Bulimia Nervosa

Bulimia Nervosa, often referred to as 'Bulimia' is a serious eating disorder commonly found in girls in adulthood. It is very rarely found in men. Person with bulimia eat a lot in a short amount of time (bingeing). This binge eating usually ends with abdominal discomfort and then the patient attempts to undo the consequences of the binge through self-induced vomiting, misuse of laxatives, severe caloric restriction, diuretics, enemas, or excessive exercising and fasting etc.

Bulimics may devour huge quantities of food, during a binge, most typically foods that would normally be not allowed in a healthy/weight reduction diet. It usually includes foods high in carbohydrates or sweets, meat, cheese etc.

There are also two subtypes of bulimia nervosa, purging and non-purging. The Purging type describes individuals who regularly compensate for the binge eating with self-induced vomiting, laxative abuse, diuretics, or enemas. The Non-Purging Type is used to describe individuals who compensate through dietary fasting or excessive exercising.

The use of vomiting by bulimics can easily become addictive. Although at first they may have done it to get rid of excess food calories, it soon becomes a form of security. They are afraid to stop because they fear their eating habits are out of control and without the use of vomiting they fear they will become grossly overweight. Self induced vomiting could also lead to further hunger and binging, thus creating a cycle.

The bulimic is dominated by a sense of lack of control over the eating. It can occur together with other psychiatric disorders such as depression, obsessive- compulsive disorder, substance dependence or self injurious behavior. Characteristics of persons with bulimia is the worry about weight and shape and tendency to go on strict diets to achieve an ideal figure

Diabetes

Healthy routine helps to minimize the risk of developing complications of diabetes. One can keep blood glucose levels normal by a healthy diet and maintaining physical fitness. Eating right, controlling your weight and exercising regularly will help you to control sugar level.

Excess consumption of alcohol is harmful as it may lower blood glucose levels and cause weight gain. Smoking is very harmful to diabetes patients, because it increases the risk of long-term complications. Foot care is important because diabetes can increase the risk of skin infections and ulcers on the feet. You must clean your feet daily and if a sore develop on your feet, consult the doctor promptly. Diabetes patients have an increased risk of high blood pressure, so regular monitoring is important.

Low-fat, vegetarian diets are ideal for diabetics. In most cases, diabetics can manage their disease much better with a food plan that gets most of its calories from complex carbohydrates while minimizing fats.

Diet for Diabetes :

With a near-vegetarian diet and exercise program, one can maintain their sugar levels with out taking any medications. Ideal diet program for a diabetic is a low fat vegetarian diet, reducing meats, high-fat dairy products, and oils. At the same time increasing grains, legumes, and vegetables.

• Have your meals at regular timings and limit your overall intake.
• Eat five servings of fruits and vegetables every day. Soluble fibers mainly found in fruits, vegetables and some seeds are good for diabetics. They reduce or slow down the absorption of glucose from the intestines.
• Diabetes patients should include leafy vegetables, vegetable soups and juices in their diet. Vegetables like tomato, cucumber, bitter gourd, carrot, cooked kidney beans, pumpkin, snake gourd, beans, cabbage, lady finger, brinjal, onion, spinach, inner part of banana stem, drum sticks etc. are good for diabetes. Fruits and fruit juices of apple, guava, lemon etc. are good. Avoid fruits like banana, mango, grapes, papaya, jack fruit etc. and vegetables like potato, tapioca, sweet potato etc. containing lot of carbohydrates.
• Eat more starches such as bread, cereal, and starchy vegetables. Aim for six servings a day or more.
• Eat sugars, sweets and fat and fat-fried items in moderation.
• It is better to avoid cakes, jaggery, honey, ghee, butter, cool drinks, biscuits, dried fruits like badam and excess use of oil while cooking.

Home Remedies

Some home remedies help to regulate the blood sugar level. You can try out some of these remedies which compliment along with the diet for diabetics and regular exercises to lower blood sugar levels and protect from diabetes related damages.

Have

• 1 litre of cinnamon water daily. Cinnamon contains a chemical to help utilize blood sugar naturally in your body. Add 3 table spoon of cinnamon to 1 litre of boiling water. Simmer for 20 minutes in a low flame, then strain the mixture.
• Fresh or dried bitter gourd (bitter melon) or 2 ounces of its juice every day. Bitter melon increases the insulin secreting cells in the pancreas and daily intake of juice reduces the risk of developing diabetic retinopathy.
• Wild (Black) cumin boiled in water regularly.
• Equal quantities of turmeric powder and dried gooseberry powder with honey or drink equal quantities of gooseberry juice and fresh turmeric juice in an empty stomach regularly.
• Regularly, the juice of crushed 'touch me not' with its roots.
• First thing in the morning, have the juice of crushed fish-berry (amruth) soaked in water for a day.
• Make coffee with powdered fried fenugreek and wheat, taken in equal quantities.
• Garlic every day early in the morning in an empty stomach.
• Tender curry leaves (fresh) twice a day.
• Crush guava leaves, a handful and 3 grams of cumin together. Boil with one glass of water and make it half.
• Drink 8 glass of water in the morning and walk for one hour.

The leaves of gymnema sylvestre (Gurmur- a climbing vine), a traditional Ayurvedic medicine for diabetics, significantly reduces the metabolic effects of sugar by preventing the intestines from absorbing the sugar molecules during the process of digestion. Add 3 quarters of gymnema powder to one glass of boiling water, strain and drink it warm twice a day, 1 hour before breakfast and 1 hour before dinner for best results. The leaves can also be ground and had. It has the property of blocking sugary taste and thus curbs the craving for sweet things.

Hepatitis

Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids (e.g. from blood transfusions or invasive medical procedures using contaminated equipment). Hepatitis B is also transmitted by sexual contact.

The symptoms of hepatitis include jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

 

Hepatitis A

Key facts

* Hepatitis A is a viral liver disease that can cause mild to severe illness.

* It is spread by faecal-oral (or stool to mouth) transmission when a person ingests food or drink contaminated by an infected person's stool.

* The disease is closely associated with poor sanitation and a lack of personal hygiene habits, such as hand-washing.

* An estimated 1.4 million cases of hepatitis A occur annually.

* Epidemics can be explosive in growth and cause significant economic losses: 300 000 were affected in one Shanghai outbreak in 1988.

* Improved sanitation and the Hepatitis A vaccine are the most effective ways to combat the disease.

Hepatitis A is a liver infection caused by the hepatitis A virus (HAV). The virus is spread when an uninfected (or unvaccinated) person eats or drinks something contaminated by the stool of an HAV-infected person: this is called faecal-oral transmission. The disease is closely associated with inadequate sanitation and poor personal hygiene. Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms.

Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. Worldwide, HAV infections account for an estimated 1.4 million cases annually. Epidemics related to contaminated food or water can erupt explosively, such as an epidemic in Shanghai in 1988 that affected about 300 000 people.

The disease can wreak significant economic and social consequences in communities. It can take weeks or months for people recovering from the illness to return to work, school or daily life. The impact on food establishments identified with the virus, and local productivity in general, can be substantial.

Symptoms

The symptoms of hepatitis A range from mild to severe, and can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). Not everyone who is infected will have all of the symptoms. Adults have signs and symptoms of illness more often than children, and the severity of disease and mortality increases in older age groups. Infected children under six years of age do not usually experience noticeable symptoms, and only 10% develop jaundice. Among older children and adults, infection usually causes more severe symptoms, with jaundice occurring in more than 70% of cases. Most people recover in several weeks - or sometimes months - without complications.

Who is at risk?

Anyone who has not had been infected previously or been vaccinated can contract hepatitis A. People who live in places with poor sanitation are at higher risk. In areas where the virus is widespread, most HAV infections occur during early childhood. Other risk factors for the virus include injecting drugs, living in a household with an infected person, or being a sexual partner of someone with acute HAV infection.

Transmission

HAV is usually spread from person to person when an uninfected person ingests food or beverages that have been contaminated with the stool of a person with the virus. Bloodborne transmission of HAV occurs, but is much less common. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water. Casual contact among people does not spread the virus.

Treatment

There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and take several weeks or months. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.

Prevention

Improved sanitation and Hepatitis A immunization are the most effective ways to combat the disease

Adequate supplies of safe-drinking water and proper disposal of sewage within communities, combined with personal hygiene practices, such as regular hand-washing, reduce the spread of HAV.

Several hepatitis A vaccines are available internationally. All are similar in terms of how well they protect people from the virus and their side-effects. No vaccine is licensed for children younger than one year of age.

Precipitate and Emergency Delivery

GENERAL

There are times when labor progresses so rapidly that the nurse is faced with the task of delivering the baby even within the confines of a hospital setting. And, in addition, there are times when a woman begins labor in a variety of physical settings and during a variety of climatic disturbances away from a medical facility. During these situations is when the nurse has the primary responsibility for providing a physically and psychologically safe experience for the woman and her baby. It is important that the nurse maintains composure and keeps calm. Whenever possible, the patient should be told what to anticipate and what she can do to cooperate effectively. Working as a team is essential and can be accomplished if confidence is instilled by competence in both the physical and emotional aspects of care.

TERMS AND DEFINITIONS

a. Precipitate Delivery. This refers to a delivery which results after an unusually rapid labor (less than three hours) and culminates in the rapid, spontaneous expulsion of the infant. Delivery often occurs without the benefit of asepsis.

b. Emergency Delivery. This refers to an unplanned, non delivery room, non-hospital birth which occurs as a result of precipitous labor, geographical distance from the hospital, or other cause for the unexpected delivery.

FACTORS THAT MAY PREDISPOSE A WOMAN TO A PRECIPITATE DELIVERY

There are common factors which may cause a woman to deliver rapidly. These factors include:

a. A multipara with relaxed pelvic or perineal floor muscles may have an extremely short period of expulsion.

b. A multipara with unusually strong, forceful contractions. Two to three powerful contractions may cause the baby to appear with considerable rapidity.

c. Inadequate warning of imminent birth due to absence of painful sensations during labor.