HOW TO REDUCE WEIGHT

     Obesity or being overweight is the causative factor for several chronic non-communicable diseases including heart disease, diabetes and certain types of cancers

. A dramatic increase in the prevalence of overweight and obesity among all the age groups has occurred in last 2-3 decades. 
. About 30-50% of adult Indians are either overweight or obese.
. Overweight and obese individuals are at an enhanced risk of co-morbidities including type 2 Diabetes. 
. Fatty liver disease, Gallstones, high blood cholesterol and triglycerides, orthopedic disorders (Osteoarthritis), hypertension and other cardiovascular diseases, certain cancers and psycho-social problems. 
. The imbalance between the energy output leads to excess accumulation of fat in various parts of the body. 

How to reduce weight: 

 There is no single regimen for weight reduction, it has to be individualized. Weight reduction should be gradual. Weight reduction diets should not be less than 1000 Kcal/day and provide all nutrients. 

 A reduction of half a kilogram body weight per week is considered to be safe. Extreme approaches should be avoided and use of drugs may be dangerous. In children, obesity should be controlled by increasing physical activity rather than restricting food intake. Modification in dietary habits to be incorporated into one's lifestyle along with adequate exercise to keep the body weight within the normal limits. 
 As fat contains more than twice the calories per gram compared to protein and carbohydrate, weight reducing dites should limit the fat intake. Refined sugar 4 kcal and alcohol 7kcal provide empty calories and should be avoided. Refined carbohydrates which promote fast absorption of glucose(Glycemic carbohydrates) also need to be restricted. 

 Plant foods that provide complex carbohydrates and fiber be preferred as they reduce blood glucose, cholesterol and triglycerides. Weight reducing diets must be rich in proteins and low in carbohydrates and fats. Consumption of plenty of fruits and vegetables would not only result in satiety but could also help to maintain adequate micronutrient intake. 

 Frequent fasting/ semi-fasting (cyclic weight reduction) followed by adequate or excess food consumption will also aggravate the problem of weight gain. All reducing regimens should be monitored by a doctor and a dietitian. 

 Obesity or being overweight is the causative factor for several chronic non- communicable diseases including heart diseases, diabetes and certain types of cancers. 

 . A dramatic increase in the prevalence of overweight and obesity among all the age groups has occurred in last 2-3 decades. 

. About 30-50% of adult Indians are either overweight or obese. 
. Overweight and obese individuals are at an enhanced risk of co-morbidities including type 2 diabetes, fatty liver disease, gallstone, high blood cholesterol and triglycerides, orthopedic disorders. Osteoarthritis, hypertension and other cardiovascular diseases, certain cancers and psycho-social problems. 
. The imbalance between the energy intake and energy output leads to excess accumulation of fat in various parts of the body. 

Weight reduction tips consider: 

 . Slow and steady reduction in body weight is advisable.
 . Severe fasting may lead to health hazards. 
 . Achieve energy balance and appropriate weight for height. 
 . Encourage regular physical activity. 
 . Cut down sugar, fatty foods, refined foods, soft drinks, and alcohol.
 . Eat complex carbohydrates, low glycemic foods, and fiber-rich diets. 
 . Increase consumption of fruits and vegetables, legumes, whole grains, and nuts. 
 . Avoid trans-fatty rich foods(Vanaspati. bakery products and sweets).
 . Use low-fat milk.
 . Limit fat intake and shift from saturated to unsaturated fats. 

The Y chromosome is disappearing so what will happen to men?

     The Y chromosome is disappearing so what will happen to men? 

The end of men? The expert reveals how the male sex chromosome could one day disappear completely. 

. University of Kent researchers have found the Y chromosome is shrinking. The Y chromosome plays a critical role in the sexual reproduction of men. The male sex chromosome determines the biological sex of an unborn baby. It has been shrinking over generations and is expected to go extinct in less than five million years. 

Darren Griffin: Professor of Genetics, University of Kent and Peter Ellis, Lecturer in Molecular Biology and Reproduction, University of Kent. 

  The Y chromosome may be a symbol of masculinity, but it is becoming increasingly clear that it is anything but strong and enduring. Although it carries the"master switch" gene, SRY, that determines whether an embryo will develop as male (XY) or female (XX), it contains very few other genes and is the only chromosome not necessary for life. Women, after all, manage just fine without one.

     What’s more, the Y chromosome has degenerated rapidly, leaving females with two perfectly normal X chromosomes, but males with an X and a shriveled Y. If the same rate of degeneration continues, the Y chromosome has just 4.6m years left before it disappears completely. This may sound like a long time, but it isn’t when you consider that life has existed on Earth for 3.5 billion years.

    The Y chromosome hasn’t always been like this. If we rewind the clock to 166m years ago, to the very first mammals, the story was completely different. The early “proto-Y” chromosome was originally the same size as the X chromosome and contained all the same genes. However, Y chromosomes have a fundamental flaw. Unlike all other chromosomes, which we have two copies of in each of our cells, Y chromosomes are only ever present as a single copy, passed from fathers to their sons.

    This means that genes on the Y chromosome cannot undergo genetic recombination, the “shuffling” of genes that occurs in each generation which helps to eliminate damaging gene mutations. Deprived of the benefits of recombination, Y chromosomal genes degenerate over time and are eventually lost from the genome.

        Despite this, recent research has shown that the Y chromosome has developed some pretty convincing mechanisms to “put the brakes on”, slowing the rate of gene loss to a possible standstill.

      For example, a recent Danish study, published in PLoS Genetics, sequenced portions of the Y chromosome from 62 different men and found that it is prone to large-scale structural rearrangements allowing “gene amplification” – the acquisition of multiple copies of genes that promote healthy sperm function and mitigate gene loss.

       The study also showed that the Y chromosome has developed unusual structures called “palindromes” (DNA sequences that read the same forwards as backward – like the word “kayak”), which protect it from further degradation. They recorded a high rate of “gene conversion events” within the palindromic sequences on the Y chromosome – this is basically a “copy and paste” process that allows damaged genes to be repaired using an undamaged backup copy as a template.

    Looking to other species (Y chromosomes exist in mammals and some other species), a growing body of evidence indicates that Y-chromosome gene amplification is a general principle across the board. These amplified genes play critical roles in sperm production and (at least in rodents) in regulating offspring sex ratio. Writing in Molecular Biology and Evolution recently, researchers give evidence that this increase in gene copy number in mice is a result of natural selection.

    On the question of whether the Y chromosome will actually disappear, the scientific community, like the UK at the moment, is currently divided into the “leavers” and the “remainder”. The latter group argues that its defense mechanisms do a great job and have rescued the Y chromosome. But the leavers say that all they are doing is allowing the Y chromosome to cling on by its fingernails, before eventually dropping off the cliff. The debate therefore continues.

    A leading proponent of the left argument, Jenny Graves from La Trobe University in Australia, claims that, if you take a long-term perspective, the Y chromosomes are inevitably doomed – even if they sometimes hold on a bit longer than expected. In a 2016 paper, she points out that Japanese spiny rats and mole voles have lost their Y chromosomes entirely – and argues that the processes of genes being lost or created on the Y chromosome inevitably lead to fertility problems. This in turn can ultimately drive the formation of entirely new species.

The demise of men?

    As we argue in a chapter in a new e-book, even if the Y chromosome in humans does disappear, it does not necessarily mean that males themselves are on their way out. Even in the species that have actually lost their Y chromosomes completely, males and females are both still necessary for reproduction.

In these cases, the SRY “master switch” gene that determines genetic maleness has moved to a different chromosome, meaning that these species produce males without needing a Y chromosome. However, the new sex-determining chromosome – the one that SRY moves on to – should then start the process of degeneration all over again due to the same lack of recombination that doomed their previous Y chromosome.

However, the interesting thing about humans is that while the Y chromosome is needed for normal human reproduction, many of the genes it carries are not necessary if you use assisted reproduction techniques. This means that genetic engineering may soon be able to replace the gene function of the Y chromosome, allowing same-sex female couples or infertile men to conceive. However, even if it became possible for everybody to conceive in this way, it seems highly unlikely that fertile humans would just stop reproducing naturally.

   Although this is an interesting and hotly debated area of genetic research, there is little need to worry. We don’t even know whether the Y chromosome will disappear at all. And, as we’ve shown, even if it does, we will most likely continue to need men so that normal reproduction can continue.

  Indeed, the prospect of a “farm animal” type system where a few “lucky” males are selected to father the majority of our children is certainly not on the horizon. In any event, there will be far more pressing concerns over the next 4.6m years.

"Asperger Syndrome"

                                    "Asperger Syndrome"

    The term "Asperger syndrome" is a neurobiological disorder characterized by a developmental disability. This Disorder is also widely recognized by the name of Autism Spectrum Disorder or ASD. It is characterized by a range of developmental disabilities. People with this kind of disorder have problems lack of desire to interact with peers, may have socially and emotionally inappropriate behavior, and generally have a  repetitive routine. It is also sometimes found that the person affected by ADS has some speech and language peculiarities. 

     As was discovered in 1944 by Hans Asperger, a Viennese pediatrician. He first described to as a personality disorders referring it as a psychopathy in the childhood. Later in 1980's Autistic psychopathy was recognized as a single disorder Known as Asperger's Syndrome, named after Hans Asperger's syndrome and high functioning autism. Because of people with As sharing the many symptoms of the high functioning autism. As a result, identifying Asperger's syndrome as a single domain remains in question, therefore, pathologists are still struggling to find the exact cause of this syndrome, of all the autism spectrum disorders like pervasive developmental disorder (PDD), phenotype(BAP), etc, Asperger's Syndrome has similar symptoms of Autism. As is marked by poor social interactions, odd speech patterns and peculiar way of carrying oneself with the same routine and have resistance to change. It is also noted that people having this syndrome lack-motor co-ordination. They are usually clumsy, shabbily dressed and fail to understand other's body language and facial expressions. They are also unable to emote their feelings and therefore fail to make many friends, and since the usual onset of Asperger's Syndrome is during childhood, therefore the habits once formed last forever.  

 The signs and symptoms present in a person's with Asperger's Syndrome can broadly be classified as under 

Social Interaction: 
  Those with Asperger's Syndrome experience failure in establishing a lifelong relationship, this result due to their poor social interaction. They lack showing empathy towards others. They are not kneed to share their experiences with others. They do not involve themselves in situations and are happy if left on their own. They fail to recognize the social norms and accepted behavior. Therefore they are unable to fit in the society. They exhibit strange behavior towards other like giving weird facial expressions, non-smiling face and use of pedantic language. They indulge in one-sided conversations and therefore are not good listeners. 

Restricted concern and conduct: 
  Another common symptom of Asperger's Syndrome patients is their inflexibility regarding their interests and behavior. They follow their own set routine and seldom allow any change. They follow their routine religiously, any change in their routine can make them violent as reported in some cases. They like to keep their things arranged and any slight change makes them throw tantrums or send them into wailings. They form a special interest in any subject and usually excel in it, but they may fail in other subjects if not of their interest. Patients with Asperger's Syndrome have strong rote memorization but lack in abstract comprehension. Additional symptoms in some cases are of repeated motor mannerisms. These mannerism include hand or finger flapping, rocking, spinning, jumping etc.

Oral Communication: 
   Those with Asperger's Syndrome might not have any delay in language formation but they do encounter problems while using correct words in the correct context. They are quite familiar with wide and new words but lack the sensibility to use them. They interpret the words according to their will. they are unable to note the elusion differences in accent, tone, and pitch. the most peculiar feature of their oral communication is their use of ornamental language. Their sentences are often laden with pedantic words as if quoting from a book. They are unable to sustain other people's interest in their conversation due to lack of correct intonation and their tendency to jump one topic to another like drop of a hat. 

Other symptoms: 
    People with Asperger's Syndrome often related their problems with their sensory experiences i.e. experiences related to the senses of touch, smell, hear and see. Other symptoms identified in some cases are attention difficulties and sleep problems. 

Causes of Asperger's Syndrome: 
 
   Many researchers believe heredity to be the main cause of this disorder while some suggest mental disorders like depression and bipolar disorder to be associated with Asperger's Syndrome. Some research in Asperger's Syndrome cases has led researchers to associate birth defect with the syndrome. Some are also looking at environmental factors as a possible cause of Asperger's Syndrome. 
Although pathologists are still trying to distinguish Asperger's Syndrome from ASD, yet some findings determine a different mechanism of Asperger's Syndrome from ASD. Neuroanatomical studies suggest that the Asperger's Syndrome's mechanism involves some abnormal migration of embryonic cell during the conception of a fetus resulting in the alteration of control thought and behavior in the later stage. 

Diagnosis of Asperger's Syndrome: 

 Can be diagnosed by testing child's learning style, speech and language, IQ, social and motor skills and according to characteristic symptoms. 

Standard treatment of Asperger's Syndrome: 

 Speech and language therapy, cognitive behavioral therapy, physical and occupational therapy and social skills training will be helpful. 

Homeopathic Treatment of Asperger's Syndrome:

  Homeopathic is one of the remedies is based on the theory of individualization and symptoms- similarity by using a holistic approach. This is the only way through which a state of complete health can be regained, by removing all the signs and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat Asperger's Syndrome but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several well-proved medicines are available for Asperger's Syndrome treatment that can be selected on the basis of cause, sensation, and modalities, for individualized remedy selection and treatment, the patient should consult a qualified homeopath. Some important remedies are shown below for as:

 Chamomilla, Ignatia, Pulsatilla, iodum, Hepar sulph, Anacardium, Lycopodium, causticum, Sanicula, Argentum nit, sulphur, silica, Bryonia, antium- crud and many other medicines. 

Crush Syndrome

                           Crush Syndrome

     Crush Syndrome (also called Traumatic rhabdomyolysis or Bywater's Syndrome) is a medical condition characterized by major shock and renal failure after a crushing injury to skeletal muscle. Crush injury is compression fo extremities or other parts of the body that causes muscle swelling and/ or neurological disturbances in the affected areas of the body, while crush syndrome is localized crush injury with systemic manifestations. Cases occur commonly in catastrophes such as earthquakes, to victims that have been trapped under fallen or moving masonry. 
     Victims of crushing damage present some of the greatest challenges in field medicine, and may be among the few situations where a physician is needed in the field. The most drastic response to cruising under massive objects may be field amputation. Even if it is possible to extricate the patient without amputation, appropriate physiological preparation is mandatory, where permissive hypotension is the standard for prehospital care, fluid loading is the requirement in crush syndrome. 

Pathophysiology:
    Seigo Minami, a Japanese physician, first reported the crush syndrome in 1923. He studied the pathology of three soldiers who died in World War I from insufficiency of the kidney. The renal changes were due to methemoglobin infarction, resulting from the destruction of muscles, which is also seen in persons who are buried alive. The progressive acute renal failure is because of acute tubular necrosis. the syndrome was later described by British Physician Eric Bywaters in patients during the 1941 London Blitz. It is a reperfusion injury that appears after the release of the crushing pressure. The mechanism is believed to be the release into the bloodstream of muscle breakdown products notably myoglobin, potassium, and phosphorus, that are the products of rhabdomyolysis (the breakdown of skeletal muscle damaged by ischemic conditions). The specific action on the kidneys is not understood completely but may be due partly to nephrotoxic metabolites of myoglobin. 

 The most devastating systemic effects can occur when the crushing pressure is suddenly released, without proper preparation of the patent, causing reperfusion syndrome. In addition to tissue directly suffering the crush mechanism, the downstream tissue is subject to the ischemia-reperfusion injury of the appendicular musculoskeletal system, without proper preparation, the patient, with pain control, may be cheerful before extrication, but die shortly thereafter. This sudden decompensation is called the "smiling death". 

   These systemic effects are caused by a traumatic rhabdomyolysis. As muscle cells die, they absorb sodium, water, and calcium, the rhabdomyolysis releases potassium, myoglobin, phosphate, thromboplastin, creatine and creatine kinase. 
Monitor for the classic 5Ps: Pain, Pallor, Parasthesias, Pain with passive movement, and Pulselessness. 

Treatment:
 Due to the risk of crush syndrome, current recommendation to lay first-aiders is to not release victims of crush injury who have been trapped for more than 15 min. Treatment consists of not releasing the Tourniquet and fluid overloading the patient. If the pressure is released during first aid then the fluid is restricted and an input-output chart for the patient is maintained, and proteins are decreases in the diet. 

 The Australian Resuscitation Council recommended in March 2001 that first-aiders in Australia, where safe to do so, release the crushing pressure as soon as possible, avoid using a tourniquet and continually monitor the vital signs of the patient. St. John Ambulance Australia, first responders are trained in the same manner. 

Field Mangement:
 As mentioned permissive hypotension is unwise. Especially if the crushing weight is on the patient more than 4 hours, but often if it persists more than one hour, careful fluid overload is wise, as well as the administration of intravenous sodium bicarbonate. 
If the patient cannot be fluid loaded, this may be an indication for a Tourniquet to be applied.