Double-contrast Barium Enema: Colorectal Cancer Screening

Double-contrast barium enema is a radiological technique that can be used to screen individuals for colorectal cancer. It is preferred in individuals who cannot undergo colonoscopy or are at an increased risk of complications from colonoscopy.

Prior to the procedure, the patient has to undergo bowel preparation with laxatives. Diet is also restricted for 1 to 2 days prior to the procedure. This ensures that the inner lining is clearly visible on x-ray. Incomplete evacuation of the bowels could result in the presence of small masses in the colon, and thus interfere with the interpretation of the test.

Following bowel preparation, the individual undergoing the test is made to lie down and an enema containing radioactive barium is administered. Subsequently, air is introduced through the anus through a thin tube. This ensures that the barium coats the inner lining of the colon. Images of the colon are obtained in the desired positions, which are then studied for any abnormalities.

Patients eligible for double-contrast barium enema

Double-contrast barium enema is especially preferred in individuals who cannot undergo procedures like colonoscopy or who are at an increased risk for complications if they undergo these procedures. A barium enema may be also required in patients who have undergone an incomplete sigmoidoscopy or colonoscopy.

Is there any need to repeat double-contrast barium enema?

Double-contrast barium enema may be repeated every 5 years. People at high risk for developing colorectal cancer may have to start undergoing the test at an earlier age and repeat it more often. 

Patients not eligible for double-contrast barium enema

Double-contrast barium enema is absolutely contraindicated during pregnancy due to the risk of radiation to the developing foetus. People with suspected perforation of the intestines, conditions that could lead to perforation such as severe ulcerative colitis or complete obstruction in the intestines should also avoid this test.

Pros of double-contrast barium enema

• The entire colon can be visualised during double-contrast barium enema
• The procedure permits visualisation not only of the inner lining of the colon on x-ray, but also detects any abnormalities within the wall of the colon as well as in the abdomen
• It helps to differentiate colorectal cancer from other conditions affecting the colon like diverticulitis
• It is more cost-effective as compared to colonoscopy
• Unlike procedures like flexible sigmoidoscopy and colonoscopy, there is minimal risk of perforation with this procedure

Cons of double-contrast barium enema

• The procedure exposes the person to radiation
• Bowel preparation with diet and laxatives is required prior to the procedure. This as well as the procedure itself may cause discomfort to the individual
• If the test detects any abnormality, the individual has to undergo a colonoscopy to obtain a biopsy or excise the lesion. Thus, doing two procedures instead of one increase the cost and inconvenience of the individual. This may be avoided in case a colonoscopy is done as the first choice
• The test may diagnose cancer in cases where it may not be present, resulting in unwanted anxiety in the individual. This could occur in case the radiologist is not experienced in interpreting the x-rays or if normal conditions like contractions or small faecal masses give the impression of a cancer
• Severe allergic reactions could rarely occur in patients allergic to barium

World Obesity Day: It’s time we start controlling obesity

Studies reveal that India will be at the helm of diabetes by 2050 if the abdominal and lower limb obesity and metabolic syndrome are not taken care of. Alarmed by the reports, the Health Ministry of India has reduced the cut-off for body mass index (BMI) to 23 kg/m2 to fight the battle against obesity. If your BMI is over 23 kg/m2, then you are considered overweight. The global standard for this is a BMI of 25 kg/m2. So, someone considered healthy by most international standards, might be overweight in India! BMI is the ratio of the body weight in kg versus height in m2. 

The guidelines were released jointly by the Health Ministry, the Diabetes Foundation of India, the All-India Institute of Medical Science (AIIMS), Indian Council of Medical Research, the National Institute of Nutrition and 20 other health organisations - Those with BMI of 25 kg/m2 will be clinically termed obese (as opposed to 30 kg/m2 at the international level) and those with BMI of 32.5 kg/m2 will require bariatric surgery to eliminate excess flab.

Along with the BMI guidelines, they have also released guidelines cut-offs for waist measurement at 90 cm for Indian men (as opposed to 102 cm globally) and 80 cm for Indian women (as opposed to 88 cm at the international level).

The study says one in every three Indians has high triglyceride (bad cholesterol) levels and 30-70 per cent has low levels of HDL (good cholesterol). For every 10 extra kilograms above the stipulated body weight (measured according to height), life expectancy of a person reduces by three years – the report said.

By the new obesity guidelines, every second person in Delhi fulfils the criteria of obesity or has excess abdominal fat and nearly one-fourth of the adolescent population in the capital has metabolic syndrome that heralds the onset of heart diseases and diabetes. So, what are planning to do, to avoid obesity? Here are some ways.

How to control over-eating

Are you tired of your binge eating habit? Do you find yourself giving into temptation to gorge down delicious food and before you can control it’s too late and the damage of consuming excessive calories is already done? Why do we find ourselves making the same mistake over and over again and how can you salvage the situation and control overeating in future?

The need to obsessively over eat is mostly triggered by emotional factors. Either you are too sad, too happy, too tired or simply bored when you get this intense urge to eat. Some studies even blame our ancestors for our compulsive binging behaviour. According to them, our primal ancestors were hunters and gatherers and went without food for long periods, so once they found it they would eat everything they could get their hands on.  The latest research suggests that starving leads to overeating and is also responsible for slowing down of metabolism. This leads to storing of food in our bellies which is linked to heart diseases and acquiring diabetes type 2.

A binging outburst can set you back to a minimum of 1000 calories per meal and above your daily calorie intake. This means that you could be potentially adding up to 1 kg each time you have 2 bags of chips while just chilling in front of the TV!

Knowing your triggers can help you minimise the damage. The logic behind cravings for high carbohydrates or sugar foods is that as they spike insulin levels in the body and release endorphins, also known as the pleasure hormone. This is the actual trigger that causes us to binge over and over again. There is a healthier alternative to this addiction. There are studies that have proved that exercise can also trigger the same happy hormone. Besides the fact exercise is great for health and helps keeping the lifestyle related disorders at bay.

The biggest downside to seeking solace in high sugar/carbohydrate food for emotional need is that over a period of time your body develops a natural resistance towards them. So your body craves more quantities to get the same desired effect. For e.g. If one slice of cake was enough to make you feel good before with time you will need at least two slices to trigger the same feeling.  It’s a tricky situation to get dependent to relieve stress or solve any other emotional conditions. Eventually it’s a mind over matter game. If you can understand your action you can control your behaviour in time and prevent causing damage to your health.

How to revive your married life?

Is your marriage life catapulted because you are at the helm of sexual crises? A sexologist is what you might need who is more than capable of listening and rectifying your problem. A sexologist is a medical professional, who deals with the human sexuality issues including sexual interests, functionality and behaviour. He can play the role of a psychologist, psychiatrist and a marriage counsellor perfectly, all at the same time. For health issues that are physical in nature like a mental condition, ageing, hormonal imbalance, alcohol addiction, you need the expertise of a regular doctor.

If you are unaware of your problem and have no clues what it might be, educate yourself more with the help of internet. You can surely find relevant and educative material. However, a sexologist can subsequently help you out as well.

A sexologist may prescribe a sex therapy which is helpful in dealing with such issues. Here is a quick overview of it.

A sex therapy is aimed at solving problems with not only the human body but emotional issues that lie beneath the physical symptoms. There are certain exercises to be performed under the supervision of sexologist after the therapeutic session. They cannot be done in accordance with the session. One of the most tried and tested exercise is sensate focus. It involves the couples massaging and cuddling each other without getting sexual. It fulfils the purpose of making couples feel good and safe in each others’ company. This naturally leads to genital stimulation.

These exercises are helpful in curing diseases in women such as inability to have an orgasm and men’s erectile dysfunction. It may take 2 months to a year of this therapy. People who have encountered sexual trauma or clueless about their sexual orientation can benefit from this treatment. The main objective of these exercises is to develop better communication and greater understanding in their relationship.

When compared with other treatments that may affect your sexual life, sex therapy can be more of a psychological thing. If your relationship is going through a rough patch, it can be of great help.         

Carbohydrates: Choose complex carbs instead of simple ones

Most people think carbohydrates are the wicked stepmother in our body’s fairy-tale, poisoning and ruining it. Accepted, the metaphor might be a bit exaggerated, but it is a fact that the unaware eye views carbs negatively.

Carbs have not always been viewed upon as bad for the body. And, to be honest, they aren’t. What we need to understand is how different types of carbs affect the body differently.   

          

They can be broadly classified into two groups: simple and complex carbs. Simple carbs are contained in processed foods like white flour and white sugar and in a wide variety of products that are made using them. Such carbs are bad for the body, and although we know we should avoid them, we are attracted to them like bees to nectar. Naans, roomali rotis, biscuits, cakes, mithais, chocolates and soft drinks are just a few of the sources of simple carbs.

Complex carbs are found in veggies, fruits, dry fruits and whole grains like rice and millets. They are healthy and help in stabilising blood sugar levels and regulating hunger, lowering weight and cholesterol levels.

Comparing to these, simple carbs make the liver and pancreas work overtime as they cause a sudden rise in blood sugar levels. And just after this sharp spike, the blood sugar levels fall dramatically. The body then craves food and the individual becomes tired, restless and irritable.

Simple carbs can also cause weight gain, chronic disorders and diseases like heart disease, gall stones, kidney stones, arthritis as well as cancer. But the fact is that your daily diet must contain at least 60 per cent of carbs. Out of this, 40 per cent of carbs should come from veggies and fruits alone. You need these for energy and with all the antioxidants, minerals and vitamins that they provide; this is the best deal you can get. 

Sources of good carbs, whether simple or complex are:

• All fruits and vegetables: They are healthy complex carbs, full of vitamins, minerals, fibre and not high in calories, making them suitable for weight loss.
• Grains: They offer both healthy complex carbs and fibre, ideal for weight-loss. Due to the low-calorie and high-fibre content, it satiates hunger for a longer duration.
• Yams: A good source of potassium, the mineral which helps control blood pressure. As it is rich in fibre it also slows the rate of absorption of sugar in the bloodstream.
• Sweet potato/potato: It contains Vitamin C, which builds immunity, Vitamin D, which increases energy levels and builds healthy bones, iron and magnesium which keep the heart healthy.
• Corn: This is high in fibre and low in fat. It contains both soluble and insoluble fibre reducing cholesterol levels, lowering the risk of heart disease and preventing constipation.
• Dry fruits: Raisins, apricots, prunes, figs and dates are low in sodium and extremely low in saturated fat and cholesterol. They are a good source of dietary fibre and satisfy sweet cravings.

Now Lazoi has presence in Udaipur, Bikaner, Jaipur and Jodhpur

New Delhi based Lazoi Lifecare Private Limited which caters to the needs of thousands of patients across Delhi/NCR by providing pioneer online appointment booking with specialised doctors is proud to announce the launch of its services in Udaipur, Bikaner, Jaipur and Jodhpur. Enumerating the existing base of cities, the company has channelised a new source of fresh revenue that will complement its current business model. Praising the dedicated team of Lazoi, the founder and CEO of the company Mr. Suvro Ghosh said, “We have given India what is known as a technological platform to bridge the gap between doctors and patients. With success in Delhi and adjoining areas, we thought of expanding our current base of target cities. And this is just the start. In future, we’ll be looking to provide these services pan India.”

Since its launch in 2012, there has been an exponential rise in the panel of doctors, all from diverse medical field. Presently, more than 40,000 expert surgeons, dermatologists, gynaecologists, psychologists etc are associated with Lazoi. This augmentation is the result of determination and commitment of the whole team. “Healthcare services have reached new heights in the past decade but not much has been done in terms of its delivery. With the launch of Lazoi in core cities of Rajasthan, patients can access quality healthcare professionals and also contribute towards providing structure to the delivery of secondary healthcare services in India” said Mr. Suvro Ghosh.

In Rajasthan, they are targeting areas which are unable to access quality healthcare services. Doctors who are confined to personal practice and unable to get patients, Lazoi services will help them too. Along with booking online appointment with their preferred healthcare practitioner, patients will benefit from a slew of other services like ‘ask aquery’, ‘online consultation with doctors’, view timing slots of doctors, their clinic or hospital address and much more. Doctors can manage appointments, get their profiles made, and promote themselves online through Lazoi’s DocPractice Software.

    

Lazoi is a one stop centre for an array of healthcare services- from scheduling appointment with doctors, creating and managing patient health records and online booking of diagnostic lab tests. All this is now accessible, thanks to the initiative taken by Mr. Suvro Ghosh. He further quotes, “There are many medical professionals who operate private clinics, but only few know them and that too people living nearby. The perspective of Lazoi is to bring this gap and provide prominent healthcare services on an online platform.”  

Creating an outstanding blend of technology and internet, Lazoi has developed a stand which entitles doctors to connect with their patients and vice-versa. One of the many benefits patients have is that they don’t have to shell a penny for acquiring these services.

Online Consultation for doctors: What is its importance?

In today’s fast paced world, everyone is busy and more often than not have packed schedule. Technological advances have pushed people wanting everything at their fingertips and performed at the click of a button. What about an online consultation with a top-notch doctor? It seems completely relevant considering most of the individuals don’t get enough time even to look after their health. Online consultation with a doctor empowers patients to educate him on their health condition without seeing and meeting him as a person. Though online consultation is not a replacement for conventional personal medical treatment, but it does saves time and can cure health issues that don’t require visiting a doctor.

These days, people are fully aware of their health concerns and they need more knowledge and education on the concerned health issue. Usually, a patient has to devote much of his time booking an appointment with the doctor and visiting him. An online consultation with the doctor gets past all these impediments and concurrently provides most useful and relevant information which patients are eagerly seeking at the comfort of their home or office without having to queue up.    

Presently, there are numerous websites and a range of hospitals and clinics that are offering optimum online consultation with doctors at an affordable price. Doctors associated with these websites are immensely qualified with loads of experience and multiple specialities. These portals work with an objective to provide state of the art, trustworthy and expert medical advice to the patients regardless of their age, gender, sex and location.

Some important features of online consultations

• All doctors are medical experts and provide online consultations round the clock. In most of the cases they revert back to any query within 24 hours.
• If the patient is unsatisfied with the service of the doctor, the chargeable fee is redeemed. Sometimes, online consultation is free of cost as well.
• Online consultation provides a perfect platform to patients to discuss their personal health problems in a secure and private manner. All the conversations are strictly confidential.
• Travelling is not needed for an online consultation, hence saving time and money both.

Overall, there is hardly any negative side to online consultations with doctors. It’s safe, secure and the best method to procure primary healthcare. 

Why Public Image is Important for Doctors

Medical profession has grown immensely for the last few decades and come up leaps and bounds. Gone are those days when patients had to queue up and wait for long hours to get themselves medically checked. Now is the time when people have choices and lots of options. There are many medical specialities in which professionals make their careers. For every practice, there are several doctors available providing the same services at similar costs. For instance, you need to get your teeth checked and if you go through newspapers, yellow pages or the internet you can find hundreds of them offering dental health services in your locality. The primary point here is that over the years patients have increased many-fold and so as the competition among doctors. Doctors need to be smart thinkers, active entrepreneurs and acute strategists to withstand some of the tough nuts thrown at them by fellow counterparts. Focusing solely on the practice will not do in the 21^st Century. They need to be professional marketers and should know how to sell their services in order to achieve desired results.

Social Image or Public Image plays a conspicuous role in determining whether a doctor truly belongs to the medical area he is practising. Interestingly, in this neck-deep competitive environment, it’s the patients who decide the fate of a healthcare practitioner. Whether his endeavours (in this case the services) will bring a fruitful result depends on the quality and effectiveness of his services. This is the precise reason why most of the doctors are either getting themselves enrolled for social media profiles or creating some of their own and handling at the same time. The internet, here is the perfect platform for them to get identified, make a brand name of their practice. People these days are tech-savvy and believe that a doctor with good reputation and social media profile is better equipped to handle their medical concerns.

Foreseeing this as a regular trend in upcoming years, many companies are offering diligent reputation management services for doctors. And doctors are happily willing to oblige because they know the value of retaining a patient. These companies are making some serious bucks by providing what we can call as “the need of the hour for doctors.” Initially, only handful of companies was offering such kind of services and now even they are facing some serious rivalry.

Coming back to doctors’ reputation, it is imperative that they don’t overdo the reputation management stuff. There is a saying in English, “Excess of everything is bad” and that holds true for this also. Patients believe in a positive word of mouth. That is only achievable when a doctor provides quality healthcare services at an affordable price. You can say that medical profession nowadays isn’t restricted to just practice. Goodwill and how to maintain that goodwill are integral part of a healthcare professional’s success. It’s a slippery path filled with snow. A step away from caution can blow the whole practice!

What doctors will miss by not creating an online presence

There is more than one reason why doctors decide to go against creating a website or involving in the social media. There are also different reasons why that hesitancy could end up hurting their practices.

If you don’t possess a social media presence or not deeply engaged in it, you could possibly miss out on a great opportunity to expand your practice. Nowadays, it’s not all about letting the patients know that you exist; it is about attracting new and retaining old ones.

It’s a different business altogether for doctors since the advent of social media. Patients too have matured along with the technology. Now, they search Google to find best of practising doctors in their area. They visit the website, if any, to gather clinical information about a particular physician. If everything suits their preferences, they quickly book an online appointment. And that’s the latest trend.

However, if a doctor still thinks that having an online presence and maintaining it is time consuming, there are things to know prior to deciding it is the best decision. 

• Your name and contact information is probably listed in Yellow Pages. But without a website, your name will not appear in Google when patients search for local doctors. Even if it does, they will easily pass by knowing you don’t own an online presence. Naturally, they will prefer one with better presentation.
• Because patients frequently throng on the internet for obtaining healthcare information, doctors who are unwilling to contribute miss out a great deal. As a patient, social media acts as a premier source of medical knowledge, particularly about diseases and symptoms. And we would be willing to contact those doctors who are easily approachable online and clear our queries, if any.
• A website is often a place where patients can give their feedback (either positive or negative) about the doctor’s services. It gives them an opportunity to have a say. But not being online prevents doctors from knowing exactly what patients think about their offerings

There was a time when patients just visited the doctor not knowing much about him/her. But times have changed dramatically. Now, patients look for doctors who can stay in touch with them 24*7. Internet provides doctors that opportunity. Those who are smart enough already have an online presence, but those who don’t are losing out big time.

Air pollution wreaking havoc on Delhi

In a latest study done by the World Health Organisation (WHO), India’s national capital Delhi is the most polluted city in the world. According to the reports of the Ambient Air Pollution (AAP), Delhi has the uppermost concentration of PM2.5- kind of air pollution, which is considered most threatening and responsible for causing multiple respiratory issues and other health complications. The condition is menacing in Delhi because it has PM2.5 concentrations of 153 micrograms and PM10 concentrations of 286 micrograms which are way beyond the permissible limits.

In 2012, WHO released estimates about 7 million deaths because of air pollution exposure. This data thwarted previous estimates and substantiates that air pollution is now the world’s leading environmental health hazard. Reducing pollution levels could save countless lives.

The new data reveals a stronger connection between indoor and outdoor air pollution exposure and heart ailments, like strokes, as well as between air pollution and cancer. This is in addition to air pollutant’s role in the growth of chronic respiratory infections and obstreperous pulmonary disorders.

Deaths caused by outdoor air pollution

• Ischemic heart disease: 40%
• Stroke: 40%
• Chronic obstructive pulmonary disease (COPD): 11%
• Lung cancer: 6%
• Lower respiratory issues in children: 3%

Deaths caused by indoor air pollution

• Stroke: 34%
• Ischemic heart disease: 26%
• Chronic obstructive pulmonary disease (COPD): 22%
• Lower respiratory issues in children: 12%
• Lung cancer: 6%

Numerous people are exposed to indoor and outdoor air pollution. Dr Carlos Dora (WHO Coordinator for Public Health, Environmental and Social Determinants of Health) says, “One of the reasons for causing air pollution is mismanagement of energy, waste management and transport sectors. WHO and health sectors have a positive role to play in deciphering scientific proof into result-driven policies that will save millions of lives.”

The release of this data is an important step in creating a road-map for WHO in preventing air pollution related diseases. This includes development of WHO-hosted global platform on air quality and supporting countries through appropriate guidance and information about health gains and key interventions. 

Help your knees: Get these exercises going

If you are suffering from a knee injury, you may think exercising could worsen the condition leading to much more discomfort. But the reality is otherwise. Strengthening the muscles that support knee and keeping them elastic is the perfect way to prevent further damage. Start slowly and build your muscles steadily. You may experience some soreness when you start, but that’s normal. If you still feel the pain, stop immediately and contact your orthopaedic.

• WARMING UP: Stretching can improve your leg functionality. Remember to warm up before stretching. You have the option of 5 min cycling or 2 min brisk walking while stretching your arms and doing 15-20 push-ups. It will significantly lower your risk of injury.
• STRAIGHT LEG RAISES: If your knee is not functioning appropriately, commence with an easy stretching of your quadriceps, the front thigh muscles. This move hardly puts any sort of pressure on the knees. Lie on your back straight and bend one knee and place your foot flat on the floor. Keeping the other leg in a straight line, elevate it to a level similar to the opposite knee. Repeat it multiple times.
• CALF RAISES: Stand facing the back of a chair and take support of another one or back of the wall is also an option. Slowly raise the heels as high as you can. Do this in three sets of 10-15.
• STEP-UPS: Place one foot on a bench or a lower staircase. Keeping your pelvis level, bend your knee and steadily lower the other foot on the floor. Touch your toe slightly to the floor and then rise back up. Repeat it 10-15 times and do vice-versa. If the exercise suits you, you can try touching your heel instead of toe.
• STRICT NO FOR YOUR KNEE: No exercise can cause pain but a little soreness after the workout is completely normal. But any kind of sudden pain in the joints or muscles is a sign that something is wrong. If you feel such a thing, stop the exercise and visit your nearby orthopaedic. 

Top foods that help in breast cancer prevention

The World Health Organisation (WHO) has stated that by the year 2020, number of breast cancer patients will increase alarmingly and one in every eight women would run the risk of developing the disease in her lifetime. However, there are certain foods when consumed regularly can cut-down breast cancer risk in women.

Flaxseed: You can consume flax in the form of whole seed, ground or flaxseed oil. Presence of omega-3 fatty acids, lignans and fibre in flaxseed form a protective shield against cancer cells responsible for breast cancer. You can add flaxseed oil to salad dressings or integrate them into baked goods, such as cookies or muffins.

Brazil nuts: Rich in selenium, fibre, and photochemical, Brazil nuts can help fight inflammation, improve the immune system and prevent tumour growth. And you do not need many of them-a handful can do the trick. Enjoy them as any other nut either with fruits or asparagus (contains the anti-cancer component, chlorophyll).

Garlic: Rich source of cancer-fighting compound called allium, Garlic and its close companions (onion, leeks, scallions, and chives) are shown to slow tumour growth and prevent breast cancer risk among other forms of cancer such as colorectal and prostate cancers. Crush or swallow a piece of garlic every morning and that's all it takes to live a cancer-free life!

Pomegranate: Pomegranate is highly recommended for preventing breast cancer. It contains polyphenol- an ellagic acid with anti-oxidant properties that prevent cancer growth. Include this delicious fruit in your diet and discover effective health benefits.

Dark-green leafy vegetables: From kale, collards to spinach, dark-green leafy vegetables probably are considered the best nutrients your body needs to fend off cancerous cells, i.e. fibre, vitamin B, phytochemicals, chlorophyll and more. It's time to add some greens to your diet.

Broccoli and broccoli sprouts: As a cruciferous vegetable along with cauliflower, brussels sprouts, cabbage and kale; broccoli is rich in sulforophane and indoles, which are shown to regulate cell growth in multiple ways and help fight a range of cancers, including breast, bladder, lymphoma, prostate and lung cancer.

Green tea: Consumption of green tea regularly has been linked to lower incidence of breast cancer. The phytochemicals in green tea can well take the credit for its health benefits. One to two cups of green tea daily can help you keep cancer at bay.

Peppers: Most peppers contain photochemical or nutrient that will help fight cancer. Chilli and jalapeno peppers have capsaicin (an active component of chilli peppers) that fights the growth rate of cancer cells. Green peppers are rich in chlorophyll which can bind cancer-causing carcinogens found in the gut. Red peppers have both capsaicin and antioxidant carotenoids.

Turmeric: A spice commonly found in our country cancer-fighting compound called curcumin can inhibit many types of cancer cells, including breast, gastrointestinal, lung, and skin cancer. Turmeric fights toughest of cancer-causing cells.

Monitoring the Fat in Your Diet

Very little disagreement exists among scientists and researchers about the need to limit fat intake! Everyone agrees that you should eat no more than 30 per cent of your diet as fats. As with protein, the type of fat that you eat needs to be considered as well as the quantity.

Dietary fat comes in several forms

• Saturated fat is the kind of fat that mainly comes from animal sources. For example, butter is made up of saturated fat. Bacon, cream, cheese, pastries, cakes, biscuits and chocolate are other examples that contain saturated fat. Two non-animal sources of saturated fat exist: Palm oil and coconut milk. Eating a lot of saturated fat increases the blood cholesterol level.
• Unsaturated fat comes from vegetable sources such as nuts and seeds. It comes in several forms.
• Monounsaturated fat doesn’t raise cholesterol. Avocado, olive oil, canola oil, olive and canola spreads are examples. The oil in nuts like almonds and peanuts is monounsaturated.
• Polyunsaturated fat also doesn’t raise cholesterol but does cause a reduction in the good or HDL cholesterol. Examples of polyunsaturated fats are soft fats and oils such as sunflower, soybean, sesame oil, oily fish (trout) and sunflower spread.

Protection against heart disease comes from including essential fatty acids, found in fish oils, in your diet. If you dislike fish or just can’t eat the required two to three serves of it each week, fish oil capsules are a good substitute. Just make sure when buying the capsules that they contain sufficient quantities of the two active ingredients (EPA) and (DHA). Diabetologists recommended you take between 1,200 milligrams and 3,000 milligrams of a combination of these active ingredients each day. To make it easier, many formulations of fish oil are now concentrated, meaning you only need to take one or two capsules per day to reach the 1,200 milligrams per day target.

Getting Enough Vitamins, Minerals and Water

Your diet must contain sufficient vitamins and minerals for good health, but the amount you need may be less than you think. If you eat a balanced diet that comes from different foods, you generally get enough vitamins for your daily needs.

• Vitamin A: Needed for growth and development, immune function, bones and healthy skin; helps with night vision. Found in eggs, oily fish, dairy products, orange and green vegetables and orange fruits.
• Vitamin B1: Converts carbohydrate into energy. Found in wholegrain cereals, meat, fish, nuts and yeast extract.
• Vitamin B2: Needed to release energy from food. Found in milk, cheese, fish, almonds, eggs, green vegetables and fortified cereals.
• Vitamin B12: Keeps the red blood cells and the nervous system healthy. Found in Animal foods only; for example, meat, seafood, eggs.
• Vitamin C: Helps maintain supportive tissues. Found in Fruit and some vegetables; for example, tomatoes and capsicum.
• Vitamin D: Helps with absorption of calcium. Found in oily fish, egg yolk and fortified milk. Also made in the skin when exposed to sunlight, although this process declines as you age.

Minerals are also key ingredients of a healthy diet. Most are needed in tiny amounts, which, with a few exceptions, are easily consumed from a balanced diet. These essential minerals are as follows:

• Calcium, phosphorous and magnesium build bones and teeth. Milk and other dairy products provide plenty of these minerals, but evidence suggests that people aren’t getting enough calcium. Pregnant women and breastfeeding mothers should have 1,000 milligrams, particularly in the final three months of the pregnancy and throughout the breastfeeding period.
• Iodine is essential for production of thyroid hormones. Iodine is often added to salt in order to ensure that people get enough of it. In many areas of the world where iodine is not found in the soil, people suffer from very large thyroid glands known as goiters.
• Iron is essential for red blood cells. Iron is obtained from red meat and iron-fortified breakfast cereals. Green leafy vegetables provide small amounts of iron; however, it’s not in a form that’s easily absorbed by the body. 

Water is the last important nutrient but it’s by no means the least important. Your body is made up of 60 per cent water and all the nutrients in your body are dissolved in it. You need to drink about six to eight glasses, or one and a half to two litres, of fluid per day — more if the weather is very hot or you’re exercising a lot. Your thirst will tell you how much you need.

Psychiatry: Approaching Mental Health Problems

Grappling with phobias

A form of anxiety that occurs only when you’re in a certain situation is called a phobia. If you suffer from a phobia, you typically try to avoid the situation that provokes your symptoms and you may become anxious even just thinking about getting into that situation. Some examples of phobias are as follows, starting with simple phobia and followed by the more complex ones:

• Simple phobia: You’re inappropriately anxious when faced with an object such as a spider or mouse, or in certain situations such as flying or being in enclosed spaces. Simple phobias commonly start in the early years of life following a stressful situation or some frightening life event, although experts don’t always know why this type of phobia occurs.
• Agoraphobia: You feel panicky or may even faint when you’re part of a crowd, out of the house or in a situation from which escape is difficult. To avoid these situations, you may avoid going out altogether, which can sometimes lead to depression and other mental health problems. It is thought that life experiences, genetic reasons and changes of chemicals in the brain may all play a role in causing agoraphobia.
• Social phobia: You have a strong and persistent fear of being negatively seen by others, and so you try to avoid social situations such as talking to groups, speaking on the telephone or going out with friends. In contrast to just being shy, social phobia can be quite disabling. Previous anxious or intense experiences in certain social situations may cause social phobias, particularly if you’ve always been shy since childhood and haven’t been able to fully develop your social confidence.

To avoid a phobia getting out of hand, consult your psychiatrist to discuss the many forms of treatment and therapy that are available. If you’re in a situation and start to feel anxious, try to relax and take control of your breathing. Open and stretch your hands, which can help release tension – our natural reaction to stress and anxiety is to close our hands or make a fist.

Handling panic attacks

Panic attacks are when you suddenly experience an intense feeling of apprehension or impending disaster. You’re likely to become anxious very quickly – often without warning and for no apparent reason. These attacks affect a lot of people and can be very frightening. Nobody really knows why panic attacks occur, but experts think that traumatic life experiences like the death of a close family member, unpleasant childhood experiences or changes in the chemicals within your brain, for example, may play a role.

If you suffer from panic attacks, you may recognise some of the following symptoms, at least four of which typically show during an attack:

• You suffer from a fast heart rate or palpitations.
• You feel short of breath or that you’re choking.
• You notice chest pain or discomfort.
• You feel dizzy, unsteady on your feet or faint.
• You feel sick or have stomach pain.
• You feel flushed or suddenly cold.
• You feel shaky and tremble.
• You’re afraid of doing something that you can’t control or that may seem crazy to other people.
• You feel like you’re not yourself.
• You may feel as if you’re about to die.

During a panic attack, try to tell yourself that you’re not coming to any harm, and that the symptoms you experience are due to anxiety. Remind yourself that attacks will pass, and ‘ride it out’. Try not to leave the situation that is causing you to have a panic attack and ‘confront’ your fear. By staying in the situation you give yourself the opportunity to discover that nothing serious is going to happen to you.

If you feel that you may suffer from panic attacks and that these attacks impact on your life, consult your psychiatrist. She/he can then exclude any potential underlying physical causes and discuss the different management options with you.