Health Wikipedia

A huge number of people develop foot pain in their 60s. Usually they think that foot pain is a part of the aging process and accept it walking with pain. But it can start as early as the 20s and 30s as well. With simple measures like proper footwear and regular exercise can play an important role in preventing foot problems.

On an average, healthy people walk the equivalent of three times around the Earth in their lifetime. That is a matter of enormous wear and tear on the 26 bones, 33 joints and more than 100 tendons, ligaments and muscles that make up the foot.

Excessive weight, diabetes and circulation problems can contribute to foot pain. The most common foot conditions that occur with age are arthritic joints, thinning of the fat pads cushioning the soles, plantar fasciitis (inflammation of the fibrous tissue along the sole), bunions (enlargement of the joint at the base of the big toe), poor circulation and fungal nails. The following questions will help you assess whether you should take more preventive action as you age.

Are you overweight? The force on your feet is about 120 percent of your weight. It can lead to plantar fasciitis and heel pain and can worsen hammertoes and bunions. It is also a risk factor for diabetes, leading to the next question.

Are you diabetic? Being farthest from the heart, the feet can be the first part of the body to manifest complications like poor circulation and loss of feeling, both of which can lead to poor wound healing and amputation. Diabetics should have their feet examined annually by a doctor and avoid shoes that cause abrasions and pressure.

Do you have poor circulation? If you suffer from peripheral artery disease — a narrowing of veins in the legs — your feet are more susceptible to problems. Smoking also contributes to poor circulation.

Do your parents complain about their feet? Family history is probably your biggest clue to potential problems.

Do your shoes fit? Feet flatten and lengthen with age, so if you are clinging to the shoe size you wore at age 21, get your feet measured (especially mothers — pregnancy expands feet).

Do your feet ever see the light of day? Fungus thrives in a warm, moist environment. Choose moisture-wicking socks (not cotton), use antifungal powders and air out your toes at home.

Do you walk? Putting more mileage on your feet is the best way to exercise the muscles and keep them healthy.

– Dr Md Rajib Hossain –

Fitness programmes abound, from yoga and Pilates to step aerobics and strength training — either at home or in a gym. So which type of fitness programme is best for you? Use these 6 simple steps to find out.

Step 1: Assess your fitness level
You probably have some idea of how fit you are. But assessing and recording baseline fitness scores can help you set your fitness goals and measure your progress. To assess your aerobic and muscular fitness, flexibility and body composition, consider recording:

* Your pulse rate before and after a one-mile walk

* How long it takes to walk one mile

* How many push-ups you can do at a time

* How far you can reach forward while seated on the floor with your legs in front of you

* Your waist circumference at the level of your navel

* Your body mass index

You may also want to consult a doctor before beginning an exercise programme, especially if you have been sedentary or you have any chronic medical conditions.

Step 2: Determine your fitness goals
Keeping your fitness level in mind, think about why you want to start a fitness programme. Perhaps your doctor has suggested that you start a fitness programme to lose weight. If you are already active, perhaps you want to rev up your fitness programme to prepare for a 5K race or get ready for a favorite sport. Having clear goals can help you stay motivated.

Step 3: Consider your likes and dislikes
Next think about the types of physical activities you enjoy most. After all, a fitness programme does not need to be drudgery. You are more likely to keep up with a fitness programme you enjoy.

If you love riding your bicycle, consider a spinning class. If you have a blast on the dance floor, an aerobics class that includes dance moves would be a good bet. If you are a social person and like to be active with others, a gym or health club membership may be the ticket. If you prefer to exercise alone or you find health clubs intimidating, exercises you can do at home may be best.

Step 4: Think variety
Varying your activities (cross-training) can keep exercise boredom at bay. Cross-training also reduces the risk of injuring or overusing one specific muscle or joint.

When you plan your fitness programme, consider alternating among activities that emphasise different parts of your body — walking, swimming and strength training, for example.

Step 5: Do the math
By now, you probably have a sense of which type of physical activities might be best for you. But you also need to make sure that your choices are in line with your budget.

If a gym membership or home exercise equipment is too pricey, consider cheaper options for getting in shape. You can base a fitness programme around brisk daily walks and inexpensive hand-held weights or resistance bands. You might consider buying used exercise equipment — or sharing the cost with a friend.

Step 6: Go for it!
You have thought through your likes and dislikes and the pros and cons of various types of fitness programs. Now it is time to get physical! Remember to start slowly and build up intensity gradually.

Each workout puts you one step closer to reaching your fitness goals. If you get bored or lose interest in your fitness programme, do not be afraid to try something new. Reassess your fitness level and set new fitness goals. The result? A future of improved fitness and better health.

Knowing the symptoms of a heart attack can save your life, the life of a loved one, or even the life of a complete stranger. When it comes to a heart attack, time is everything. The sooner you get medical treatment, the better your chances of surviving a heart attack.

According to the American Heart Association, the classic warning signs are:

* An uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that lasts for more than a few minutes, then disappears and returns.

* Pain that radiates to the shoulders, stomach, back, arms, neck, or jaw.

* Chest discomfort with dizziness, fainting, nausea, sweating, fluttering heartbeat, or shortness of breath

Women may also have these warning signs, which are less common:

* Unusual chest pain, stomach, or abdominal pain, which may feel like indigestion or the need to belch.

* Difficulty breathing and shortness of breath.

* Unexplained weakness, fatigue, or anxiety.

* Palpitations (an irregular heart beat), rapid heart beat, paleness, or breaking into a cold sweat.

* Pain in the jaw or back.

If you or anyone you know is having these symptoms, get to a hospital immediately. Not all the symptoms show up in every attack. Do not wait, because the heart muscle starts to die during an attack and every minute counts. It is always better to be safe than sorry.

Childlessness may be a tragedy for the married couple and a of marital upset, personal unhappiness and ill health. Infertility often plays a major role in breaking the marital bridge and important cause of separation between partners.

According to the experts, infertility is considered when a couple is unable to achieve conception after one year of unprotected coitus. If you have been trying to conceive for more than a year, there is a chance that something may be interfering with your efforts to have a child.

Infertility may be due to a single cause in either you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing.

In any series of infertile marriage, the main etiological factor is found in the female in about 40 percent of cases; about 35 percent of the husbands concerned have some degree of infertility. In 10-20 per cent of cases a combination of factors operates and rest has unexplained infertility.

In majority of cases female infertility is due to the obstruction in fallopian tube, loss of motility of tube, polycystic ovarian syndrome diabetes, thyroid disorder etc. Whereas in case of male, factor implies a lack of sufficient numbers of competent sperm, resulting in failure to fertilise the normal ovum. Other important causes are varicocele, genetic predisposition, occupational and environmental factor.

Sexual inadequacy is one of the important factors contributing to infertility. It is important to realise that the age of a woman is a factor to be considered and there should not be any delay in offering suitable treatment for the couple.

Over the past decades, there has been much improvement in the treatment of both infertile female as well as the male. Assisted conception is one of them. It is the facilitation of natural conception by some form of scientific interventions.

In Bangladesh assisted reproduction technology has become a promising one. Technologies available in the country include IUI (Intrauterine Insemination), IVF (In Vitro Fertilisation) and ICSI (Intra Cytoplasmic Sperm Injection).

In vitro fertilisation (IVF) is the most effective ART technique. IVF involves retrieving mature eggs from a woman, fertilising them with a man’s sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilisation. IVF often is recommended when both fallopian tubes are blocked. It is also widely used for a number of other conditions, such as endometriosis, unexplained infertility, cervical factor infertility, male factor infertility and ovulation disorders.

Intracytoplasmic sperm injection (ICSI) technique consists of a microscopic technique (micro-manipulation) in which a single sperm is injected directly into an egg to achieve fertilisation in conjunction with the standard IVF procedure. ICSI has been especially helpful in couples who have previously failed to achieve conception with standard techniques. For men with low sperm concentrations, ICSI dramatically improves the likelihood of fertilisation.

IUI technique attempts to assist the implantation of the embryo into the lining of the uterus. With this advancement it is possible to treat the vast majority of subfertile couple successfully and give them the child they so desire.

Kidney stone is one of the most painful disorders that lead a person to expensive and unpleasant emergency visits, hospitalisations and undergo surgical procedures.

Half of all untreated people will form additional stones and some will form stones chronically. Preventing kidney stones is the primary goal and we have peer-reviewed clinical data for last 20 years proving that the treatment guideline can help reducing kidney stone formation rates up to 80 percent.

Kidney stones form when urine has too many crystal-forming chemicals and/or not enough substances that protect against crystal formation. If the crystals do not rapidly pass through the urinary tract, they can accumulate and form stones. When the volume of urine is too low, stone-forming materials become concentrated helping to promote stones.

Kidney stones can be prevented if measures taken properly. During the last 30 years, treatment plans incorporating diet, fluids and medications have been developed to prevent or stall the formation of new stones.

The primary treatment have been proven in controlled clinical trials. Your preventive treatment may consist of fluid, diet, and/or medications. Diet changes are just as essential as any medications your urologist may prescribe.

General kidney stone prevention guidelines
Increase fluid intake: A very common question is how much water should I drink each day? You should be producing at least 2.5 liters of urine a day. How much you need to produce that much urine will vary depending on many things.

1. Activity level (The more active you are the more you perspire and need to replenish your body with fluids)

2. Living/working in a hot/dry environment

3. Frequent flying (Pilots, flight attendants, business travelers etc.) and flying all day can cause dehydration

4. Salt intake (High salt intakes increases water retention)

Increasing your fluid intake keeps urine diluted and helps keep crystals from forming.

Low oxalate diet: Unfortunately, oxalate is found in healthy plant foods. High oxalate containing foods are tea, beans, nuts, peanuts, peanut butter, soybean curd (tofu), sunflower seeds, chocolate milk, pepper, ginger, soy sauce, blackberries, grapes, lemon peel, bread, whole wheat etc.

If you have other medical conditions like heart related problems, diabetes, high blood pressure, etc. you may have been advised by another physician to eat a diet low in fat and sugar but rich in vegetables that may contain high oxalate.

Then your key to diet should be everything in moderation. Cut on the portion size of the high oxalate containing foods and the number of times a day or week you are eating these foods.

Here and there you will indulge and when you do, make sure you flush out the extra oxalate with an added 8 ounce glass of water – before and after your treat.

Low salt diet: Your sodium intake should be between 2300-3300 mg per day.

Sodium is added to many of our foods that we buy in restaurants or at the store. A single restaurant meal can contain anywhere from 1000 to 4000 milligrams of sodium! It is important to read the nutrition labels on all packaged foods and to look at the ingredients listed. As a rule, if salt and several sodium compounds are listed as ingredients, the product contains more salt than is advisable on a low-sodium diet.

Low purine diet: Purine is a compound that is mainly found in animal protein and when metabolised, breaks down into uric acid. When you eat a diet that is high in protein (beef, poultry, pork and chicken), you have higher uric acid levels.

The normal diet contains from 600 to 1000 milligrams of purines daily. A low-purine diet is restricted to approximately 100 to 150 milligrams daily.

Current treatments
The current treatments available for kidney and ureteric stones include conservative management (waiting for spontaneous passage), extracorporeal shockwave lithotripsy (ESWL), endoscopic techniques (rigid and flexible ureteroscopic lithotripsy), and percutaneous treatments.

The American Urologic Association Stone Guidelines Panel has identified ESWL as a potential first-line treatment for both proximal and distal ureteric stones and for Kidney stones smaller than 2 cm.

ESWL is a noninvasive procedure that uses shock waves to break up the kidney stone into small pieces that can more easily travel through the urinary tract and excreted from body. However, complex presentations frequently are treated best endoscopically.

Following its introduction in 1980, ESWL dramatically changed the management of Kidney stone disease. ESWL is a procedure in which kidney and ureteric stones are pulverised into smaller fragments by shock waves. These small fragments then can pass spontaneously in urine.

ESWL can not be performed in patients with acute urinary tract infection, uncorrected bleeding disorders, pregnancy, sepsis, and uncorrected obstruction distal to the stone. Otherwise, this noninvasive approach allows patients to be rendered stone-free without surgical intervention or endoscopic procedures.

Diabetes nutrition focuses on healthy foods. But you can eat sweets once in a while without feeling guilty or interfering with your blood sugar control. The key to diabetes nutrition is moderation.

The scoop on sugar

For years, people with diabetes were warned to avoid sweets. But what researchers understand about diabetes nutrition has changed.

* Total carbohydrate is what counts. It was once assumed that honey, candy and other sweets would raise your blood sugar level faster and higher than would fruits, vegetables or “starchy” foods such as potatoes, pasta or whole-grain bread. But this is not true, as long as the sweets are eaten with a meal and balanced with other foods in your meal plan. Although different types of carbohydrates can affect your blood sugar level differently, it is the total amount of carbohydrate that counts the most.

* But don’t overdo empty calories. Of course, it is still best to consider sweets as only a small part of your overall plan for diabetes nutrition. Candy, cookies and other sweets have few vitamins and minerals and are often high in fat and calories. You will get empty calories — calories without the essential nutrients found in healthier foods.

Have your cake and eat it, too
Sweets count as carbohydrates in your meal plan. The trick is substituting small portions of sweets for other carbohydrates — such as bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt or potatoes — in your meals. To allow room for sweets as part of a meal, you have two options:

* Replace some of the carbohydrates in your meal with a sweet.

* Swap a high carb-containing food in your meal for something with fewer carbohydrates and eat the remaining carbohydrates as a sweet.

Let’s say your typical dinner is a grilled chicken breast, a medium potato, a slice of whole-grain bread, a vegetable salad and fresh fruit. If you would like a frosted cupcake after your meal, look for ways to keep the total carbohydrate count in the meal the same. Trade your slice of bread and the fresh fruit for the cupcake. Or replace the potato with a low-carbohydrate vegetable such as broccoli. Adding the cupcake after this meal keeps the total carbohydrate count the same.

To make sure you are making even trades, read food labels carefully. Look for the total carbohydrate in each food, which tells you how much carbohydrate is in one serving of the food.

Consider sugar substitutes
As part of diabetes nutrition, artificial sweeteners can offer the sweetness of sugar without the calories. Artificial sweeteners may help you reduce calories and stick to a healthy meal plan — especially when used instead of sugar in coffee and tea, on cereal or in baked goods. In fact, artificial sweeteners are considered free foods because they contain very few calories and don’t count as a carbohydrate, a fat or any other food in your meal plan.

Examples of artificial sweeteners include:

* Acesulfame potassium

* Aspartame

* Saccharin

* Sucralose

Artificial sweeteners don’t necessarily offer a free pass for sweets.

* Keep an eye out for calories and carbs. Many products made with artificial sweeteners, such as baked goods and artificially sweetened yogurt or pudding, still contain calories and carbohydrates that can affect your blood sugar level.

* Sugar alcohols are not calorie-free. Sugar alcohols, another type of reduced-calorie sweetener, are often used in sugar-free candies, chewing gum and desserts. Check product labels for words such as “isomalt,” “maltitol,” “mannitol,” “sorbitol” and “xylitol.” Although sugar alcohols are lower in calories than is sugar, sugar-free foods containing sugar alcohols still have calories. And in some people, sugar alcohols can cause diarrhea.

Reconsider your definition of sweet
Diabetes nutrition does not have to mean no sweets. If you are craving them, ask a registered dietitian to help you include your favorite treats into your meal plan. A dietitian can also help you reduce the amount of sugar and fat in your favorite recipes. And don’t be surprised if your tastes change as you adopt healthier eating habits. Food that you once loved may seem too sweet — and healthy substitutes may become your new idea of delicious.