TRANSIENT ISCHEMIC ATTACK-TIA

 

Transient ischemic attack

A transient ischemic attack (TIA) is an episode in which a person has stroke -like symptoms for up to 1-2 hours.
A TIA is often considered a warning sign that a true stroke may happen in the future if something is not done to prevent it.

Causes, incidence, and risk factors

A transient ischemic attack (TIA) is caused by temporary disturbance of blood supply to an area of the brain, which results in a sudden, brief decrease in brain function. (A decrease in brain function is called a neurologic deficit.)
A TIA is different than a stroke. Unlike from a stroke, a TIA does not cause brain tissue to die. The symptoms of TIAs do not last as long as a stroke and do not show changes on CT or MRI scans. (Strokes usually show changes on such tests.)
The temporary loss of blood flow to the brain can be caused by:

• Blood clot within an artery of the brain
• Blood clot that travels to the brain from somewhere else in the body (for example, the heart)
• Injury to blood vessels
• Narrowing of a blood vessel in the brain or leading to the brain

For instance, the temporary disruption in blood flow could be due to a blood clot that occurs and then dissolves. The blockage breaks up quickly and dissolves.
Less common causes of TIA include:

• An irregular heart rhythm called atrial fibrillation
• Certain blood disorders, including polycythemia, sickle cell anemia, and syndromes where the blood is very thick
• Conditions that cause blood vessels problems such as fibromuscular dysplasia, systemic lupus erythematosus, and syphilis
• Inflammation of the arteries such as arteritis, polyarteritis, and granulomatous angiitis
• Spasm of the small arteries in the brain

Atherosclerosis ("hardening of the arteries") is a condition where fatty deposits occur on the inner lining of the arteries. This condition dramatically increases the risk for both TIAs and stroke. Approximately 80-90% of people who have a stroke due to atherosclerosis had a TIA episode before.
Other risks for TIA include high blood pressure, heart disease, migraine headaches, smoking, diabetes, and increasing age.

Symptoms

Symptoms begin suddenly, last only a short time (from a few minutes to 1 to 2 hours), and disappear completely. They may occur again at a later time. Symptoms usually occur on the same side of the body if more than one body part is involved.
A TIA is different than a stroke. However, the symptoms of TIA are the same as a stroke and include the sudden development of:

• Muscle weakness of the face, arm, or leg (usually only on one side of the body)
• Numbness or tingling on one side of the body
• Trouble speaking or understanding others who are speaking
• Problems with eyesight (double vision, loss of all or part of vision)
• Changes in sensation, involving touch, pain, temperature, pressure, hearing, and taste
• Change in alertness (sleepiness, less responsive, unconscious, or coma)
• Personality, mood, or emotional changes
• Confusion or loss of memory
• Difficulty swallowing
• Difficulty writing or reading
• Lack of coordination and balance, clumsiness, or trouble walking
• Abnormal sensation of movement (vertigo) or dizziness
• Lack of control over the bladder or bowels
• Inability to recognize or identify sensory stimuli (agnosia)

Signs and tests

TIAs do not show brain changes on CT or MRI scans. (Most strokes do show changes on such tests.) Because symptoms and signs may have completely disappeared by the time one gets to the hospital, a diagnosis of a TIA may be made on a person's medical history alone.
A physical examination should include a neurological exam, which may be abnormal during an episode but normal after the episode has passed.
Blood pressure may be high. The doctor will use a stethoscope to listen to your heart and arteries. An abnormal sound called a bruit may be heard when listening to the carotid artery in the neck or other artery. A bruit is caused by irregular blood flow. In some cases, low blood pressure may be seen before symptoms of a TIA occur.
Tests will be done to rule out a stroke or other disorders that may cause the symptoms.

• Head CT scan or brain MRI is almost always done.
• Angiogram, CT angiogram, or MR angiogram may be done.
• An echocardiogram may be done if your doctor thinks you may have a blood clot from the heart.
• Carotid duplex (ultrasound) can show if the carotid arteries in your neck have narrowed. Cerebral arteriogram reveals which blood vessels is blocked or bleeding.
• EKG and heart rhythm monitoring may be done to check for irregular heart beats.

Additional tests and procedures may include:

• Blood clotting tests to rule out a blood disorder
• Blood chemistry
• Complete blood count (CBC)
• C-reaction protein
• ECG
• ESR (Sedimentation rate)
• Serum lipids
• Tests for syphilis, Lyme disease, and other infections

Your doctor may use these tests to check high blood pressure, heart disease, diabetes, high cholesterol, and peripheral vascular disease.

Treatment

The goal is to prevent a stroke from occurring.
If you have had a TIA within the last 48 hours, you will likely be admitted to the hospital so that doctors can determine the cause and treatment.
Underlying disorders such as high blood pressure, heart disease, diabetes, and blood disorders, should be treated appropriately.
Blood thinners, such as aspirin, may be prescribed to reduce blood clotting. Others include dipyridamole, clopidogrel, Aggrenox or heparin, Coumadin, or other similar medications. Treatment may be continued for an indefinite time period.
Surgery (carotid endarterectomy) may be appropriate for some people who have clogged neck arteries.
Smoking should be stopped.
Your doctor may recommend a low-fat and low-salt diet. Other dietary changes may be recommended.

Expectations (prognosis)

TIAs do not cause lasting damage to the brain,
However, they are a warning sign that a true stroke may happen in the future. Over 10% of people who have TIA will have a stroke within 3 months. Half of these strokes happen during the 48 hours after TIA. The stroke may occur that same day or at a later time. Some people have only a single episode and some have recurrent episodes.
Your chances of a future stroke can be reduced by close follow-up with your health care provider to manage risk factors.

Complications

Complications of TIA include:

• Death of brain cells due to too little blood flow to the brain
• Injury that occurs from falls
• Stroke

Prevention

Prevention of TIA includes controlling the risk factors such as high blood pressure, diabetes, heart disease, and other associated disorders. Smoking should be stopped.

Please Note

TIA is a medical emergency. Call  local emergency number immediately. Do not ignore symptoms just because they go away. They may be a warning of a future stroke.With the inability to predict the future, there is no way of knowing whether the symptoms will resolve. If the symptoms persist and a stroke situation exists, there is a narrow window of time to intervene and potentially use TPA (a clot-busting drug) to restore blood supply to the brain and reverse the neurologic deficits. Depending on the hospital and its capabilities, there may be only three to four and a half hours from the onset of symptoms in which to administer the drugs. In that time, the patient needs to be examined, blood tests need to be drawn, a CT scan of the head needs to be performed to insure that a hemorrhagic stroke (bleeding into the brain) is not the cause, and a neurologist needs to be contacted.
If Emergency response is not activated and the symptoms resolve so that the patient, family, or friends suspect that a TIA has occurred, there is still a need to seek care urgently. It may be reasonable to contact the family doctor to help coordinate the evaluation.

CONVULSIONS

 

 

Convulsions

Convulsions are when a person's body shakes rapidly and uncontrollably. During convulsions, the person's muscles contract and relax repeatedly.

The term "convulsion" is often used interchangeably with "seizure," although there are many types of seizures, some of which have subtle or mild symptoms instead of convulsions. Seizures of all types are caused by disorganized and sudden electrical activity in the brain.

Considerations

Convulsions can be unsettling to watch. Despite their appearance, most seizures are relatively harmless. They usually last from 30 seconds to 2 minutes. However, if a seizure is prolonged, or if multiple seizures happen and the person doesn't awaken in between, this is a medical emergency.

If a person has recurring seizures, and no causes can be identified, that person is said to have epilepsy. Epilepsy can usually be controlled well with medication.

Pay attention to:

• Which arms or legs are shaking
• Whether there is any change in consciousness
• Whether there is loss of urine or stool
• Whether the eyes move in any direction

Causes

• Alcohol use
• Barbiturates, intoxication or withdrawal
• Brain illness or injury
• Brain tumor (rare)
• Choking
• Drug abuse
• Electric shock
• Epilepsy
• Fever (particularly in young children)
• Head injury
• Heart disease
• Heat illness
• Illicit drugs, such as angel dust (PCP), cocaine, amphetamines
• Low blood sugar
• Meningitis
• Poisoning
• Stroke
• Toxemia of pregnancy
• Uremia related to kidney failure
• Very high blood pressure (malignant hypertension)
• Venomous bites and stings
• Withdrawal from benzodiazepines (such as Valium)

Symptoms

• Brief blackout followed by period of confusion
• Drooling or frothing at the mouth
• Eye movements
• Grunting and snorting
• Loss of bladder or bowel control
• Sudden falling
• Teeth clenching
• Temporary halt in breathing
• Uncontrollable muscle spasms with twitching and jerking limbs
• Unusual behavior like sudden anger, sudden laughter, or picking at one's clothing

The person may have warning symptoms before the attack, which may consist of:

• Fear or anxiety
• Nausea
• Vertigo
• Visual symptoms (such as flashing bright lights, spots, or wavy lines before the eyes)

First Aid

1. When a seizure occurs, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects.
2. Cushion the person's head.
3. Loosen tight clothing, especially around the person's neck.
4. Turn the person on his or her side. If vomiting occurs, this helps make sure that the vomit is not inhaled into the lungs.
5. Look for a medical history or a tag.
6. Stay with the person until he or she recovers, or until you have professional medical help. Meanwhile, monitor the person's vital signs (pulse, rate of breathing).

In an infant or child, if the seizure occurs with a high fever, cool the child gradually with tepid water. You can give the child acetaminophen (Tylenol) once he or she is awake, especially if the child has had fever convulsions before. DO NOT immerse the child in a cold bath.

DO NOT

• DO NOT restrain the person.
• DO NOT place anything between the person's teeth during a seizure (including your fingers).
• DO NOT move the person unless he or she is in danger or near something hazardous.
• DO NOT try to make the person stop convulsing. He or she has no control over the seizure and is not aware of what is happening at the time.
• DO NOT give the person anything by mouth until the convulsions have stopped and the person is fully awake and alert.

Signs and tests

A physical examination (including a detailed neurologic examination) may be normal, or it may show abnormal brain function related to specific areas of the brain.
People with epilepsy will often have abnormal electrical activity seen on an electroencephalograph (EEG). (An EEG is a reading of the electrical activity in the brain.) In some cases, the test may show the location in the brain where the seizures start. EEGs can often be normal after a seizure or between seizures, so it may be necessary to perform a longer test.
Various blood tests and other tests looking for temporary and reversible causes of seizures, may include:

• Blood chemistry
• Blood sugar
• CBC (complete blood count)
• CSF (cerebrospinal fluid) analysis
• Kidney function tests
• Liver function tests
• Tests for infectious diseases

Tests for the cause and location of the problem may include:

• EEG
• Head CT or MRI scan
• Lumbar puncture (spinal tap)

Treatment

If an underlying cause for recurrent seizures (such as infection) has been identified and treated, seizures may stop. Treatment may include surgery to remove a tumor, an abnormal or bleeding blood vessel, or other brain problems.
Medication to prevent seizures, called anticonvulsants, may reduce the number of future seizures. These drugs are taken by mouth.

• The type of medicine you take depends on what type of seizures you are having. The dosage may need to be adjusted from time to time.
• Some seizure types respond well to one medication and may respond poorly (or even be made worse) by others. Some medications need to be monitored for side effects and blood levels.
• It is very important that you take your medication on time and at the correct dose. Most people taking these drugs need regular checkups and regular blood tests to make sure they are receiving the correct dosage.
• You should not stop taking or change medications without talking to your doctor first.

Some factors increase the risk for a seizure in a person with epilepsy. Talk with your doctor about:

• Certain prescribed medications
• Emotional stress
• Illness, especially infection
• Lack of sleep
• Pregnancy
• Skipping doses of epilepsy medications
• Use of alcohol or other recreational drugs

Epilepsy that does not get better after two or three seizure drugs have been tried is called "medically refractory epilepsy."

• Some patients with this type of epilepsy may benefit from brain surgery to remove the abnormal brain cells that are causing the seizures.
• Others may be helped by a vagal nerve stimulator. This is a device that is implanted in the chest (similar to a heart pacemaker). This stimulator can help reduce the number of seizures, but rarely stops the seizures completely.

Sometimes, children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, may also be helpful in some adults.
Persons with epilepsy should wear medical alert jewelry so that prompt medical treatment can be obtained if a seizure occurs.

Please Note

Call your doctor or hospital:

• This is the first time the person has had a seizure.
• A seizure lasts more than 2 to 5 minutes.
• The person does not awaken or have normal behavior after a seizure.
• Another seizure starts soon after a seizure ends.
• The person had a seizure in water.
• The person is pregnant, injured, or has diabetes.
• The person does not have a medical ID bracelet (instructions explaining what to do).
• There is anything different about this seizure compared to the person's usual seizures.

Expectations (prognosis)

Some people with certain types of seizures may be able to reduce or completely stop their seizure medicines after having no seizures for several years. Certain types of childhood epilepsy goes away or improves with age -- usually in the late teens or 20s.
For some people, epilepsy may be a lifelong condition. In these cases, the seizure drugs need to be continued.
Death or permanent brain damage from seizures is rare. However, seizures that last for a long time or two or more seizures that occur close together (status epilepticus) may cause permanent harm. Death or brain damage are most often caused by prolonged lack of breathing, which causes brain tissue to die from lack of oxygen. There are some cases of sudden, unexplained death in patients with epilepsy.
Serious injury can occur if a seizure occurs during driving or when operating dangerous equipment. For this reason, people with epilepsy whose seizures are not under good control should not do these activities.
People who have infrequent seizures may not have any severe restrictions on their lifestyle.

Complications

• Difficulty learning
• Inhaling fluid into the lungs, which can cause aspiration pneumonia
• Injury from falls, bumps, or self-inflicted bites during a seizure
• Injury from having a seizure while driving or operating machinery
• Many epilepsy medications cause birth defects -- women wishing to become pregnant should alert their doctor in advance in order to adjust medications
• Permanent brain damage (stroke or other damage)
• Prolonged seizures or numerous seizures without complete recovery between them (status epilepticus)
• Side effects of medications

Prevention

Generally, there is no known way to prevent epilepsy. However, proper diet and sleep, and staying away from illegal drugs and alcohol, may decrease the likelihood of triggering seizures in people with epilepsy.
People with epilepsy should always take any prescribed medication and wear a medical alert tag.
Keep fevers under control, especially in children
Reduce the risk of head injury by wearing helmets during risky activities; this can help lessen the chance of developing epilepsy.
Persons with uncontrolled seizures should not drive. Each state has a different law that determines which people with a history of seizures are allowed to drive. If you have uncontrolled seizures, you should also avoid activities where loss of awareness would cause great danger, such as climbing to high places, biking, and swimming alone.

CALORIES AND DIET

Negative Calorie Foods

Calorie is a unit of energy. The energy can be measured by many methods. The calories in foods depend on their composition and the calorie value of a food is not actually its measured values, but is the average energy of a large number of different samples of the food.
1 calorie = 4.184 joule
1 negative calorie = -4.184 joules
Commonly Calories refer to kilocalories.
1 kilocalorie (kcal) = 4.184 kilojoules (kJ)


Negative calorie foods are foods, which use more calories to digest than the calories food actually contains! Calories from these foods are much harder for the body to use. In other words, the body has to work hard in order to extract calories from these foods. Even though a food may contain equal amount of calories, much less of these calories can possibly turn into fat in negative calorie foods as fewer calories are actually available to the body. This gives these foods a tremendous natural fat-burning advantage.


Consider the facts;

1. A piece of dessert consisting of 400 Calories (actually 400 kilocalories) may only require 150 Calorie (actually 150 kilocalories) to digest by our body, resulting in a net gain of 250 calories which is added to our body fat !
2. On the other hand, a 5 calorie raw piece of celery will require much more calories to chew and digest, so resulting in a net loss of calories from our body fat !! It implies that the more you eat, the more you lose weight!!!

Therefore, these foods are said to be good for achieving weight loss naturally without starving.


How it works?

All foods have a nutrient (carbohydrate, fat, protein), caloric (calories) and vitamin & mineral content. Vitamins stimulate living tissues to produce enzymes that breakdown the caloric nutrients of that food.
The foods with negative calorie contain sufficient vitamins & minerals that produce enzymes in quantities sufficient to break down not only its own calories, but additional calories from body in digestion as well. This is called "negative calorie effect".

The Free List of Foods Possessing Negative Calorie Effect

These foods will have maximum benefits when eaten without any empty calorie foods (junk foods). There are several foods such as vegetables and fruits that have negative calorie effect. Some of the foods that can be eaten in generous quantities are: Asparagus, Beets, Carrot, Zucchini, Papaya, Strawberry, Raspberry, etc. Look at the list below.

Free List of Negative calorie Foods

Negative Calorie Vegetables
Asparagus Beet Root Broccoli Cabbage Carrot Cauliflower Celery	Chicory Hot Chili Cucumber Garden cress Garlic Green Beans	Lettuce Onion Radish Spinach Turnip Zucchini
Negative Calorie Fruits
Apple Blueberries Cantaloupe Cranberry Grapefruit	Honeydew Lemon/Lime Mango Orange Papaya Peach	Pineapple Raspberry Strawberry Tomato Tangerine Turnip Watermelon

Negative Calorie Diet

This diet is based on the fact that in order to lose weight you have to burn more calories than you consume. The diet recommends to eat the foods from the above list. The negative calorie diet (some says it zero calorie diet) is very helpful in fast weight loss. You should know the complete list of the foods requiring your body to "burn" more calories processing them through your digestive system than the actual calorie content of the food itself. This results in your body burning up the excessive stored fat!


If you are looking for easy diet plans to help you lose weight there is one thing you need to remember. The diet plan itself maybe easy to follow along with, however you are still going to need a little bit of discipline with your eating habits otherwise it will just turn out to be another fad diet that hasn't worked for you. Some of the most popular weight loss methods are probably the same information that you have seen presented in different ways whether it be low carb, full on Atkins or just healthy eating, but the key to following these and making them into an easy diet plan is not letting yourself off the hook too often.

Easy Diet Plan in 6 Simple Steps

1. Make sure you start the day off with some breakfast. Breakfast is the most important meal of the day because it kick starts your metabolism after you have been asleep. If you fail to have breakfast then your body will be sluggish in its efforts to burn off fat.
2. As well as ensuring you have breakfast you also want to make sure you don't skip meals. Skipping meals can have a disastrous effect on your weight loss efforts in two ways. Firstly your body will think it is being deprived of food and therefore store the fat; secondly if you skip meals, somewhere along the lines your going to become hungry and end out eating snack food which is going to undermine all of your healthy eating plan.
3. Mix up your food – The surest way for any kind of diet to fail is if you are eating boring monotonous food day in day out, after all who wants to eat cabbage every day? In addition to that make sure the food you eat looks like real food and avoid processed foods at all costs – especially the low fat ones as they are normally extremely high in sugar which is even worse for you.
4. Boost your metabolism (and your bowels) by drinking hot water with a slice of lemon in it. This is especially good for you first thing in the morning and as an added bonus it helps detoxify your body.
5. Take your time when you eat. Part of the problem a lot of us have is that we eat our food too fast, and because of this the chemical reaction that goes from our stomach to our brain to tell us we are full does not get triggered properly and we end out overeating. So, taking that into mind make sure you chew your food properly and take your time.
6. Remember you are human. Look there are times when you are going to want to eat something that you know you shouldn't and if that occurs only once in a while then do it, it will stop you building up a huge craving and then undoing all of the good work that you have done. Just remember though this should be a once in a while treat to yourself and don't let yourself off the hook too much.

As you can see these six steps are the basis of most easy diet plans, the secret to making it all work is you. Be true to yourself, set your weight loss goal, don't set unrealistic expectations or let yourself off the hook too much and you will achieve what you want to.

Diabetes Diet

There is no special "Diabetes Diet" to manage or control diabetes or reversing diabetes. What you have to do is to eat a “balanced” meal plan. People with diabetes can eat and drink just like everyone else. However, they have to be careful about maintaining a good blood glucose level by monitoring your blood glucose frequently. Develop a personal meal plan with your Dietician. The proper meal plan can be a solid foundation for a complete diabetes management and care program.
Diet plays a major role in controlling the diabetes. The main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. Consult your dietician who will recommend you the daily intake of calories, carbohydrates, fats, fiber, etc and the food sources good for you.
We often hear that a person with diabetes should avoid sugar and carbohydrates at all cost. This is not correct, most people with diabetes can enjoy their favorite foods, including desserts, if they monitor the calories, carbohydrates and other dietary components and monitor their blood glucose levels regularly.

1. Avoid western diet, adapt to non-meat non-dairy vegetarian diet.
2. Schedule regular meal times and maintain a consistent diet to monitor your blood glucose level effectively.
3. When buying food items, read the food nutrition labels for nutrient contents carefully, particularly their carbohydrate content.
4. Avoid too much of artificial sweeteners as it can cause gas and diarrhea, according to The American Diabetes Association. replace sugar with sugar substitutes.
5. Your whole family, with or without diabetes, should eat the same healthy meal plan.
6. You can make a list of "safe foods" based on how they affect your blood sugar. Test your blood glucose level 1-2 hours after eating.
7. Do not skip meals. Eat meals at regular times every day. Maintain your eating timings.
8. If you eat magnesium rich foods, you can lower the risk of developing type 2 diabetes significantly. Magnesium is found in green vegetables and nuts.
9. 25 - 100 grams of fenugreek seedseaten daily can diminish reactive hyperglycemia in diabetic patients.

Seven Day Diet Regime – Targeting a weight loss of up to 4 Kgs a week

Day 1 [Fruits] 

 Day one of your diet regime will start with all fruits diet. You may eat fruits of your choice and in any quantity. There is no limit. Eat till your stomach is full. In case you don’t find fruits in nearby stores, you can substitute it with packaged fruit juices but avoid fruit juices that have preservatives in it, they don’t really do any good in this case. On day one, you must eat fruits ONLY and don’t forget to drink at least 7 glasses of water.
Note: The only fruit that will not be on your plate is Banana. Every other fruit is ok except banana. Don’t limit it to just one fruit, have as many different fruits you can.

Day 2 [Vegetables]

This is all vegetables day. If you prefer, you may have raw or/and cooked vegetables. Eat as much as you want to, no quantity restrictions. If you want to cook the vegetables, you may do so but avoid using oil while you cook. 7 glasses of water today also.

Day 3 [Fruits and Vegetables]

On day three, you will eat a mixture of fruits and vegetables. No quantity restrictions, eat till you fill your stomach. Also, eat one banana today, just one!

Day 4 [Vegetables, Bananas and Milk]

Today you will eat 6 bananas, 3 glasses of milk and small quantity of vegetables. In the morning, your breakfast will start with 2 bananas and one big glass of milk. You will follow this in the afternoon for your lunch. In the evening eat 2 bananas, eat vegetables and drink one glass of milk.

Day 5 [Rice and tomatoes]

Today you will have one cup of rice, six full tomatoes (medium size) and since you are having lots of tomatoes, drink 10 glasses of water today.

Day 6 [Rice and Vegetables]

One cup of rice and raw/cooked vegetables of your choice. It’s recommended that you eat rice in the morning and for rest of the day, eat vegetables.

Day 7 [Fruits, Vegetables and Rice]

On day seven, eat fruits, vegetables and 1 cup of rice. You may substitute fruits and vegetables with juices as well, but that is to avoid.
This diet regime works well by burning more fat than accumulating it and since it avoids all sorts of food items that eventually gets converted to fat to become a part of your body, the weight loss is faster and harmless.

Frequently asked doubts about diets.

Does diet and exercise help lose weight?

Yes! A diet that’s rich in proteins and vitamins but low on carbohydrates and fat helps you stay fit. Low carb diet helps reduce the excess fat from your body but it’s a gradual process and you must not expect to lose weight overnight. Exercising regularly helps burn calories and fat in your body and keeps you fit. Even a walk for 10 mins or climbing 20 stairs helps burn calories.

What are the most easy ways to lose weight?

Some easy ways to lose weight is by controlling your diet and exercising regularly. Prefer a diet that’s low in carbs and at the same time doing exercise will create a deficit of calories in your body which will help in faster burning of the excessive fat from your body.

Can drinking only water help lose weight?

Certainly not! Although water has zero calories it also has no proteins or nutritions. The only suggestion about water is to replace soda drinks with water. By only drinking water you should not expect any weight loss.

What is BMI (Body Mass Index)?

Body Mass Index (BMI) is a statistical measure of the weight of a person scaled according to height, to determine amount of body fat and applies to both men and women. The following are the BMI categories:

BMI value of less than 18.5 -> Underweight
BMI value of between 18.5 and 24.9 -> Normal weight
BMI value of between 25.0 and 29.9 -> Overweight
BMI value of 30 and above -> Obese

How is BMI calculated?

When measurement units for weight is in kilograms and height is in meters:
Formula: weight (kg) / [height (m)]2
Example: Weight = 68 kg, Height = 165 cm (1.65 m)
Calculation: 68 ÷ (1.65)2 = 24.98
When measurement units for weight is in pounds and height is in inches:
Formula: weight (lb) / [height (in)]2 x 703
Example: Weight = 150 lbs, Height = 5’5” (65″)
Calculation: [150 ÷ (65)2] x 703 = 24.96

Please note the following points before you take up this weight loss diet regime.

• If you are not comfortable, you can discontinue the diet program on any day.
• You must drink at least 7 glasses of water everyday unless specifically mentioned to drink more in the regime below.
• Continue this program till you lose extra weight. Once you attain proper weight, you may either continue or discontinue the diet regime and follow it whenever you need to.
• This is one of the top 10 diet plans if you are aiming at gradual and healthy weight loss.
• This is a low carb diet plan. If you are suffering from any illness and require high carb diet, consult your doctor before you follow this weight loss plan.
• Don’t blame us if you don’t lose enough weight. Just continue the regime for another 7 days.

10 Tips for Easy Weight Loss

Tip 1: Find out how many calories you need

BMR (Basal Metabolic Rate) BMR [kcal] Body Weight [lb] x 15 + (moderate activity [mins/day] x 3.5) Since you wish to lose weight, your target = BMR - 500 kcal For instance, you weigh 140 lb and you perform 20 mins of moderate activity every day. BMR of this example = (140 x 15) + (20 x 3.5) = 2100 + 70 = 2170 kcal. BMR minus 500kcal; it would be 2170 - 500 = 1670 kcal. Therefore 1670 kcal is the target in this example to losing 1 lb per week.

Tip 2: Eat at least 5 servings of fruits and vegetables per day

Fruits and vegetables are packed with beneficial fibers, vitamins and antioxidants. They fill up your stomach fast so you feel full earlier. They are also low in calories and helps to keep your calorie count low.

Tip 3: Watch for Portion Size

One serving of pasta means 1/2 cup of cooked pasta. However, most restaurants serve a pasta dish with 4 servings of pasta!!! You do not need to finish and clean off the plate every time. You can simply ask to take home the leftover.

Tip 4: Do not Skip Meals

Eating small frequent meals help to balance your calorie intake throughout the day and also keeps your blood sugar level balanced. Instead of eating 3 big meals, try to eat 5 - 6 smaller meals throughout the day.

Tip 5: Go for wholesome fresh foods

If possible, purchase fresh foods and avoid package (processed) and convenient foods such as fast food. Packaged and convenient foods are often higher in sodium and fat content. Many people we spoke to are amazed that they can easily lose weight by packing a home-cooked lunch to work instead of eating out.

Tip 6: Don't be overly-restrictive

Everyone has his or her favorite treats. Simply allow yourself a little indulgence, but watch out for the frequency and the quantity. Having a small treat once in a while can be rewarding to your weight loss experience. Cutting too much of your favorite treats usually lead to an early relapse.

Tip 7: Understand Food Claims and Labels

A product labelled with a fat-free claim does not mean that it is low in calories. Similarly a product labelled as low-sugar or low-carb does not mean it is low in fat or calories. Always read the nutrition label on the packaging.

Tip 8: Watch for the sugary drinks

Juices, soda, cream & sugar in your coffee or tea all add up. Opt for drinking at least 8 glasses of water a day. In addition to providing hydration to your body, it will also help you feel full.

Tip 9: Keep a food journal

Keeping a food journal helps you pin point your eating pattern and will enable you to easily modify it. If possible, have your Registered Dietitian review your journal.

Tip 10: Exercise, period

Most authorities recommend 30 - 60 minutes of physical activity a day to stay healthy. Also try adding weight-bearing exercises at least 2 times a week. This will help burn some of the unwanted calories.

MEDICAL EMERGENCIES

A medical emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from a first aider to an emergency physician through to specialist surgeons.
Any response to an emergency medical situation will depend strongly on the situation, the patient involved and availability of resources to help them. It will also vary depending on whether the emergency occurs whilst in hospital under medical care, or outside of medical care (for instance, in the street or alone at home).

The following are warning signs of a medical emergency:

• Bleeding that will not stop
• Breathing problems (difficulty breathing, shortness of breath)
• Change in mental status (such as unusual behavior, confusion, difficulty arousing)
• Chest pain
• Choking
• Coughing up or vomiting blood
• Fainting or loss of consciousness
• Feeling of committing suicide or murder
• Head or spine injury
• Severe or persistent vomiting
• Sudden injury due to a motor vehicle accident, burns or smoke inhalation, near drowning, deep or large wound, etc.
• Sudden, severe pain anywhere in the body
• Sudden dizziness, weakness, or change in vision
• Swallowing a poisonous substance
• Upper abdominal pain or pressure

BE PREPARED

• Determine the location and quickest route to the nearest emergency department before an emergency happens.
• Keep emergency phone numbers posted by the phone. Everyone in your household, including children, should know when and how to call these numbers. These numbers include:
  • Fire department
  • Police department
  • Poison control center
  • Ambulance center
  • Your doctors' phone numbers
  • Contact numbers for neighbors or nearby friends or relatives.
  • Work phone numbers
• Know at which hospital(s) your doctor practices and, if practical, go there in an emergency.
• Keep a medical history card if you have a chronic condition or look for one on a person who has any of the symptoms mentioned.
• Get a personal emergency response system if you are elderly, especially if you live alone.

WHAT TO DO IF SOMEONE NEEDS HELP?

• Remain calm, and call your local emergency number.
• Start CPR or rescue breathing, if necessary and if you know the proper technique.
• Place a semiconscious or unconscious person in the recovery position until the ambulance arrives. DO NOT move the person, however, if there has been or may have been a neck injury.

Upon arriving at an emergency room, the person will be immediately evaluated. Life- or limb-threatening conditions will be treated first. Persons with conditions that are not life- or limb-threatening may have to wait.

CALL YOUR LOCAL EMERGENCY NUMBER or AMBULANCE  IF:

• The person's condition is life-threatening (for example, the person is having a heart attack or severe allergic reaction)
• The person's condition could become life-threatening on the way to the hospital
• Moving the person could cause further injury (for example, in case of a neck injury or motor vehicle accident)
• The person needs the skills or equipment of paramedics
• Traffic conditions or distance might cause a delay in getting the person to the hospital.

SOME QUICK LOOK REMEDIES FOR COMMON MEDICAL EMERGENCIES : 

MYOCARDIAL INFARCTION : 

“Heart Attack” Impairment of heart function- inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation.
Obstruction due to 1)Thrombus 2)Plaque rupture 3)Vessel spasm.

Symptoms 

Acute central chest pain not responding to nitrates.

Pain radiating to neck/left arm ,Associated with nausea/sweating/breathlessness/palpitations/collapse.Silent MI (diabetics & elderly)

What can be done?



Give semi-sitting position,Reassure, immobilize.
Call Ambulance.
Angina medications – nitrates (sublingual tablets/sprays),Aspirin, chewable.
Monitor pulse & breathing CPR if necessary

CARDIO-PULMONARY RESUSCITATION : 

CARDIO-PULMONARY RESUSCITATION UNRESPONSIVE?? SHOUT FOR HELP.
OPEN AIRWAY BY HEAD TILT/CHIN LIFT LOOK, LISTEN, FEEL IF BREATHING.
RECOVERY POSITION FOR BREATHING IF NOT BREATHING.
CALL FOR ASSISTANCE 30 CHEST COMPRESSIONS (AT RATE OF 100/MIN) 2 RESCUE BREATHS 30 COMPRESSIONS.

STROKE:

Rapidly developed clinical signs of focal disturbance of cerebral function lasting more than 24 hrs or leading to death, with no apparent cause other than vascular origin.
Recovery within 24 hrs – TIA, no residual deficit.
Causes – Thrombus/Embolus/Hemorrhage

 Symptoms 

Sudden weakness of one side of the body (sign of paralysis).

Difficulty in speaking/ drooping mouth,Dribbling of saliva from one side of mouth,Blurred vision/ partial loss of sight / flashing lights, Confusion and disorientation,Sometimes loss of consciousness.

What to do?



If unconscious then place the person in recovery position.
If conscious, make him lie down with head and shoulders raised Monitor, Reassure, Call Ambulance,Resuscitate if necessary.

HYPOGLYCEMIA : 

Low blood sugar level.
Causes- Diabetics on Insulin Starvation, Excessive alcohol intake.
Less common causes – liver failure, sepsis, endocrine tumors

Symptoms 

History of diabetes,Excess hunger, Feeling faint or dizzy, Strange behavior – Confusion, aggression.Palpitations, tremors Pale, cold, sweaty skin .

Loss of consciousness e/o diabetes – medic alert/syringe in bag

What should be done




If conscious, give GLUCOSE orally till person feels better. If unconscious, monitor airway and breathing and seek medic help. Give glucagon inj (keep prefilled syringe in c/o diabetes) If possible, IV glucose.

SEIZURES : 

Seizure – paroxysmal event due to abnormal,excessive, hyper synchronous discharges from an aggregate of CNS neurons.
Epilepsy – a condition in which a person has recurrent seizures due to a chronic, underlying process

Symptoms 


Aura Sudden rigidity of body – tonic phase ,Collapse d/t which injuries may be sustained F/b periodic relaxation of muscles – clonic phase, Tongue bite B&B incontinence Post ictal exhaustion & confusion/headache.
Other types – absence seizure, partial seizure, secondary generalized etc

First Aid


Move person away from danger e.g. fire, water, furniture. Don’t try to restrain. Don’t insert anything in mouth. After convulsion ceases, give recovery position Ensure airway is clear. Don’t leave person alone even after seizure.Reassure, support. If seizure persists >5 min/recurs w/o regaining consciousness- call Ambulance

ASTHMA : 

Disease of airways charac. By increased responsiveness of the tracheobronchial tree to a variety of stimuli. Clinical Course – Acute exacerbations with remissions / Continuous episode (status asthmaticus)

Causes – genetic (hereditary) allergic idiopathic.

Triggers Allergens d/t weather & season change, animal fur & dander, smoke, dust Pharmacologic agents - aspirin coloring agents 
Air pollutants – ozone, nitrogen dioxide, sulfur dioxide 
Occupational asthma Infections – influenza, parainfluenza Exercise Emotional upsets

Symptoms 


Shortness of breath Cough Chest tightness 
Wheezing Associated symptoms – inability to speak, pale skin, blueness, distress, confusion Ultimately – unconscious & ceases to breathe

What you should do:


Move away from the thing that triggered the episode. Take a quick relief asthma medication Stay calm so that breathing gets better
Call Ambulance if: No response to medication Lips/fingernails turn blue or grey It is hard to talk Nasal flare Skin is pulled around the neck & ribs when person breathes Heartbeat/pulse is too fast

ROAD TRAFFIC ACCIDENTS : 

Critical four minutes: One of the most common causes of a road accident death is due to loss of oxygen supply. Normally it takes less than four minutes for a blocked airway to cause death. The 'golden hour’: The first hour after the trauma is called the 'golden hour'

What can you do? : 

Beware of further collisions and fire Alert oncoming traffic to the danger ahead.
Don’t allow anyone to smoke. Get assistance from bystanders.
Call Ambulance. Don’t move casualties who remain in their vehicles, unless they are in danger by doing so. Never remove a motorcyclist’s helmet unless deemed necessary. Avoid unnecessary movements.
Reassurance

If person responsive, ask questions/shake gently by shoulders and ensure airway is open.
If breathing but unconscious put in recovery position.
 If not responsive then start CPR In case of bleeding- check if there are any objects in the wound If the wound is clear of objects apply firm pressure over the wound If there are objects embedded in the wound do not press them, and build up padding around the object.

CARDIO-PULMONARY RESUSCITATION : 

CARDIO-PULMONARY RESUSCITATION UNRESPONSIVE?? SHOUT FOR HELP.
OPEN AIRWAY BY HEAD TILT/CHIN LIFT LOOK, LISTEN, FEEL IF BREATHING .
RECOVERY POSITION FOR BREATHING IF NOT BREATHING.
CALL FOR ASSISTANCE 30 CHEST COMPRESSIONS (AT RATE OF 100/MIN) 2 RESCUE BREATHS 30 COMPRESSIONS

 

In case of burns- Cool it by clean cold water for at least 10 mins Don’t remove anything that may be stuck to it