Maintaining a Healthful Body Weight

 Evaluate Your Body Weight

Various methods are available to help you determine whether or not you are currently maintaining a healthful body weight. Let’s review a few of these methods.

Determine Your Body Mass Index (BMI)

Body mass index (BMI or Quetelet’s index) is a commonly used index representing the ratio

of a person’s body weight to the square of his or her height .It is a way of seeing if your weight is appropriate for your height.  A person’s BMI can be calculated using the following equation:

                             BMI (kg/m2) = weight (kg)/height (m) 2    (Thompson et al, 2011)

BMI can also be calculated on the Internet using the BMI calculator found at www.nhlbisupport.com/bmi.

The actual calculation is your weight (in kilograms) divided by your height (in meters) squared but it's also easy to read on the chart

WHY IS BMI IMPORTANT?

BMI provides an important clue to a person’s overall health. Research studies show that a person’s risk for type 2 diabetes, high blood pressure, heart disease, and other diseases largely increases when BMI is above a value of 30. On the other hand, having a very low BMI, defined as a value below 18.5, is also associated with increased risk of health problems and death. . BMI can be divided into several categories and generally the higher your BMI, the greater your risk of a large range of medical problems.

BMI CATEGORIZATION
< 18.5	Underweight
18.5 to 24.9	Healthy
25 to 29.9	overweight *
30 to 34.9	grade 1 obesity
35 to 39.9	grade 2 obesity
>40	grade 3 (morbid obesity)

 Separate charts are available for children’s weight and heights.

LIMITATIONS OF BMI

 Calculating BMI can be very helpful in estimating our health risk, yet this method has a number of limitations that should be taken into consideration. BMI cannot tell us how much of a person’s body mass is composed of fat, nor can it give us an indication of where on the body excess fat is stored. A person’s age affects his or her BMI; BMI does not give a fair indication of overweight or obesity in people over the age of 65 years, as the BMI standards are based on data from younger people, and BMI does not accurately reflect the differential rates of bone and muscle loss in older people. BMI also cannot reflect differences in bone and muscle growth in children. Recent research indicates that BMI is more strongly associated with height in young people; thus, taller children are more likely to be identified as overweight or obese, even though they may not have higher levels of body fat. Inaccuracies can also occur if you're an athlete or very muscular as this can give you a higher BMI even though you have a healthy level of body fat and this BMI chart is not appropriate for women who are pregnant  or breast feeding  or people who are very frail.

As BMI is based on weight and height, by losing weight you will reduce your BMI and put yourself into a lower risk group. A healthy diet, including a balance of food groups, vitamins and minerals, is essential for a long and active life. Keeping it simple, body weight and shape are a balance of energy intake (dietary calorific content) against output (calorific burn from activity & exercise) (www.bbc.co,uk/health/treatments/healthy_living).

Many studies have shown that, to slowly and steadily lose weight, any diet which includes a healthy balance will work if you're motivated. Ideally a low fat, high fibre diet is best but low calorie diets, low-carb diets, meal replacement diets or simply reducing portion size will work as long as, at the end of the day, you're not taking in too much energy for your body’s particular needs. Generally, to lose 1lb /week you need to take in 500 calories less every day.

BY: NANA OFFEI BEKOE

HEART BURNS

HEART BURNS

    If someone should tell you he or she has been diagnosed of liver failure, you would know or at least guess that he or she has a problem with his or her liver. The same with a common disease like appendicitis -an inflammation of the appendix. On the contrary, if you should apply the same rule here you would be wrong. Heartburns is an exception to this rule, it has nothing to do with the heart. Absolutely nothing! Instead, it is a digestive problem.

    The oesophaegeal sphincter (a muscle in the throat that opens to allow food to enter the stomach and closes right after food has entered) may sometimes relax to allow stomach contents to escape into the oesophagus. The stomach content is acidic because it has been mixed with hydrochloric acid in the stomach. Due to its acidic nature, it burns the lining(mucosa) of the oesophagus. When this happens a heart burn is said to have occurred.

The name heart burns is derived because, both the heart and the oesophagus are found in the mediastinum (a body cavity that contains the heart, oesphagus, remains of the thymus and other structures). Thus, when the regurgitation of gastric contents occurs you would feel it around your sternum and you might think the burning sensations are coming from your heart but actually they are as a result of the irritation of the oesophagus with gastric acid.

   Now the question is, if the stomach produces the acid then why doesn't it burn the stomach as well. After all, the acid is being produced there? God in his own wisdom, made the stomach in such way that it can withstand the corrosive nature of gastric acid. The mucosa (lining) of the stomach has mucus secreting cells that produce a thick layer of mucus. This mucus protects the stomach walls from the corrosive nature of the hydrochloric acid.

        However, the oesophageal mucosa was not really made to withstand acid in the sense that even though it produces mucus it is not as thick as that of the stomach so when the reflux occurs it burns the oesophageal lining. Heart burns usually occur in pregnant women this is because in pregnant women, progesterone (a hormone produced by the ovaries) causes the lower oesophageal sphincter to relax making the woman more prone to heart burns.

       Occasional heart burns are common and normal but persistent ones may be  a symptom of any underling disease such as Gastro-Oesophageal Reflux Disease(GORD).Persistent heartburns can result in inflammation of the oesophagus-Oesophagitis. These conditions demand serious medical attention. Heart burns are usually experienced at night after the evening meal. You can use these simple and natural means to provide some relief if you do get a heart burn.

·       Prop yourself up with extra pillows at night instead of lying down flat on the bed.

·       Take sips of warm water and milk.

Some medical means include

·       Take some over-the-counter drugs like magnesium trisilicate, milk of magnesia.

 These are antacids that neutralize the gastric acid so that it can no longer irritate the lining if the reflux should occur.

You can also avoid a heart burn if you do the following:

·       Eat small quantities of food at frequent intervals instead of consuming much at once. It can trigger a reflux.

·       Limit intake of acidic or spicy foods

·       Avoid taking in greasy or fatty foods

·       Avoid carbonated or fizzy drinks like coca-cola.

·       Avoid bending over immediately after meals

·       Sit up for some minutes after meals.

·       Eat at least 2-3 hours before bedtime.

·       Avoid the intake of alcohol. It can also trigger a reflux.

   

                     References

·       Davidson's Principles & Practice Of Medicine, 20th Edition, Church Hill Livingstone. Elsivier.

·       Ojo O.A & Enang B.B(2006) A Textbook For Midwives I n The Tropics,2nd Edition, Jaypee Publications. New Delhi.

·       Hutchison's Clinical Methods, 22nd Edition, Saunders, Elsivier.

·       www.stopheartburntoday.com. Retrieved on 22^nd March, 2012

·       www.heartburnrelieftips.org. Retrieved on 22^nd March, 2012

BY: LOIS APPIAH

FIRST AID TIPS: WHAT DO YOU DO WHEN SOMEONE FAINTS?

FIRST AID TIPS IN TREATING A FAINTED PERSON

Marching on Independence Day for your school is like being chosen as an American Idol winner for most pupils in Ghana. However, as a teenager, even though I fancied marching, I never joined the school cadet because I was scared I would faint if I was chosen to march on Independence Day. I had heard stories of most pupils fainting on the parade grounds because they didn’t eat heavily enough. On the contrary, fainting has nothing to do with food! 

Ross and Wilson define fainting as a brief loss of consciousness. It happens as a result of a fall in the volume of blood supply to the brain cells and since the blood carries oxygen to the brain, the brain cells do not get sufficient oxygen to function effectively. Some people may faint at the sight of blood or upon receiving bad news. 

The causes of fainting are numerous and varied. Here are some of the commonest:

• ·         Emotional factors such as sudden severe pain, grief or fear.

• ·         Excessive loss of blood due to haemorrhages (bleeding).

• ·         Standing in the same position for a long time.

• ·         Shock.

• ·         In a hot, moist or stuffy environment.eg walking on a desert.

• ·         Abnormal heart rhythms (too fast or too slow). When it beats too fast it doesn’t take enough time to fill its chambers with enough blood thus less blood supply to the brain. On the other hand, if its too slow it takes too much time to fill thus the rate at which blood is supplied to the brain is slow.

• ·         Disease conditions of the heart. Example, people with conditions where a part of the heart muscle dies (myocardial infarction). The heart muscle cannot pump the blood effectively in such cases.

• ·         Postural hypotension also known as orthostatic hypotension. When you wake up quickly from bed after lying down for a long time. Force of gravity acts on the blood causing it to pool or gather in your legs so that there is less blood in the hands, chest and the head. This is normal but sometimes the drop in blood pressure becomes too much as the body is not able to act quickly enough to restore blood pressure, then postural or orthostatic hypotension occurs. Thus, a second factor is needed to trigger this mechanism such as pregnancy, disease or medication so that the fall in blood pressure is much lower than normal.

Often before fainting one would show the following signs, however, in patients with cardiac problems, they rather complain of chest pain.

• ·         The person turns pale and the lips become white.

• ·         The skin becomes cold and clammy.

• ·         Sweating around the mouth and on the forehead.

• ·         Rapid and shallow breathing.

• ·         Rapid and faint pulse.

• ·         The person sinks to the ground unconscious.

The objective in treating someone who has fainted is to improve blood supply to the brain and also improve oxygen supply. Here are a few measures to take in treating someone who faints.

If you notice the first four signs on time, let him lie on his back for about 10-15 minutes or preferably let him sit with his head in between his knees to enhance blood supply to the brain. Remember, you only do this when the person is still conscious or awake. You can even give him or her a cold drink.

Loosen any tight clothing around the neck, waist or chest to enhance blood supply and also to improve the free flow of air around the patient.

However, if the person is already unconscious, just loosen any tight clothing. Allow fresh air to circulate around the patient. You can do this by opening all windows if indoors, control bystanders who tend to crowd around the person making less room for fresh air or you can also fan him or her.

You can also raise the person’s limbs (legs) above the heart so blood would move quickly to the brain.

Turn the person to his or her side to drain any saliva or secretions out of the mouth because these tend to choke the individual and obstruct breathing.

 If the person sustains a head injury, bandage the site to control bleeding and transport to the hospital immediately for further investigations and treatment.

Never attempt to lift a person who just fainted back on his or her feet. Instead, allow the person to continue lying down. It’s an attempt by the body to move blood to the brain.

If the individual does not regain consciousness in a few minutes, transport him or her to the hospital at once.

If the cause of fainting is due to a cardiac problem, transport patient to the hospital immediately.

REFERENCES

·         Ross and Wilson. Foundations of Nursing and First Aid. 6^th Ed,Longman Group UK

·         www.medicinenet.com

·         www.medlineplus.com

·         www.emedicinehealth.com

BY: LOIS APPIAH

CONJUNCTIVITIS

CONJUNCTIVITIS

Conjunctivitis also called pink eye or madras eye refers to inflammation of the conjunctiva (the outermost layer of the eye and the inner surface of the eyelids). It is commonly due to an infection usually viral, but sometimes bacterial or an allergic condition.  Red eye (hyperaemia, irritation (chemosis) and watering (epiphora) of the eyes are symptoms common to all forms of conjunctivitis.

Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold and a sore throat. Its symptoms include watery discharge and variable itch. The infection usually begins with one eye, but may easily spread to the other.

Bacterial conjunctivitis due to common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, grayish or yellowish mucopurulent discharge that de may cause the lids to stick together, especially after sleep. Another symptom that could be caused by bacteria conjunctivitis is severe crusting of the infected eye and the surrounding skin. However, contrary to popular belief, discharge is not essential to the diagnosis. Bacteria such as chlamydia trachomatis or moraxella can cause a non-exudative but persistent conjunctivitis without much redness. The gritty and/or scratchy feeling is sometimes localized enough for patients to insist they have a foreign body in the eye. The more acute pyogenic infections can be painful. Like viral conjunctivitis it usually affects only one eye but may spead easily to the other eye. However, it is dormant in the eye for three days before the patient starts showing symptoms.

Chemical conjunctivitis is due to an eye injury caused by either an acidic or alkali substance getting in the eye. Mild burns will produce conjunctivitis while more severe burns may cause the cornea to turn white. Chemical conjunctivitis show primarily marked redness.

Conjunctivitis is most commonly caused by viral infection, but bacterial infections, allergies, other irritants and dryness are also common etiologies for its occurrence.  Both viral and bacterial infections are contagious. Commonly, conjunctiva infections are passed from person-to-person, but can also spread through contaminated objects or water.

A purulent discharge (a whitish-yellow or yellow-brown substance, more commonly suggests a cause from fecal matter unless there is known exposure to toxins. It can also be caused by bacteria from feces, pet   hair, or by smoke or other fumes. Infection with Neisseria gonorrhea should be suspected if the discharge is particularly thick and copious. Itching (rubbing eyes) is the hallmark symptom of allergic conjunctivitis. Other symptoms include past history of eczema, or asthma. A diffuse,” less” conjunctivitis (looking pink rather red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy. Many people who have conjunctivitis have trouble opening their eyes in the morning because of the dried mucus on their eyelids. There is often mucus on the eye after sleeping for an extended period.

Conjunctivitis resolves in 65% cases without treatment, within two to five days. For the allergic type, cool water poured over the face with the head inclined downward constricts capillaries, and artificial tears   sometimes relieve discomfort in mild cases. In more severe cases, nonsteroidal anti-inflammatory medications and antihistamines may be prescribed. Conjunctivitis may also require topical steroid drops.

Bacterial conjunctivitis usually resolves without treatment. Antibiotics, eye drops, or ointment are thus only needed if no improvement is observed after three days. In patients receiving no antibiotics, recovery was in 4.8 days, with immediate antibiotics it was 3.3 days and with delayed antibiotics 3.9 days.

There is no specific treatment for viral conjunctivitis. People are often advised to avoid touching their eyes or sharing towels and washcloths.

Conjunctivitis due to chemicals is treated via irrigation with Ringers lactate or saline solution(a sterile solution of sodium chloride in water). Chemical injuries (particularly alkali burns) are medical emergencies, as they can lead to severe scarring, and intraocular damage. People with chemically- induced conjunctivitis should not touch their eyes regardless of whether or not their hands are clean, as they run the risk of spreading the condition to another eye.                                

                                                                                                                                SOURCE : Wikipedia

BY: ABIGAIL GBEMU

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