. For example, after a meal containing 1000 calories, the body uses 70 to 100 calories just to process the meal. The TEF helps to explain why studies consistently show that when adults and children overeat and consume high amounts of dietary fat, they tend to gain weight. Conversely, when the intake of dietary fat is low and the intake of carbohydrate and fiber is high from nutrient-dense foods, desirable body weight is more readily achieved. Cross cultural comparisons confirm the dietary fat-obesity relationship. For example, Americans eat more than twice as much fat as the Chinese, yet the Chinese consume 20% more calories and there is little obesity in China.

Because the energy in carbohydrate stores (glycogen) is very small in relation to that in fat stores, the glycogen can be depleted quickly and frequently. The glucose requirement of the brain, other cells of the nervous system, and a few other tissues provides a stimulus for carbohydrate ingestion. The higher the proportion of fat in the diet, the more total food must be consumed to obtain enough carbohydrates to fill glycogen stores in the muscle and liver.

The high-fat theory of obesity leads to an important question: can a person lose weight by simply focusing on fat calories? In highly controlled studies in which food intake is carefully monitored, researchers found that subjects whose diets contained no more than 20% fat calories lost weight even when there were no restrictions on how much food was eaten. But was the weight loss the result of eating less fat or less calories? The answer seems to be that both fat and calories matter. In controlled studies, when people concentrate on eating less fat they also

Dietary fat promotes fat storage in the body. The body expends only 3 calories to convert an extra 100 calories of dietary fat to storage fat. Fat storage is accelerated if dietary fat is combined with simple sugar in the same meal, such as a ham­burger with a sugared cola drink. Sugar triggers the release of extra insulin. Insulin activates fat cell enzymes that promote movement of fat from the blood to the fat cells. On the other hand, the ingestion of an extra 100 calories of complex carbohydrates requires that the body expend 25 calories to convert it to fat for storage. The conversion process for carbohydrates is more costly than that for fats and provides another reason for reducing fat consumption and increasing carbohydrate consumption.

consume fewer calories and lose weight. This is due to the consumption of mainly nutrient dense foods. Does the same thing happen in real life? Apparently not. Studies of the eating habits of both men and women who consume low-fat products reveal that they often compensate by eating more snack and dessert foods high in sugar but low-fat so the use of low­fat foods becomes an excuse to eat more. The idea that people can eat as much as they want as long as it’s fat free appears to be more fantasy than fact. Although some researchers believe that fat is the main culprit associated with obesity; other experts emphasize that calories count. This helps to explain why Americans are getting heavier with each passing year, even though they are consuming a lower proportion of fat. Increased consumption of low-fat foods by itself does not result in weight loss. Whereas eating low-fat foods is good for health and weight control, eating them in buffet-sized portions isn’t.

In 1995, many women were crest­fallen when a popular over-the­counter contraceptive choice and an FDA-approved product, Today’s sponge, was taken off the market. After an FDA inspection raised concern over the air and water quality in the plant that manufactured the sponge, there were some questions over the potential for an abundance of bacteria, an exposure the FDA felt could have compromised the safety of the product and women who used it. As a result, despite the fact that the product itself still met all FDA standards, the manufacturer halted production due to the prohibitive cost of upgrading the plant in order to pass inspection.

Now under different ownership, Allendale pharmaceutical company has addressed the environmental issues of the plant and plans once again to stock the shelves with, today’s sponge. The product will be no different than its last configuration. It has retained its donut­shape and continues to be coated in nonoxynol-9 spermicide. Its ease of use requires simply inserting it into the vagina and pushing it up to cover the cervix. Removal is equally simple; just pull on the loop, This device can be inserted up to 24 hours before intercourse and does not require repeat applications for repeated intercourse.

The demise of the sponge in 1995 became part of contemporary folklore when it was parodied on the popular television comedy, Seinfeld. When one of the characters, “Elaine,” found herself hoarding the limited supply of sponges still on the shelves, she also began to use it as a basis for rating the romantic potential of men she met. A relationship that had potential was considered to be spongeworthy, which meant Elaine might be willing to dip into her precious supply of sponges at some point. As in many cases, pop culture served as a fair barometer of contemporary society as the show reflected the feelings of many women around the country who felt a real loss when the sponge was no longer produced, Soon there will be no need for anymore hoarding.

Arteriosclerosis (hardening of the arteries) is a condition which accounts for onset of high blood pressure, coronary heart disease along with their attendant symptoms. As a first step effort should be of both preventive and curative measures. If the basic cause is not ruled out and eliminated, the resultant diseases may seem to have abated, for the time being, but may surface again in the absence of corrective measures. The damage and the ravages, caused by arteriosclerosis, may not be fully brought under control, but their further and the damages, that are likely to surface, can be easily minimized, if not fully eliminated. High blood pressure exerts adverse effects on sensorium brain, heart, kidneys and some other vital organs. If blood pressure is controlled then further damage to vital organs can, at least, be suspended. It may again be mentioned that high blood pressure, like diabetes, can only be controlled and treated but not cured once forever. Do not feel elated if blood pressure is found to be normal for some days and this progress should not be construed to mean that, since blood pressure is under control, there is no. need to take any anti­hypertensive drugs. In fact, such treatment and the medicines, suggested therefore, should never be delayed or discontinued, except under medical advice. This is more true in cases of essential hypertension, when the real cause has not been deduced. If the real and basic cause has been discerned, then treatment of the affected organs will in itself, let the blood pressure remain under normal limits. The latter condition is known as primary hypertension, which is far cashier to cure than the former condition. Let all the hypertensive patients never forget that they will be simply exposing themselves to far horrible risks and, at times, even with irreversible symptoms, leading even to fatal end. Imagine what would the condition of a person if he loses his vision or he gets paralyses, due to sheer negligence.

Coronary heart disease and high blood pressure are merely extended forms of the accumulation, in higher concentration, of cholesterol which, in turn, owes its origin to wrong habits and, more so, of wrong food habits and faulty living life style. The chief cause is wrong food and rise in cholesterol is merely a result thereof. Had there been no food fads and wrong eating, there would have been no rise in cholesterol. Some of the prominent symptoms of blood pressure may be summed up as : Tension, worries and cares of modern life style and self-imposed indiscretions and relaxations, blurred vision, severe headache, throbbing of blood vessels and temples, reddened face, insomnia, bleeding (in extreme case) from any orifice (opening) of the body, palpitation, pain in chest, swelling in the face and ankles, excessive sweating, dizziness, nausea or vomiting.

All the above conditions surface when, due to accumulation of cholesterol in the arteries, the passage becomes narrower and the blood exerts pressure on the walls of the arteries which, due to lack of flexibility and narrow passage, are not in a position to cope with pressure of blood. As result of blockade and hardening of the arteries, the blood supply to the heart is retard, resulting in palpitation and, sometimes, pain in heart region. It can now be deduced that cholesterol is the main cause for all the heart diseases, kidney problems and for that matter, all of the symptoms mentioned above. Following steps may help in reducing blood pressure and keeping the same within normal confines.

As a rule all saturated fats, tobacco, tea, coffee, strong drinks, meats should be avoided but should be substituted by unsaturated fats, bland diet, rich in green leafy vegetables, fruits. Avoid all types of irritant and precipitating factors. Foods, rich in cholesterol, as mentioned earlier also, bears repetition. Beef, mutton chicken, oyster, chicken, crab, shrimp, lobster and eggs increase cholesterol in blood, as far as meat products are concerned. Saturated fats like cream, ghee, butter, dalda (vegetable ghee), margarine, coconut oil should be ruled out from diet, or at least tapered to minimum level of consumption. Vegetable fats should be substituted by soyabean oil, maize oil, sunflower oil, generally. Adopt the habit of low salt, low calorie, low fat diet.

It is also important to detoxify body, by means of juices of fresh fruits and vegetables. The obese must try to shed extra weight by means of regular physical activity, dietary regimen. Avoid sleeping during early hours in the morning. Cultivate an active habit of ‘Early to bed and early to rise.’ Keep your bowels in good humour. Avoid constipation at any cost and, if there is any problem on that count, try to meet the situation by aid of natural means, but not by laxatives or purgatives. Do not ever agitate your mind or disturb your digestive system. Never hurry, worry or scurry. Feel normal and act and behave like a normal person.

As soon as you notice symptoms of high blood pressure, never delay seeking medical guidance and advice. Any delay can prove suicidal and damaging, at times with dangerous/fatal consequences. Before concluding on this topic, it would be in order to resort to natural means but, if the situation demands medicinal use, it should never be delayed. There is no reason or cause for any alarm, under any circumstance, but a dilatory and complacent approach is also suicidal. An old adage will go a long way in pressing home our view point (viz, a stitch in time saves nine). Always avoid an acute angle approach. Sedentary and inactive life style, so called compulsions and constraints of modern life, unnatural living pattern, which seeks divorce from nature, is never a favourable option. If it is a matter of option, then why not opt for a better and healthier way in life instead of falling a prey into the hands and clutches of mad race for ‘modernity.’