PURPURA

DOC I HAVE PURPURA

Purpura is a physical sign of escape of red blood cells through the endometrial wall of the dermal capillaries resulting in purplish blotches under the skin.

What is the cause of Purpura?

It is usually due to vacular wall defect, low platelets, infections or injury:

Vascular wall defect may be caused by:
1.Scurvy or lack of vitamin C
2.Fragilty of vascular wall due to age(senile purpura, anemia, diabetes or steroid therapy
3.Autoimmune disease such as Henoch Schonlein purpura
4.Blood cancer such as multiple myeloma

Infections:
1.Dengue fever - cause low platelets
2.Subacute bacterial endocarditis - cause low platelets
3.Typhoid fever
4.Rocky mountain fever

Low Platelets:
1.Aplastic anemia - low production of red blood cells, white blood cells and platelets from marrow
2.Megaloblastic anemia
3.Leukemia
4.Exposure to toxic drugs (chemotherapy) or radiation
5.Splenomegaly
6.Idiopathic thrombocytopenic purpura
7.Lymphoma
8.Neonatal thromocytopenia
9.Drug induced thrombocytopenia

Others:
1.Injury
2.Trauma
3.Burns
4.Dialysis
5.Blood thinners such as aspirin, warfarin, plavix
3.alcohol

What are the symptoms of Purpura?

Symptoms:

1.typical purple blotches under the skin
2.fever with purpura is a medical emergency
3.fundoscopic bleeding
4.abdominal pain may be a recurring symptom
5.splenomegaly
6.low platelets
7.bleeding time prolonged

How do you made the diagnosis of Purpura?

Diagnosis of Purpura is often based on
1. history of Purpura
2. history of drug allergy
3. history of blood thinners
4. Full blood count
5. Bone marrow biopsy

What are the complications of Purpura?

The complications of Purpura are:

1. Anemia

2. damage to liver , spleen and nerves

What is the treatment of Purpura?

Treat the underlying cause:
1.Blood transfusion of platelets in severe cases

2.Antibiotics for infections

3.Avoid causative agents especially drugs, vitamin deficiency,renal disease,radiation

4.corticosteroids is useful in idiopathic thrombocytopenic purpura

5.Splenectomy may be helpful

What is the prognosis of Purpura?

Prognosis depends on the cause of Purpura.
Patients with blood cancer has a poorer prognosis compared to injury.

WEIGHT LOSS 3

DOC HOW DO I LOSE WEIGHT?

Control Diet

15.)Grocery store shop at outer aisles

There is one common thread in all grocery store designs: the healthy foods are on the perimeter aisles. Think about it, when you go into the grocery all of the healthy stuff, fruits, vegetables, meats, and dairy products are arranged around the stores walls whereas the center aisle areas in those few stores that stock butter and cheese in the center near the frozen foods. .

Train yourself to start on one end of the outer aisle and work your way around. You will be able to fill your basket with healthy items if you do so.

16.)Get good cook books

Get a good cookbook. Not all recipes in a cookbook are low-carbohydrate fare. However you will be surprised at the number of low-carbohydrate friendly recipes you can find in a standard Betty Crocker Cookbook.

Cookbooks often contain handy tips on purchasing cuts of meat and preparing meats, fruits and vegetables in new and exciting ways. New low-carbohydrate cookbooks are hitting the shelves all the time. Try to take advantage of these resources to eat something new, different and nutritious.

17.)Take a good multivitamin as supplement to your diet The most conscientious food combiner may miss some healthy vitamins, minerals and trace elements in their diets. To help supplement your diet, consider taking a good multivitamin. If you are an otherwise healthy individual, your body will do its part. Keep to the low-carbohydrate diet plan that is right for you with some variety to your meals to help you on the path to good health and weight loss goals.

18.) Reward Yourself

Once in a while reward yourself. You will be less likely to cheat on your new diet if you grant yourself small rewards. If you are a chocolate lover, treat yourself to a small square of chocolate  each evening.

BURN YOUR CALORIES

1.) Work Out with Weights

Beside the diet control the other way is to burn up the fat. One way is to add a weight exercise program and routine work out. Weight training will not only tone your muscles but will strengthen your body and improve your general health. Lifting weights will also help to burn calories and fat more quickly than ordinary exercise.It will also boost your blood circulation and metabolism.

2.) Avoid Marathon Work Outs

Some people feel that the best way to burn fat and lose weight is to have one long, extensive work out. That is not true because it will exhaust all your energy leaving less energy for the next exercise. Break up your work out plan into small manageable sessions throughout the day. For example take a brisk walk in the morning, enjoy a work out at lunch, and then exercise more in the evening. This will keep you active all day long and will better maintain your metabolism.

3.) Mix It Up

Being active in different quality exercises will keep your interest and help you to maintain your goal of burning fat. Changing exercises such as to swim laps one day, jog another, and riding a bicycle the next will not only allow you to experience a variety of physical activities, it will also allow you to better tone your body.

Finally a positive and cheerful optimism will help a long way to reduce your weight. If you can control your diet and burn your calories you will definitely lose weight! Do not doubt that!

WEIGHT LOSS 2

DOC HOW DO I LOSE WEIGHT?

Control Diet

7.)Avoid meal replacements

Every day new meal replacement shakes and bars are sold on the market.They may claim to be healthy, but almost all of them contain hydrogenated oil and sweeteners.

Low carbohydrate doughnuts and muffins can be found at your neighborhood grocery store . While low-carbohydrate pastries may be tempting to buy, unfortunately they still contain all of the usual carbohydrate suspects: sugar and flour.

They may be healthier than your typical muffin as an occasional treat but not for long term eating.

8.) Low Glycemic Index Diet

A low Glycemic Index(sugar index) diet is a good way of burning fat quickly. This diet allows people to take large amounts of foods with low rankings on the Glycemic Index. These foods have enough nutrition and will help your body to burn fats and calories faster. The diet includes many of your favorite fruits, vegetable, meats, dairy, and grain products.

9.)Get fresh fruits not squeezed

Fruit juice can be very tempting as a replacement for soda but most commercial fruit juice has very little actual fruit juice.

Instead you will find lots of sugar water and other ingredients. Skip the juice altogether and eat a fresh piece of fruit instead. Not only does fresh fruit contain less sugar than juice. Fresh fruit also has fiber which is good for you and will help you feel fuller longer.

10.)Cooking your own food:

Many food in restaurents claims to have low carbohydrate and calories but most of them are not ideal low-carbohydrate fare. There are many recipes for good nutritional and easily prepared meals that you can cook yourself at home.

If you cook your own foods, you will be able to know exactly the contents of the food and you will have better control for hidden sugar and otherwise processed foods.

The other benefit is the significant cost per meal as opposed to eating at restaurants and fast food establishments.

It is also easier to control your diet with your favorite fresh food selections available at your kitchen.

11.) Eat slowly and enjoy your food

You will feel full and more satisfied if you take the time eat slowly by chewing it and savouring your food. Do not eat while standing . Sit down and chew.

Eating slower will help you enjoy your food more, notice what it is you are actually eating and get a better knowledge of when you are actually full.

12.) Cut Calories Wisely

It is tempting to drastically cut your calorie intake when you start on a healthy lifestyle. By reducing calories too quickly, your body will be too rapidly burning all available calories, which will slow down your metabolism.
Instead use a step method when cutting your calorie intake to minimize risk.Furthermore, you are more likely to maintain your healthy lifestyle through this step method.

13.) Skip Happy Hour

Avoid alcohol. Alcohol is rich in sugars and carbohydrates, and therefore a high calorie substance. These calories can add up quickly and take away from essemtial nutrients that should be included in your daily diet. Besides this alcohol acts as an inhibitor for burning fat allowing your body to store the fat faster.

14.)Having your food storage containers

Using your food storage containers of various sizes will make it so much easier for you to plan your meals. You can buy and store nuts, fruits and vegetables in bulk for easy use later.

Fix your own lunch and snacks and bring them in containers with you to work.

WEIGHT LOSS 1

DOC HOW DO I LOSE WEIGHT?

A Simple Guide to your weight loss program involve 2 main components:
1.Control Diet
2.Burn up Calories

Control Diet
1.) Drink More Water

Drinking water 8 to 10 times each day to stay hydrated and healthy. Once you get started, you will begin to crave water.

Start with a glass of water first thing in the morning before you eat. If you really do not like the taste of water, try adding a few drops of lemon or lime to your water but no sugar or sweetener! Ice also helps.

One of the best weight loss secrets is to avoid the sweet drinks and the sodas which are all calorie laden. Instead grab a refreshing glass of water.

Besides flushing toxins and waste material out of your system, drinking water encourages you to build muscle.

Drinking a glass of water after very meaal will help you get in your 8 to 10 glasses of water each day but it can also have other benefits.If you feel hungry after a smaller meal, try drinking water after the meal. The water will help you feel full and prevent further eating.

2.) Eat More Small Meals

Do not skip breakfast each morning even if you will have to go bed earlier 20 mins each night to wake up for a proper breaskfast! Breakfast is the most important meal of the day and will contribute to your good health and to weight control.

Eating breakfast is not only good for overall weight loss, it will help you control your diet the rest of the day. You will less likely to eat something sweet and in the bread group if you skip breakfast.

Keep a couple of hard-boiled eggs in the fridge or some high-fiber, low starch fruit around to take for breakfast. Breakfast is the best time to take fruits.

You will feel better and lose weight quicker if you eat a large breakfast and eat a smaller dinner. Try and eat the majority of your carbohydrates earlier in the day, leaving a salad and lean meat protein for dinner.

By eating larger meals during the part of the day when you are most active will help you to feel less hungry throughout the day and stop cravings for unhealthy snacks.

Traditional three-large-meals-a-day plan will not help your body to burn up large meals and any excess will be turned into fat. Many nutritionist believe you should eat six small meals a day. You should cut back on your food consumption at each meal, or else you will be doubling your intake of calories!

Just like eating breakfast will increase your metabolism, so will eating small meals more often. This will also help you reduce the total carbohydrate intake by making sure that your meals are planned and occur regularly throughout the day.

3.) Consider eating a salmon or fish during breakfast

This is one way to work in Omega-3 fatty acids that are good for you and add some variety to your daily diet. After a time you may tire of eating eggs and bacon for breakfast. Eating a salmon or fish will give you the protein and healthy fish oils you need.

4.)Avoid White Foods

Anything which is made from sugar, flour, potatoes, rice or corn - just avoid. Always look for colorful fruits and veggies to substitute for the white foods. Buy broccoli, lettuce, bell peppers, green beans and peas, brown rice in moderation, leafy greens like kale and spinach, apples, melons, oranges and grapes.

Fruits and vegetables are not only colorful but they are also high in fiber, nutrients and important antioxidants. Eating colorful fruits and vegetables will give your diet variety as well as healthy benefits with their fresh vitamins, minerals and fiber. Most people will find some vegetables that they enjoy eating. Vegetarians have food that looks and taste as good as meat .They are actually made out of soya bean and flour.

5.) Choose Protein

Choose protein-laden foods for boosting your metabolism and enabling your body to burn fat rapidly. In addition to burning fat, consuming a protein-enriched diet will help you rebuild muscle after work outs and maintain leanness of that muscle. Wisely choose proteins for your diet. Take great care to pick proteins low in fat so you do not consume extra calories.

6.)Eat more protein at every meal

Eating protein helps you burn more calories. This iss because protein is made up mainly of amino acids, which are harder to breakdown in your body so you burn more calories getting rid of them.

Eating a protein rich snack can help you to lose weight.

Eating protein will also help you feel full so that you have less craving for unhealthy snacks.

BRISTOL STOOL SCALE

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DOC HOW DO I KNOW WHETHER MY STOOL IS NORMAL

Actually many people do not know the definition of diarrhea.

They define the word diarrhea as watery stools where in fact the word diarrhea means any stools which are softer or more frequent than normal.

The researchers at the Bristol University have come out with a scale which is called the Bristol Stool Scale.

According to the Bristol Stool Scale, the seven types of stools
are:
1.Type 1: Separate hard lumps like nuts
2.Type 2: Sausage shaped but lumpy
3.Type 3: like a Sausage but with cracks on its surface
4.Type 4: like a Sausage or snake, smooth and soft
5.Type 5: soft blobs with clear cut edges
6.Type 6: Fluffy pieces with ragged edges, a mushy stool
7.Type 7: Watery, no solid pieces. Entirely liquid.

Type 1 and 2 indicate constipation while type 5-7 indicate diarrhea. Type 3 and 4 are considered ideal stools because they are the easiest to pass.

Avoidance of constipation include:

1. Increase in daily fiber intake to at least 15gm (eg. 1 bowl of bran cereal for breakfast),
fruits and vegetables).
Fibre increases the bulk of the stool allowing easy passage of stools through the large
intestine.

2. Drink at least 8 glasses of water a day (2 liters). Water reduces the hardness of stools.

3. Regular exercises at least 2-3 times a day especially after meals. Exercise will enhance
intestinal movement.

4. Allow a distraction free period of 15 min a day for bowel movement. The strongest
intestinal movement occurs after breakfast.

5. Do not ignore or suppress the urge to pass bowel movement. This may impair the
sensation to detect initiation of bowel movement leading to constipation.

Avoidance of  diarrhea include:

1.washing your hands thoroughly for 20 seconds after using the bathroom or changing diapers

2.washing your hands thoroughly for 20 seconds before eating

3.disinfecting contaminated surfaces such as counter tops and baby changing stations

4.Avoid eating or drinking foods or liquids that might be contaminated

5.Avoid rapid intestinal movement from stress, irritable bowel syndrome

Please read my blogs on constipation and diarrhea

BIRD FLU

DOC I HAVE BIRD FLU

Bird Flu or more correctly, avian flu is new strain of influenza virus H5N1 which can infect humans.

It has been around for 1987 and was expected to be the next big pandemic to hit the world.

Millions of birds and poultry has been culled all these countries especially in Thailand and China.

Just in December 2011 there has been a few cases found in Hong Kong where culling of poultry has been done .

The number of cases of avian flu in humans in the current outbreak is very small, and almost all have come about by direct contact with infected or dead birds or poultry.

The first outbreak of bird flu occurred in 1987 . Since then the bird flu have claimed at least 306 human lives in Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Laos, Nigeria, Pakistan, Thailand, Turkey, and Vietnam.

Just as recent as December 2011 one woman in Shenzhen which is in southern China died of bird flu(H5N1).

On January 7th 2012 another person also died of Bird flu in Indonesia.

Central to the problem of dealing with bird flu is diagnosis.
A number of upper respiratory infections have similar symptoms—at least at the onset of the illness, including the common cold, seasonal influenza, and bird flu.

Seasonal flu and bird flu have almost identical symptoms:
1.fever,
2.cough,
3.malaise (feeling unwell),
4.nausea,
5.vomiting,
6.diarrhea.

The Multiplexed Respiratory Test, discriminates influenza A from influenza B and identifies the H5-subtype of influenza A (bird flu is “H5N1”) from all other H subtypes.
In addition, it can identify almost all the other common—and some uncommon—viruses that cause influenza-like illnesses.

Preparation to treat a bird flu epidemic:
1. The single most important thing for an epidemic such as avian bird flu is to have well-prepared local health care systems.

2. Regular hand washing, and other beneficial cleanliness custom may save more lives than all other medicines combined.

3. The proper recognition and prizes should be given to those who have come up with effective vaccines for the avian bird flu disease. On the same note, vaccine makers should be given the freedom to make use of state materials needed for the vaccines.

4. Relevant drugs and vaccines for the avian bird flu disease should be bought and sold at fair prices.

5. Make preparations to ensure the continuity of food and power supplies.

6. It is therefore appropriate to have local health authorities ready to be used when the situation calls for it.

7. Encourage the formation of prediction markets about the avian bird flu epidemic.

8. There should be useful information about the progress of avian flu.

This will be especially useful in some Asian countries where the avian bird flu epidemic is expected to be rampant.

9. The World Health Organization should be prepared for such a bird flu epidemic.

During an avian bird flu epidemic, there are also things that should not be done:
1. Tamiflu and vaccine stockpiling have their useful roles.

In addition to the medical limitations of these investments(Tamiflu is losing its effect on most influenza because of their frequent use especially in Hong Kong), other institutional factors, such as transportation, will restrict the ability to allocate these supplies promptly to the persons needing them(healthcare and emergency staff)

2. Quarantines and mass isolations are useless in a bird flu epidemic.

3. In an avian bird flu epidemic  the health authorities must be in full control of the situation

4. It is pointless to block off or isolate the pandemic in its country of origin.It may have spread abroad already. Besides birds are migratory.

5.Public places such as schools and marketplaces should be closed immediately to be on the safe side.

5. People should not obsess over avian bird flu at the expense of other medical issues.

BED BUGS

DOC I HAVE BEEN BITTEN BY BED BUGS

What are Bed Bugs?

A Bed Bug is an insect called Cimex lectularius which is a small living insect that one can hardly see with the naked eye.

Bed bugs can be found in schools, hotels, apartments and houses. They can usually crawl and hide themselves in clothes, quilts, bed covers, pillow, furniture, cracks and crevices in the home.

Bed bugs are usually active at night. They mostly bite at exposed skin area such as face, neck, arms, hands feet etc. leaving swelling and redness at those bitten areas.

Their bites are characterized by itchiness and secondary skin infections.

Bed bugs are very flexible and tough insects because after they eat once in their life  they can spend their whole life span on that single meal.

The Life span of bed bugs is only one year.

Bedbugs can survive as long as up to one year without sucking blood.

The female bug can lay lay eggs three times in their life. and 300 eggs at one time. The eggs hatch in 6-10 days into adult bed bugs.

What are the Symptoms of Bed Bugs?

1.itching which is worse at night

2.rashes and abrasions on the skin due to scratching and secondary infections.

Rashes typically are present on legs and arms, sometimes on the body , seldom on the face. Rarely it may be present on the scalp.

Bedbug bites can not be felt immediately because of a sedative present in the saliva of the bedbug that keeps the blood from clotting and immunes the body for some time.

The process of sucking blood of a host lasts for 4-5 minutes.

The only good thing about these bugs is that they don not carry germs or bacteria that may cause harmful diseases to human body.

How do you confirm the diagnosis of Bed Bugs?

Skin scrapings can be examined microscopically for the Bed Bugs bites.

What is the Treatment of Bed Bugs?

Wash the infected area with an antibacterial liquid and apply calamine lotion afterward.

Pesticides (chemicals to treat Bed Bugs) actually contain mild insecticide :

Benzyl benzoate lotion

Malathion lotion

Gamma benzene hexachloride cream

Permethrin cream

Bathing is followed by application of the insecticide to the whole body from the neck to soles, left for 24 hours.

Treatment of contacts may be required if there is obvious signs of Bed Bugs.

While the Bed Bugs cannot live off the human skin for longer than 24 hours, each treatment with pesticide should be accompanied by washing, in hot water, of bedsheets, pillow cases and any clothes worn over the previous week.

Most people improve within a few days of treatment but it may take 4-6 weeks for the itch and rash of Bed Bugs to go away completely.

Prevention:
Keep your house clean and spray an effective pest control formula to eradicate these bugs completely.


 

AEROBICS

DOC WHAT IS AEROBICS?

Accordingly, aerobics is defined as “a method of physical exercise for producing beneficial changes in the respiratory and circulatory systems by activities which require meeting a modest increase of oxygen intake and so can be maintained."

Because of today’s many new illnesses (hypertension, type 2 diabetes, and other cardiovascular conditions) brought about by modern man’s generally inactive physical lifestyle, experts strongly recommend aerobics for everyone.

Aerobic exercise

The common definition of aerobics is simply the activity that consists of low-intensity repetitive motions of mostly the large muscles of the arms and legs for a period of time. This activity increases breathing and heart rate.

Most low-intensity activities you do during the day also fall under this category. It includes such regular activities as walking, jogging, swimming, and cycling.

For individuals who are beginners in exercise programs, or maybe have histories of health conditions, light exercise routines are recommended at first on most days of the week.

Cardiovascular benefits

Experts advise that these aerobic exercises have to be performed at moderate intensity. This level of activity is safe for almost everyone, and it still provides the desired health benefits.

Recent research brings in additional good news. It is revealed that aerobics performers can still have cardiovascular benefits even if the exercise routine (usually 30 minutes total) is broken into three or four 8-10 minute segments, as long as they are of the same intensity.

Intensity

Doctors, however, discourage infrequent bouts of high-intensity aerobics routines. It is found that this approach is not very healthy.

In the first place, reduction in risks of hypertension, high cholesterol, type 2 diabetes and other conditions depends on the total volume of the exercise done, rather than on intensity.

Higher intensity exercise activities raise your chances for muscle or joint injury. Worse, it may trigger fatal consequences because of heart rhythm disturbances.

Aerobics instructors always begin their sessions with light stretching and low-intensity movements for about 5 to 10 minutes. This warm-up routine is important to avoid injury. At the end of the routine, a similar cooling-down period for about 5 to 10 minutes is also done.

Benefits

As had been proven these years, people who engaged in regular aerobics have been known to benefit by way of lower blood cholesterol counts, lower blood pressure, toned body because of fat reduction and beneficial weight loss.

They have been known to have developed muscular and overall body endurance, have a happier disposition and moods, and a medically-certified general lower risk to cardiovascular diseases.

Common activities

The best part is the easy way on how to do your aerobics, even without going to the gym and participating in gym routines.

Doctors recommend a simple walk that totals around 10,000 steps a day. Start with something lower, and add the number of steps slowly everyday until you reach your goal.

Done on a regular basis, brisk walking is guaranteed to erase your common health risks. Your need for aerobics is not be that hard to fill up.

HYPNOTHERAPY

DOC WHAT IS HYPNOTHERAPY?

Hypnotherapy is the use of hypnosis to treat patients who are in pain or who are having problems within their minds.

The word Hypnotherapy is based off the word "Hypnos," and this was the name of the Greek god of sleep.

Those who use hypnotherapy believe that patients who enter a trance are much more likely to listen to suggestions which are given to them.

Some conditions which are treated by hypnotherapy are
1.pain,
2.stress,
3.obesity,
4.smoking,  
5.amnesia.
6.hysteria

While many of these conditions are related to the mind, some functional ailments can be treated as well.

Hypnotherapy is a practice that was started by the Ancient Egyptians and Indians. Here the practice would often have a religious tone, and both music and dance was included in the practice.

It wasn't until the 19th century that a number of healers begin developing the methods that would come to be known as hypnosis. Franz Anton Mesmer developed a theory which has come to be known as animal magnetism.

He did extensive research on hysteria, and his studies indicated that advanced cases were similar to what is called a post-traumatic stress disorder.

The work of Sigmund Freud also played an important role in the development of hypnotherapy.

A number of criticisms have been made against the practice:

1.Some believe that the connection between the patient and the therapist may cause problems.

2.The patient may want to please the therapist, or they may worry that the therapist doesn't like them.

However, many of these claims are inconsistent because clinical hypnotherapy will generally take place in a medical facility.

There are a number of common techniques that are used in this practice.
1.Regression method-One of the primary techniques is age regression. The hypnotist will attempt to mentally return the patient to a previous state, and this will often be done to help the patient gain something that they have lost.

2.Revivification -the second technique that is commonly used in hypnotherapy is called revivification. In this technique, the hypnotist will help the patient remember previous experiences they've had. As an example, the hypnotist may ask a patient if they have ever been fishing, and if they have been, they will begin recalling the time that they went fishing, and there will be no need for the hynotist to create a new state.

3.Guided Imagery -another common method that is used in hypnotherapy is called a guided imagery. With this technique, the hypnotist will guide the patient through a pleasant experience.

4.Repetition method-The hypnotist may often repeat certain ideas or concepts in order to get the patient to accept them, and this is called repetition.

In general, people are more relaxed when they are in a dream state. When a person is able to visualize something they desire, research has shown that it is much more likely that they will obtain it.

In this situation, the goal of the hypnotist is to help the patient achieve a desired goal.

This technique has primarily been used to help people on a mental level since the 19th century.

MAJOR COSMETIC SURGERY

DOC WHAT ARE THE MORE MAJOR COSMETIC SURGERIES AND PROCEDURES

Major Cosmetic Surgeries which has some risks:
1.Facelifts for patients with wrinkles, excess folds of skin over jaw and neck.
During a facelift operation the wrinkles and excess skin  are eliminated by by tightening of the skin pulling it upwards and backwards.The purpose of the surgery is to give the patient a natural face tension and smooth skin without excess skin under the jaws and neck.Complications to this surgery include bleeding and infection, damage to the facial nerve .Incisions are hidden within the hairline and in front of the ear.
A normal facelift can last for 5 to 10 years.However not all wrinkles can be eliminated.

2.Eyelid surgery such as double eyelids, removal of bags under the eye and drooping eyelids:
Double eyelids operations are done by incision(cut) under local anesthesia of the skin of eyelid, excess fat is removed and the upper eyelid muscle(levator palpebae superior) is attached to the upper eyelid skin to simulate a natural fold. The result is an eye that look brighter and more awake.
Drooping eyelids are due to stretching of upper eyelid skin as a result of aging.
Removal of the excess skin and any excess fat tissue through an incision of the upper eyelid under local anesthesia will tighten the upper eyelid and prevent drooping.
Bags under the eyes is due mainly to aging with congestion of blood, water and fat under the eye as well as looseness of the lower eyelid. They make a person look tired, sad and old. Excess fat, skin is removed through an incision very close to the margin of the lower eye under local anesthesia.
Recurrence of all 3 conditions can occur after a few years.

3.Nose operation includes reduction of large nose or augmenting a flat nose.
Reduction Rhinoplasty: here the nose is too large,so the operation require dissection of the nasal bone with fine saws and reduction of cartilage under general anesthesia to give the desired shape.
Augmentation Rhinoplasty:The nose is too small, the bridge is too low or the tip is too short .The best way to reshape the nose is with a silicone implant tto alter the shape of the nose aand lift the bridge and tip of nose.This is done under local anesthesia through incision through the nostril so there is no obvious scar.

4.Reduction of bat ears which are sticking out can be done by reshaping the abnormal  ear cartilage and the ear folded backwards until it is parallel to the side of the face. This is done under local anesthesia and usually done for children before going to school.

5.Chin and neck problem can be either protruding too much forward or too far backwards.  Where there is no problem with teeth alignment, treatment is easier with reshaping of the front of the jaw bone.
In cases where the jaw is too short, the shape of the jaw can be corrected with a silicone implant through a small incision inside the mouth.
Where there is problem with teeh alignment, the jaw may be required to be shortened and the teeth realigned. This usually requred the services of a specialist dental surgeon.
Double chin patients usually have too much fat and skin under the neck. The fat and can be removed through a small incision in the neck under local anesthesia and the excess skin can also be removed easily by surgery.

6.The breasts can be either too small or too big.
Augmentation surgery usually involve the insertion of a silicone or saline prosthesis into the space between the breast and the chest wall through an incision under the breast.
Reduction of large breast is done under general anesthesia in hospital with removal of excess breast tissue and transplant of the nipple higher to a normal position.

7.Spare tyre may be in the form of excess fatty tissue and loose skin.
The commonest area is in the bulging abdomen especially in the elderly and in women with several pregnancies. The commonest way to remove excess fat is by liposuction which is done under general anesthesia to suck out most of the fat tissues in the abdominal area, thighs, hips or buttocks.The fat is often softened with saline or liquefying agent.
In cases where there is excessive loosness of the skin some surgery may be needed to remove the excess skin and tighten the muscles of the abdomen.

8.Collagen and botox injections: Collagen injections are used to fill up the depression of scar tissue or deep wrinkles. They are also used to tighten the sphincter of urinary tracts or anus in incontinence cases.
Botox injections are used to numb the nerves of the skin so that the muscles of the skin do not tighten to cause wrinkles.

HEALTH EDUCATION

THE IMPORTANCE OF HEALTH EDUCATION AS AN INTEGRAL PART OF PRIMARY HEALTH CARE

by Kenneth Kee 1993

A Dissertation Presented in Partial Fulfilment of the Requirements for the Degree of Doctorate of Philosophy with a Major in Health Care Administration and approved in 1993

ABSTRACT OF DISSERTATION:

This paper examines how health education and promotion forms an integral part of the Primary Health Care System.

It also shows how the concept of health has changed from its original definition by the World Health Organization as a state of complete physical, mental and social well being and not merely the absence of of disease and infirmity to something more realistic, dynamic and measurable.

The original definition has been described as an ideal state which is rarely attainable in real life.

The definition of of health care has also changed from a hospital based curative medicine to one of Primary Health Care and Preventive Medicine.

Primary Health Care is emphasized as the cornerstone of all good health care systems.

The escalating cost of health care associated with high technology and hospital based medicine in the treatment and rehabilitation of chronic diseases has led to the realization among many health care providers that many of the risk factors in the chronic diseases can be prevented at the Primary health care level.

A more rational approach to the current health may require more of a preventable rather than a curative approach in medical treatment.

To this end health education and promotion has proved its importance in the fight against disease and form an integral part of the health care system.

This paper also examines some well known models of health education and promotion such as the Tanahill's model of identifying key groups and their roles in health education and the Green's Proceed-Precede planning framework which identifies various behavioral and environmental factors affecting health.

It recommends various strategies for the [promotion of health such as formulation of definite goals, intersectional collaboration in health education and community participation in health education and community participation.

This dissertation about health education has brought me more knowledge about health issues than 20 years of practice in the field of primary health care.

It has focused my mind on the very important field of preventive medicine and health education.

It has made me more determined than ever to continue my work as a health educator as well as a medical practitioner

It has made me even more aware of the need of continuous medical education to keep abreast of the latest advances in medicine.

Unless I continuously update my medical knowledge I will not be able to explain the latest medical advance to my patient.

Lastly I must always remember that it is the patient who will benefit from my knowledge and that knowledge is not to be kept but to be imparted.

In the words of Professor Rosalind Miller:

"it is a society with myopic vision that foster episodic medical care than health care that includes Primary prevention particularly for those at greatest risk and where social welfare and health problems are indispensable"

PRIMARY HEALTH CARE

IMPORTANCE OF PRIMARY HEALTH CARE IN SINGAPORE

by Kenneth Kee 1991

A Dissertation Presented in Partial Fulfilment of the Requirements for the Degree of Master of Science with a Major in Health Management and approved in 1991

ABSTRACT OF DISSERTATION

Health care is divided into:

1.Primary Health Care (Government Outpatient Doctors, General Practitioners)

2.Secondary Health Care ( Specialist Doctors and Clinics)

3.Tertiary Health Care (Hospital Doctors and Institutional Clinics)

In the past, secondary and tertiary health care have always been the most important agenda in the Singapore Government Health Care Plan.

There has upgrading of specialist clinics and hospitals in Singapore.

In stark contrast the Primary Health Care sector has remained rather stagnant and even comparatively underdeveloped.

Perhaps this is because hospital and specialist health care carry a glamor about it unlike the Primary Health Care doctor who works in the community outsides the confines of the hospital setting.

It is therefore important that the Primary Health Care should be emphasized as the foundation of any good Health Care System.

Unlike the specialist and hospital medicine which represents only the tip of the iceberg of morbidity in a whole community, Primary Health Care covers the whole spectrum of undifferentiated illnesses with its continuing care and management of the whole person from infancy to death.

The WHO at the Alma Ata conference has adopted the objective of "Health For All" which is a rallying call to the international community to enable attainment by all the citizens of the world of a level of health that will permit them to lead a socially and economically productive life.

"Primary Health Care address the main health problems in the community providing promotive, preventive, curative and rehabilitative services accordingly.Since these services reflect and evolve from the economic conditions and social values of the country and community but will include at least:
promotion of proper nutrition and adequate supply of safe water,
basic sanitation,
maternal and child care including family planning,
immunization against the major infectious illnesses.
prevention and control of local endemic diseases,
education concerning prevailing health problems and the methods of preventing and controlling them,
and appropriate treatment of common diseases and injuries."

REIKI

DOC WHAT IS REIKI

Reiki developed in 1922 by Japanese Buddhist Mikao Usui is a form  of complementary and alternative medicine using palm healing to transfer healing energy in the form of ki through the palms.

There are two main forms of Reiki:
1.Traditional Japanese Reiki
2.Western Reiki.

Reiki teachings claim that Reiki is inexhaustible and that it can be used to induce a healing effect.

Within both forms of Reiki, there are three forms of degrees:
1.The first degree Reiki course teaches the basic theories and procedures.
Students learn hand placement positions on the recipient's body that are thought to be most conducive to the process in a whole body treatment.
Having completed the first degree course, a Reiki practitioner can then treat himself and others with Reiki.

2.In the second degree Reiki course, the student learns the use of a number of symbols that are said to enhance the strength and distance over which Reiki can be exerted.

Having completed the second level, the student can work without being physically present with the recipient - a practise known as distant healing.

Students in Japan sometimes only attained the Second Degree after a period of 10, sometimes 20, years of practice.

3.Through the third degree, or "master training", the student becomes a Reiki Master.
The new Reiki Master can attune other people to Reiki and teach the three degrees.
The duration of the master training can be anything from a day to a year or more, depending on the school and philosophy of the Reiki Master giving the training.

There are commonly two types of Master:
Master Teacher  -a Master Teacher is a Master of Reiki and also has the ability teach Reiki
Master Practitioner - Master Practitioner is a Master of Reiki but does not teach Reiki.

Practice
The seven major chakras.
A schematic diagram of the human body's meridians.

In Western Reiki, it is taught that Reiki works in conjunction with the meridian energy lines and chakras through the use of the hand-positions, which normally correspond to the seven major chakras on the body. These hand-positions are used both on the front and back of the body, and can include specific areas

Healing
The Reiki practitioner touched the diseased parts of the body, he massaged them, tapped them lightly, stroked them, blew on them, fixed his gaze upon them for two to three minutes, and specifically gave them energy, and used a technique commonly referred to as palm healing

Whole body treatment
The Reiki practitioner instructs the recipient to lie down, usually on a massage table, and relax. Loose, comfortable clothing is usually worn during the treatment.

The treatment proceeds with the practitioner placing the hands on the recipient in various positions.
However, practitioners may use a non-touching technique, where the hands are held a few centimetres away from the recipient's body for some or all of the positions.
The hands are usually kept in a position for three to five minutes before moving to the next position.
Overall, the hand positions usually give a general coverage of the head, the front and back of the torso, the knees, and feet.
Between 12 and 20 positions are used, with the whole treatment lasting anywhere from 45 to 90 minutes.

Many Western practitioners use a common fixed set of 12 hand positions,

The use of the 12 hand positions energise on many levels by,

1.physical level through the warmth of the hands,
2.mental level through the use of the Reiki symbols,
3.emotional level through the love that flows with the use of the symbols,
4.energetic level though the presence of the Reiki practitioner as well as the Reiki power itself.

The recipient often feels warmth or tingling in the area being treated, even when a non-touching approach is being used.

A state of deep relaxation, combined with a general feeling of well-being, is usually the most common immediate effect of the treatment although emotional releases do occur.

The Reiki treatment is believed to stimulate the body's natural healing processes.

In a 2008 systematic review of randomised clinical trials assessing the evidence basis of Reiki,there is no proof Reiki had been effective for any condition.

SEXUAL HEALTH

DOC WHAT IS SEXUAL HEALTH?

Sex is the need for intimacy ,affection and emotional bond between a man and woman.

It is not just a physical relationship between 2 persons but an emotional tie between the two people called love.

A person's hunger for affection, intimacy, and emotional bond with another person is limitless.

Sexual health refers not only to reproductive sex and organs, but also the physical, emotional and social aspects of the sex act.

It is important to have a positive and respectful approach to sexuality and sexual relationships.

Any couple who has sexual health also feels well emotionally, mentally and socially when talking about sexual matters.

Here are some ways to achieve sexual health:

1. Understand sexuality

Sexuality is defined by the attitudes and values of a couple regarding sexual matters.

It represents a range of issues - from sexual thoughts and actions, to gender identity and roles.

Many factors,from biological,economic,and psychological factors, to social, ethical and religious ones.make up the complete entity of sexual attraction between a couple.

2. Understand that every one have sexual rights

The laws protect every person against sexual violations and discrimination.

Every person have the right to choose whether to be sexually active or not, and  have control over whom he/she wish to have sex with and how it is done.

3. Understand the partner’s sexuality

Because everyone is different, he/she have attitudes, feelings and desires that are different from his/her partner.

Once both partners understand and respect each other’s sexuality, he or she can improve their sexual health and pleasure.

It is therefore important to communicate each person's views to his or her partner and vice versa.

Once a person share what he or she is comfortable with and what he or she want in sex, they are both better prepared for sex.

4. Develop a healthy self-esteem for each other

A healthy self-esteem means to feel good about each other and be comfortable with whom each other are.

If every partner in a sexual relationship have a healthy self-esteem, the acceptance and enjoyment in each other’s presence is increased.

On the other hand, poor self-esteem often leads to unhealthy or even abusive relationships.

5.Always practice safe sex

Sexually Transmitted Infections (STIs) are contracted during unprotected sex and their symptoms vary widely.

The risk of contactiing STI is by practising safe sex, through the use of condoms.

Condoms however do not offer 100% protection so the best option is for a couple to be in a monogamous and faithful relationship.

With no fear of contracting STIs, the couple can relax and enjoy a pleasurable, healthy sexual relationship.

Some common STIs are:

HIV, the virus that causes AIDS

Chlamydia

Gonorrhoea

Herpes

Syphilis

Genital warts

It is important to treat STIs early to reduce complications and stop the spread of infection to others. Some STIs can be cured, while for AIDS, there is no cure.

6. Reproductive health is part of sexual health

Sexual health includes being able to have children, and planning when to have them.

Checkups on reproductive health means a regular visit to the gynaecologist.

Family planning is important so that the couple will never have to deal with an unwanted pregnancy or about passing an infection to the child.

7. Children should be educated about sexual health

There has been an increase in cases of teenage sex in the past few years.

This has resulted in a rise in unwanted pregnancies, abortions and STIs.

Being a parent it is important to keep the children safe from such consequences by educating them on sexual health.

It is important to start when they are young and just beginning to form their values and attitudes towards sex.

In summary, to be in good sexual health, the couple must pay attention not only to physical health.

Mental, emotional, spiritual and sexual health are equally important to achieve overall sexual health.

ANGER MANAGEMENT

DOC HOW DO I MANAGE MY ANGER

Anger is an emotion which is experienced by kids and adults alike as a normal response to interference by others in a negative manner.
Anger is a normal response to such a situation.

Anger can be classed as a mild or intense irritation.
It depends on the individual, the circumstance and their emotions.
1.Some people tend to keep their anger to themselves, bottling up their negative emotions and hurt.
2.Others lash out or become extremely defensive and even abusive.

Anger may be a healthy, normal emotion.
Regular episodes of angry or reckless behavior in a person can a problem, one that needs to be dealt with.
Anger can be also intense to the point of violence.
However when the anger takes over an individual's life, it can making them destructive to themselves and everyone around them. 

Controlling anger is considered anger management.
1.Most important to controlling anger is to admit there is a problem.
2.people who have major anger issues cannot see it.
3.They will continue down a path where they are constantly angry
4.Anger prevents them from seeking the help they require
5.The angry individual will likely experience loss of their family, their job and their own identity.
 
Anger management is designed to :
1.help the individual work out their problems,
2.help them figure out why they become so angry.
3.teach the person techniques which prevent them from getting angry as often or for very long.
4.help them have a better quality of life and live a healthy, normal life..

Anger management strategies are programs created specifically to help those with anger issues.
These programs address different people, kids, teens, adults, couples and families.
These programs are there to teach or help people to work on their anger.
Teaching people strategies to work out their problems and control their anger is important in anger management.
Every program is intended to help people who are hot-tempered and frequently have fits of rage.
Anger management strategies are designed to help an individual return to a healthy, normal existence.

1.Taking a time-out is considered a healthy management strategy.
Removing oneself from a situation or person that makes a person angry is practicing time-out.
This anger management strategy might simply require a ride in the car or a walk on the beach.
Playing sports or working out will help an individual to use up some of the extra energy without involving
Some other suggestions for time-out are reading, listening to music or sitting alone in silence.
Each of these activities are healthy anger management strategies.

2.A second example of a healthy anger management strategy is owning up to the anger.
Although the anger is usually brought on by an irritating situation or a confrontation with another individual, the anger actually belongs to the troubled person.
Only the person who's experiencing the anger issues can control their fits of rage.
He mustlearn anger management strategies and how to deal with his emotions in a healthy way.
When an individual becomes mad or upset he or she need to try to disclose the reasons for the anger whether it is hurt, fear, frustration sadness, confusion , jealousy or whatever seems to bring unleash the rage.

3.Another healthy anger management strategy is to look back on those situations that upset an individual and try to find ways to make changes.
Learning the cause of the anger may help the individual to avoid those situations.
Not only might the person learn to avoid these incidents but they might also choose to take what they've learned and attempt to deal with the situation without bursting into a frenzy.

4.A fourth suggestion regarding healthy management strategies is to confront the situation or person.
Talk to the person or people involved, calmly of course, to try to determine the root of the problem.
The angry individual might actually discover that the whole thing was a mix-up, a misunderstanding.
The individual might also try asking the person or people in the situation to think about their behavior and perhaps even change it.
It may be surprising what people would be willing to do to help the person who is attempting to deal with their problems with anger.
Hopefully everything will work out for the best.
If not there has to be room for acceptance.
Sometimes a person must simply accept the situations and people they cannot change and either deal with it or walk away.

Learning healthy anger management strategies should be considered by those with anger problems.

VEGETARIAN

DOC I AM A VEGETARIAN

A Vegetarian Diet is important for those people who opt for Optimal Personal and Environmental Health.

It’s been well documented through the years that vegetarians are healthier than people who eat meat.

Vegetarians are less likely to :
1.be obese
2.have high blood pressure,
3.diabetes,
4.rheumatoid arthritis
5.colon cancer
6.less likely to die from heart disease.

Vegetarians have lower blood pressure even when they eat the same amount of salt as meat eaters and exercise less.

Many studies show that vegetarians have less instances of colon cancer, due in large part to the differences in the bacterial flora that is present in the colon.

There are many factors in the vegetarian diet that contribute to better health.
1.Vegetarians consume two to three times as much fiber as do meat-eaters, which has been shown to reduce cholesterol and blood glucose levels, and protect against colon cancer.

2.They also consume more antioxidants, which are found in a wide variety of plant foods and protect cells from oxygen-induced damage and reduce the risk for heart disease, arthritis, cancer, and other diseases.

3.Vegetarians eat more isoflavones than do meat eaters. These compounds, found mostly in soy foods, are a type of phytochemical. Research shows that isoflavones may reduce the risk for prostate cancer and may improve bone health.

4.Vegetarians also consume much less saturated fat and cholesterol than do meat eaters, resulting in significantly lower levels of blood cholesterol, decreased instances of heart disease and possibly for diabetes and cancer.

5.And, since vegetarians do not eat meat, they are not exposed to heme iron, a type of iron found in meat that may increase the risk of heart disease and cancer.

6.Lastly, being a vegetarian is not only optimally healthy for your body, but also for your your environment and the planet’s animals.

It allows you to live more harmoniously with the world around you, which improves mental and emotional health accordingly.

MASSAGE THERAPY

DOC WHAT IS MASSAGE THERAPY?

What is Massage Therapy?

Massage therapy is a form of therapy that a licenced massage therapist or physiotherapist does massage of painful muscles or the body to improve blood circulation in a patient.

Besides being able to help relieve sore muscles, massaging a body needs a massage therapist who know what are the risks, if there are any side effects and how it supplements conventional medicine for stress and improving blood flow in the body.

Types of Massage Therapy include:

1.reflexology,

2.shiatsu,

3.back massage,

4.hot stone,

4.deep tissue,

5.aromatherapy

6.Swedish.

7.Thai

Risks with  massage therapy  can be avoided if you take the proper precautions.

The best thing to do will be to consult with your doctor to see if it is safe for you to see a masseuse.

Patients who have the following conditions should not undergo massage therapy. These include 1.deep vein thrombosis that happens to be a blood clot in a deep vein, usually in the legs,

2.bleeding disorder or taking blood-thinning drugs such as warfarin,

3.damaged blood vessels

4.weakened bones from osteoporosis,

5. recent fracture,

6.cancer.


7.fever, 

8.open injury,

9.damaged nerves, 

10.an infection or acute inflammation.

Certain conditions could also be dangerous if you decide to have a massage. These include 1.pregnancy,

2.cancer,

3.fragile skin,

4. dermatomyositis

5.heart problems,

Side effects associated with massage therapy include:

1.temporary pain or discomfort,

2.bruising,

3.swelling

4.sensitivity or allergy to massage oils.

Massage therapy should not be used a substitute for regular medical care.

If your doctor tells you that you can see a massage therapist, do some research about the person.

You should check on their credentials or licenses, years of experience and training.

If you need massage therapy to help cure medical condition, find out beforehand if they have specialized training in this field.

It would not hurt to also ask if they use other practices aside from massage therapy to help their patients.

Some examples of these include the use of herbs and requiring the patient to go on a special diet.

Some people may even ask for a free ten minute test to see how well they perform.

The best part about massage therapy is that it can provide relief without the need to ingest pain killing drugs and knowing some facts about it is good so you know what you are getting yourself into once you visit the place.

As long as there is no dangers or side effects, going for a session of massage therapy by a licenced massage therapist to relieve some stress or pain may be beneficial for your health

PHYSIOTHERAPY

DOC WHAT IS PHYSIOTHERAPY

Physiotherapy is also known as physical therapy of medical conditions. That answers the question of what is physiotherapy for many people.

As a supplementary type of health care, physiotherapy concerns itself with providing physical healing methods for many different kinds of injuries and illnesses.

Therapy at a Physiotherapy Clinic:

When a patient is referred to the physiotherapy clinic, he or she will be evaluated by a physiotherapist.

After this initial evaluation, he or she will be scheduled for treatments like ultrasound or acupuncture etc as recommended by the doctors in conjunction with the physiotherapists.

They will be assigned exercises to do at the clinic. A good physiotherapist will begin treatment right away.

The different types of Physiotherapy:

1.massage or manipulation (hands-on) of the musculo-skeletal system when the muscles and tissues are injured.

2.Traction of the skeletal system to lengthen the spaces between bones so that nerves or tendons are pressed on by the bones

3.Strengthening of the muscular system helps the patient to recover from surgery as well as prevention of tightening of the muscles and tendons and making them more flexible.

4.Heat (heat pads, infra-red light, shortwave diathermy) help the blood circulating after injuries and help earlier recovery

5.ice (cold compress) help to reduce swelling and tissue damage

6.ultrasound treatment, radiofrequency waves , are all useful to relieve pain and stiffness.

7.Hyperbarbaric treatment: Increase in oxygen pressure can improve the faster healing of injuries and recovery from surgery.

All these methods tend to promote better health, both physical and psychological.

The importance of physiotherapy equipment:

Equipment for helping patients regain their strength and mobility are a part of what is physiotherapy. This equipment may allow a person who is partially paralyzed to get the most exercise possible. This is crucial in maintaining the integrity of their spines and muscles.

The importance of Education in Physiotherapy:

Besides the methods used in Physiotherapy, education is a part of what is physiotherapy. A physiotherapist will teach a patient how to care for their injuries. He will teach exercises to do at home so that therapy can continue beyond the walls of the clinic or hospital. He will teach ways to overcome difficulties that cannot be cured.

Rehabilitation is another part of Physiotherapy treatment:

Patients have injuries from sports, car accidents, or assault. These injuries can be treated through physiotherapy. Given the right treatments and an injury that will respond to treatment, much progress can be made. Full functioning may be regained. It may even be possible for them to go back to work rather than being laid up at home.

Physiotherapy is a carefully planned and executed treatment strategy.

It is based upon assessments of the conditions that patients suffer. If all goes well, the patient will return to their original condition. If this is not possible, the goal is for the patient to reach a goal that is the best movement and lack of pain that is possible.

The preventative side of the field of physiotherapy is very important in the overall holistic treatment of a patient.

It is a part of the work of practitioners of physiotherapy to encourage exercises and postures that will help patients avoid physical injuries and conditions requiring their services.

An excellent physiotherapist will have fewer return patients, but the flow of people needing physiotherapy continues.

YOGA

DOC WHAT ARE THE HEALTH BENEFITS OF YOGA

Yoga is a physical, mental, and spiritual discipline, originating in ancient India,whose goal is the attainment of a state of perfect spiritual insight and tranquility.

The goals of yoga are varied and range from improving health to achieving Moksha which is liberation from all worldly suffering and the cycle of birth and death .

The more technical sense of the term "yoga", describing a system of meditation or contemplation with the aim of the cessation of mental activity and the attaining of a "supreme state" .

"Ashtanga Yoga" ("Eight-Limbed Yoga").

The Eight Limbs are:
1. Yama (The five "abstentions"):
non-violence,
non-lying,
non-covetousness,
non-sensuality,
non-possessiveness.

2. Niyama (The five "observances"):
purity,
contentment,
austerity,
study,
surrender to god.

3. Asana: means "seat", and refers to the seated position used for meditation.

4. Pranayama ("Suspending Breath"):
interpreted as control of the life force.

5. Pratyahara ("Abstraction"):
Withdrawal of the sense organs from external objects.

6. Dharana ("Concentration"):
Fixing the attention on a single object.

7. Dhyana ("Meditation"):
Intense contemplation of the nature of the object of meditation.

8. Samadhi ("Liberation"):
merging consciousness with the object of meditation.

Types of Yoga are:
1. Raja Yoga: the first yoga the path of meditation
2. Karma yoga: The yoga of action.
3. Bhakti yoga: The yoga of devotion,
4. Jnana yoga: The yoga of knowledge.
5. Hatha Yoga: the purification of the physical body as leading to the purification of the mind.

The Hatha Yoga is generally the yoga accepted by the western world as the yoga which they practiced .

Health benefits of yoga:
Yoga came to the attention of an educated western public in the mid 19th century as a form of purely physical system of health exercises :
1.meditation
2.breathing
3.concentration

Yoga is used for treatment of cancer patients :
1.to decrease depression,
2.reduce insomnia,
3.relieve pain, and fatigue
4.control anxiety.

stress.
Treatment with yoga reported significantly :
1.less mood disturbance and
2.reduced stress
3.positive effects on sleep anxiety,
4.better quality of life,

Schizophrenia:
Yoga's ability to
1.improve cognitive functions
2.reduce stress
makes it appealing in the treatment of schizophrenia because of its association with cognitive deficits and stress related relapse.

Heart disease.
studies of the effects of yoga on heart disease suggest:
1. yoga may help reduce high blood pressure,
2.improve symptoms of heart failure,
3.enhance cardiac rehabilitation,
4.lower cardiovascular risk factors.

Other health benefits:
1. musculoskeletal and mental health improvements,
2.reduced symptoms of asthma in asthmatics.
3.improve mood and anxiety more than other exercises, such as jogging or walking.

MEDITATION

DOC WHAT IS MEDITATION?

Meditation is a method to make the mind calmer and more focused.

Meditation can also help to understand body and mind interaction.

Meditation can help to transform the mind:
1.from negative to positive,
2.from disturbed to peaceful,
3.from unhappy to happy.

Overcoming negative minds and cultivating constructive thoughts is the purpose of the transforming meditations found in the Buddhist tradition.

There is the need for Meditation because:
1.many people feel stressed and over-worked as the result of the hectic pace and stress of modern life
2.there appears to be insufficient time in the day to get everything done.
3.The stress and tiredness make people unhappy, impatient and frustrated.
4.Loss of self confidence in achievements can cause despondency or irritation.

The Purpose of Meditation is:
1.The purpose of meditation is to make the mind calm and peaceful.
2.If the mind is peaceful, there will no worries and mental discomfort and true happiness will be achieved
3.Meditation training will help the mind to gradually become more and more peaceful and a purer form of happiness will be obtained.
4.Eventually the person will be able to stay happy all the time even during the most difficult circumstances.
5.Training in meditation creates an inner space and clarity that enables the person to control our mind regardless of the external circumstances.
6.Gradually the person develop mental equilibrium, a balanced mind that is happy all the time.
7.In this way the person will come to experience a permanent inner peace known as nirvana where day and night in life after life there will be only peace and happiness.

The Benefits of Meditation are:
1.Meditation will remove all distracting thoughts and there will a sense of inner peace and relaxation.
2.When the otherwise incessant flow of distracting thoughts is calmed through concentrating on the breath, the mind becomes unusually lucid and clear.
3.The mind will feel lucid and clear and the body will feel refreshed.  
4.It is possible to experience inner peace and contentment just by controlling the mind without having to depend at all upon external conditions.
5.Much of the stress and tension comes from our mind
6.When the turbulence of distracting thoughts subsides and their mind becomes still, a deep happiness and contentment naturally arises from within.
7.This feeling of contentment and well-being helps the mind to cope with the busyness and difficulties of daily life.
8.Many of the problems in life including ill health are caused or aggravated by this stress and can be overcome with meditation.
9.Difficult situations will become easier to deal with.
10.The mind will naturally feel warm and well disposed towards other people, and the relationships with others will gradually improve.

A Simple Breathing Meditation

1.The first stage of meditation is to stop distractions and make the mind clearer and more lucid. This can be accomplished by practising a simple breathing meditation.
2. Choose a quiet place to meditate and sit in a comfortable position.
The most important thing is to keep the back straight to prevent the mind from becoming sluggish or sleepy.
3.First stop distractions and make the mind clearer and more lucid.
4.Sit with our eyes partially closed and turn the attention to the breathing.Breathe naturally, preferably through the nostrils, without attempting to control the breath.Be aware of the sensation of the breath as it enters and leaves the nostrils.
5.remain focused single-pointedly on the sensation of the breath
6.Slowly by focusing on the breathing, the mind becomes relaxed and that is the essence of meditation .

TINNITUS TREATMENT

DOC I NEED TINNITUS TREATMENT

Treatment depends on the type of hearing loss and degree of tinnitus.
A.Medicines and others
1.antianxiety or antidepressant medication

2.relaxation techniques help when stress is a factor.

3.Avoiding caffeine which may worsen symptoms.

4.Biofeedback may  diminish tinnitus in some patients.

5.Avoid aspirin  in large quantities

6.protection of hearing and avoiding loud noises

B.Non-invasive.
The treatment can be in the form of
1.hearing aid,
Hearing Aid  may have dual functions. It helps to improve hearing acuity, clearer speech understanding as well as to cover the tinnitus effect. However, it may be unsuitable for people with a reduced sound tolerance level, and sensitivity to loud, unpleasant sounds .

2.Tinnitus Retraining Therapy (TRT),
Tinnitus Retraining Therapy (TRT) has been widely used for many years.
The approach is to desensitize the tinnitus via a broadband tinnitus masker (such as the sound of a fan, radio, or white noise machine) along with a specific course of counselling to retrain the brain of sufferers until they are habituated to the tinnitus and it is no longer disturbing.

The therapy may be long-term and time-consuming.

3.Neuromonics tinnitus treatment -very successful in ‘desensitizing’ patients towards their tinnitus.
The sound stimulus is transmitted at specific intervals coordinated with embedded music  2-3 hours a day when the tinnitus is most disturbing.
The idea is to desensitize the brain’s limbic system until patients becomes used to it and get relief.
The treatment can occur while reading, relaxing, doing house chores, computer work or before going to bed. During the treatment process, patients are guided through an interactive and progressive programme of care with the audiologist, as they adjust to each stage of treatment. The audiologist will then assess the patients’ progress.

It is a 6 months program involving the following stages:
1.Pre-conditioning stage (first 2 months) – use of special shower sound to interact with the tinnitus.
2.Active stage (subsequent 4 months) – constant interaction with the tinnitus.

At the end of 6 months program, the sufferer enters the maintenance stage when he/ she can manage without clinical support.
Generally, the treatment involves stimulating the hearing pathways affected by tinnitus or hearing loss with a customized music therapy.

Over 90% reported:
a.A relief from their tinnitus
b.Ability to sleep well
c.A sense of control over their tinnitus
d.A decreased sound disturbance from tinnitus

4.Counselling & Educational Support
If the tinnitus is not serious, the patients can see a counsellor or a psychologist for direct counselling program, and educational support. The purpose is to provide :
a.advice and information about tinnitus;
b.explain what self-help strategies are available for patients and how they work;
c.current medical treatment and management,
d.availability of group support and facilities.

C.Surgery
Surgery of the acoustic nerve to block the tinnitus only for individuals who're becoming or definitely deaf.

Other surgeries may be used when the tinnitus is caused by a tumor across the ear,  the tumor is usually eliminated.

Prognosis:
Depending on the type of tinnitus, symptoms will tend to recur over time.
Stress level, diet, and  noise exposure can worsen tinnitus.
Many people find their tinnitus annoying but can learn to adapt without difficulty.

Prevention:
1.Protect your hearing at work.
2.When around any noise that bothers your ears (a concert,  hunting), wear hearing protection or reduce noise levels.
3.Everyday noises such as blow drying the hair or using a lawnmower can require noise protection.Keep ear plugs or earmuffs handy for these activities.

TINNITUS

DOC I HAVE TINNITUS

Tinnitus is the symptom of perception of sound in the human ear or head in the absence of external sounds.
It is not a illness.
The sound is sometimes accompanied by hearing loss and dizziness in a syndrome known as Meniere's diseas

It affects a large proportion of adult population.
Almost 12 percent of men who are 65 to 74 years of age are affected by tinnitus.
1.Construction site workers
2.MP3 player users
3.Rock concert goers
4.Gun and rifle users

The causes of Tinnitus are:
1.hearing loss is the most common cause.
Age or trauma to the ear (through noise, drugs, or chemicals)cause the damage of the portion of the ear for hearing (the cochlea) becomes damaged.
Because the cochlea do not send the normal signals to the brain, the brain becomes confused and essentially develops its own sound (the tinnitus) to make up for the lack of normal sound signals.

2.ear trauma is usually noticed in both ears, because both ears are usually exposed

3.the harmful effects of excessively loud noise from firearms, high intensity music, or other sources is a very common cause of tinnitus because of  hearing damage

4.ear infection or excess wax in the ear can affect  the ear.

5.drugs such as aspirin (if overused), aminoglycoside antibiotics and quinine may damage the hearing nerve.

6.brain tumor known as an acoustic neuroma which grow on the nerve that supplies hearing can cause tinnitus.
This tinnitus usually affects one ear unlike  the hearing loss  seen in both ears.

Signs & Symptoms
The sound that they perceive in the ear or head has been described as:
1.ringing,
2.whistling,
3.vacuuming,
4.hammering,
5.buzzing
6.humming sounds.

About 2% of tinnitus sufferers have:
1.Disturbed sleeping patterns.
2.Anxiety and depression.
3.Inability to relax and concentrate.
4.Sensitivity to loud sounds and noises.
5.A negative impact on work, family and social life.

An ENT doctor may be consulted for tinnitus:

1.When medical and/or surgical contraindications are not present.
2.family members are worried or concerned about the “non-stop” tinnitus.
3.Your sleep, concentration and general health is affected.

Exams and Tests
1.complete history and physical examination of the head and neck
2.A complete hearing test (audiogram)
3.auditory brainstem response
4.brain scan such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be required.
5.blood tests for hyperthyroidism may be taken.
6.spinal tap may be rarely performed to measure the fluid pressure in the skull and spinal cord.

EATING DISORDERS

DOC I HAVE EATING DISORDERS

Eating disorders is defined as the persistent refusal of a person to eat resulting in marked loss of weight.


It is a psychological problem with patient becoming obsessed with his or her so called obesity with intent to lose weight as a result  


This condition is more prevalent in women than in men.


Onset usually occur in puberty.

Eating disorders include:
1.anorexia nervosa - refusal to eat or eating very minimally
2.bulimia - eating followed by vomiting
3.binged eating with induced vomiting

The most common cause is obstensible fear of obesity resulting in excessive dieting.

There is this distorted image of the body size related to social norms and psychosexual conflicts.

Other causes are:
1.anxiety


2.depression


3.low self esteem


4.troubled family and personal relationships


5.history of physical or sexual abuse


6.cultural and social norms that value people on basis of physical appearance and not inner qualities and strength


7.sometimes may be hereditary - It may run in families

Symptoms of eating disorders are:
1.progressive and excessive weight loss


2.loss of muscle mass (thin stick like)


3.loss of bone mass with osteopenia, osteoporosis , possible fractures,


4.Damage to esophagus, lining of stomach, gastritis, bloating from gas


5.Associated induced endocrine changes (amenorrhea, hirsutism)


6.Stunted growth due to  insufficient growth hormones as a result of  malnutrition


7.Weakened immune system with icy hand and excess hairs on the skin (body too cold)


8.Anemia and Induced vitamin deficiency due to poor nutrition


9.Fainting spells, sleep disruptions, mental confusion, seizures due to insufficient nutrients to the brain


10.Low blood sugar with chills, giddiness, shaking and restlessness from insufficient absorption of sugars


11.Disruption of body fluid mineral balance especially potassium can affect the heart with irregular heart beat , cardiac arrest and death


12.general organ failure resulting in kidney and liver damage from insufficient nutrients to the body's organs


13.Constipation, urinary and anal incontinence, resulting from weakened perineal muscles of the pelvis

14.Mental development and psychological development may be affected from the lack of nutrients to the brain

Treatment of eating disorders:
1.Hospitalization is necessary when the condition becomes life threatening


2.Weight restoration to improve mood and health of patient

3.Correction of nutrition and metabolic deficiency in patient


4.Psychotherapy and counseling of individual to develop healthy ways of controlling one's life


5.Use of antidepressant and serotonin blockers and other newer medications for depression and anxiety


6.Support groups to help family and nutritional counseling

Prognosis of eating disorders:
1.Good in mild cases


2.Poor in severe cases,may be fatal