World of Health

Diabetic ketoacidosis Treatment

Initial treatment of dehydration caused by diabetic ketoacidosis should be carried out with 0.9% NaCl solution at a rate of 1 to 2 L every hour during the first 2 hours. Treatment is urgent and must be installed immediately, and has two main objectives, the correction of dehydration and correction of hyperglycaemia.

Additionally, they should monitor and treat electrolyte deficits and eliminate or treat the underlying cause or predisposing factors. In general, the goal is to remove the patient from acidosis in up to 6 hours.  Correction of dehydration can be attempted by mouth if the patient is oriented and aware.

Unfortunately the vast majority of patients have some degree of impaired alertness (disorientation, drowsiness, stupor, coma), and in this case is formally contraindicated with oral fluids because of the risk of aspiration.

Fluid replacement is usually initiated with a hypotonic solution of 0.45% NaCl concentration, in order to manage water essentially “free”, restoring intravascular volume and correcting dehydration.

Gradually and according to the patient’s improvement, isotonic solutions can be alternated with NaCl 0.9%, continuing hydration and replenishing the lost sodium diuresis without causing an electrolyte imbalance.

The correction of hyperglycaemia is performed with the administration of insulin by injection. The dose depends on the route used and the method used, for example, using the intramuscular (IM) or subcutaneous (SC). Usually indicated by 0.1 IU / kg body weight as initial dose, split half intravenously (IV) and the other half by the method chosen (IM or SC).

When using only the intravenous route (more practical) an initial dose of 0.15 UIN / kg is given. In both cases treatment is with an insulin infusion at doses of 0.1 UIN / kg / h.  Intramuscular insulin is an alternative when there is a continuous infusion pump or when intravenous access is difficult, as in the case of children.

It is essential to remember that monitoring blood levels of glucose, serum electrolytes, blood pH and serum osmolality must be closely monitored, once every hour.  To avoid dosing errors, adjust the dose according to the evolution and preventing disorders such as dilutional hyponatremia-refund excess fluid, cerebral edema, by altering the osmolarity-or hypo-insulin overdose.

Besides the above, replacement should be considered if the potassium concentration is less than 3.3 mEq / L, and bicarbonate if the pH is less than 7.0, although none of these measures must be a priority to the restoration of fluid and treatment of hyperglycaemia.

Although the concentration of potassium in the blood appears to be physiological, every patient with diabetic ketoacidosis has a decrease in body potassium which may prove grave.  Potassium is administered only if the patient has good renal function and is not disclosed in the early hours because that the patient is receiving rapid rehydration.

If potassium in blood plasma is less than 3.3 MEG / L they are usually given 40 mEq of potassium in 24 hours. If serum potassium is between 3.3 and 5 mEq / L they are given between 20 and 30 mEq in 24 hours. These measures must be maintained to achieve a glucose concentration exceeding 200 to 250 mg / dL.  Once this is achieved, the rest of the therapy should be consistent with individual patient characteristics and evolution.

Vitamin E is a fat-soluble vitamin which is found primarily in foods such as natural oils, seeds, nuts and cereals. In additional to this, you can also take Vitamin E supplements in order to ensure you are consuming the right amount. The general Recommended Daily Allowance of Vitamin E is 3mg for women, 4mg for men.

There are several potential benefits of taking Vitamin e. These are namely; helping diabetics, preservation of eye health, and slowing down the aging process. Due to the fact that Vitamin E is an anti-oxidant, it destroys harmful molecules in the body (or free radicals) which can damage genetic material. The high anti-oxidant qualities of Vitamin E are exactly the reason that having enough Vitamin E can help sufferers of diabetes.

Diabetics can have low levels of anti-oxidants, so increasing these levels can reduce the risk of heart disease and other health complications. Vitamin E has also been linked with improving eye health, particularly macular degeneration (AMD) which is a common cause of blindness and uveitis. Vitamin E has been shown to work with zinc, beta-carotene and Vitamin C to combat these eye disorders.

Vitamin E is also a key anti-aging Vitamin; this is due again to its high level of anti-oxidants. It can be effective if applied directly to your skin, when taken as a supplement or in your diet (although, it may not always be easy to get the levels of Vitamin E which you need through your diet alone).

It is also Vitamin E’s anti-oxidants which give it its anti-aging qualities, this is also the reason it may help in reducing the appearance of scars and stretch marks. Finally, Vitamin E can help the body to use Vitamin K, which aids in the formation of red blood cells.

Being healthy is important to maintain, not only physical, but mental health too. A healthy lifestyle ensures a long, fulfilled life and all you need to do is follow these 5 simple rules.

1. Exercise is key to a healthy lifestyle. However, this should suit your lifestyle; if you don’t enjoy running, why run marathons? If yoga doesn’t appeal to you, why stretch yourself into crazy positions. Choose exercise that you enjoy, otherwise it’s totally pointless. Use walking your dog for an hour everyday or use a zumba class as your weekly social with your friends. There are fun ways to keep fit, promise.

2. Eat healthily. Make sure you eat a balanced diet; this includes making sure you get your vitamins, minerals, carbohydrates, essential fats and protein. Find new and interesting ways to get your 5-a-day into your daily meals, try adding blueberry’s to your cereal and lots of vegetables into your stir fry.

3. Do things that make you smile. Make sure you do something each day that you ˜want™ to do. Whether that be have half an hour to yourself to read a book or dance to your music with it turned up loud. It’s important for mental health to stay positive and to not let the everyday grind get you down.

4. Stay away from alcohol and cigarettes. Of course, this sounds harsher than it seems, but with cigarettes there are absolutely no benefits. They are linked lung cancer and a number of other health problems, not to mention making you smell, tainting your teeth and using up cash that could be spent on nicer things. With alcohol, make sure you drink in moderation. However, if meeting your friends for an after work drink makes you smile, then do it, just not every day.

5. Monitor your health. Make sure you know your body’s norms, so that if anything is slightly odd or strange you notice straight away. Even if it’s something as small as noticing your nails are weak or your skin’s dry. There are supplements and methods to fix these small body problems which you are able to obtain from http://www.hollandandbarrett.com/.

A new website, backed up by a hard hitting campaign, has been launched by 14 councils across the Yorkshire and Humber reasons in a unique bid to champion the roles that are played by children’s social workers, and to highlight the difficult but rewarding job that they do.

Children’s social workers across the country are currently have to deal with a record breaking number of cases, and in the Yorkshire and Humber region alone, they were called on to help and support over 74.000 children in 2010. The council has joined forces with another 14 to ensure that the standard of care that vulnerable children so badly need will continue to improve.

A video has been produced to promote the new website, and while there are no images in the video, the words projected on the screen, highlighting the kind of problems that children’s social workers deal with on a daily basis, are nevertheless heart wrenching.

We read about children left alone while their parents go abroad on holiday, a young an vulnerable girl who end up pregnant at 12, physical and mental abuse, neglect, it makes difficult reading but this is the reality of life when you are a children’s social worker, one of the hardest jobs in the world.

The campaign is operating under the banner of ‘Children’s Social Work Matters’ and is also a recruitment drive to attract more children’s social workers to the region, which is the largest region in the UK, and also to change the many misconception that exist about this vital service.

On the website you will be able to see real life stories told on video by some of the children’s social workers in the region, and they also explain how they manage to deal with both the complexities and the challenges that such a job entails. You will also get to meet the team of social work champions who will be dealing with online questions about the role they play and just what it takes to be a successful children’s social worker.

The Department for Health announced this week that the British population should ‘move more and eat less’ in order to tackle the rising obesity problem in Britain. This may sound like an obvious message to promote to the general public, however, the fact remains that we Brits have an ever expanding waistline and we don’t seem to take note of these vital messages!

The government’s biggest challenge will not be promoting public health messages and press releases but encouraging people to actually put its message into action. Most of us spend our working day sat down in front of a computer, with virtually no physical activity, and commute to and from work by car. This leaves us precious little time to fit the required level of activity that would help keep us at a healthy weight. We all know we should exercise more but, with limited time, it is often difficult to find the motivation.

The key to any successful and sustainable exercise regime is to make it part of your daily routine and make sure it is an activity you enjoy and do not find a chore; otherwise the novelty will soon wear off!  The local gym or a running club might be fine for those who take fitness seriously but, for others, the very thought of squeezing in to a tight lycra outfit and running on the treadmill next to a fitness fanatic is enough to bring them out in a cold sweat. Moreover, gym membership can be an expensive mistake, with most gym contracts tying you in for around £50 per month for 12 months. TGI data conducted a research study and found that only 27% of all gym members regularly go to the gym!

So what about dancing as a fun and active way of keeping fit? Regular viewers of BBC 1’s ‘Strictly Come Dancing’ will know that the professional dancers on the show are far from overweight and have extremely tightly toned physiques. The celebrity contestants on the show also seem to have taken advantage of the health benefits of dancing. All of the female stars from last year’s show radically changed body shape by slimming down and toning up. Pamela Stephenson said of the 2010 competition to the Daily Mail, ‘Strictly Come Dancing is the best fat club in the universe,’ after losing over two stone. Felicity Kendall and Patsy Kensit also slimmed down by two dress sizes. It is not just the women either; former Eastender Ricky Groves shed over two stone when he took part in 2009.

So which sort of dancing is a good choice? Latin dancing such as the Argentine Tango seems to have much better results than slower types of dance such as ballroom and swing. Tango is much more energetic with its fast paced movements. The high energy nature of the dance not only burns more calories and raises the heart rate; the bending, twisting and lunging moves of the Tango are fantastic for toning up legs and bums, as well as helping improve flexibility and posture.

The social nature of the tango with its group style dancing classes can make it an extremely fun way of keeping fit as well as being a social event as you can learn as a group with friends or make new friends at the Tango classes. This will keep you going back time and time again! The rhythmic nature of the music can be addictive, and further good news is that many Tango dancers also find it an extremely therapeutic way of also improving their general mental well being. This is because to dance the Tango successfully, the dance requires intense concentration to ensure mastering the quick footwork; meaning that you can completely focus and shut off from the stresses and strains of busy daily life.

A report published on Tuesday has indicated that a malaria vaccine will be partially successful in protecting children against the deadly disease. Bill Gates, the billionaire philanthropist who funded the research, described it as “a significant milestone in combatting the disease.”

Andrew Witty, the chief executive of GlaxoSmithKline has said about the vaccine, “This vaccine will half the risk in young children who are less than 17 months old. It is this kind of work that GSK is doing that shows we care about health problems in the developing world as well.”

While clinical trials have shown great promise for the vaccine, more research is needed before it is known exactly how effective it will be. It is estimated that malaria kills around 800,000 people every year. The World Health Organisation has said that this is a reduction on the near 1 million deaths that were occurring 10 years ago.

It was just five years ago when Mr Gates stated that his ultimate philanthropic goal was to eradicate malaria. He has invested over $1.75 billion in combatting the disease. He also stated that this is just the first vaccine that has been developed, a second-generation vaccine is already in the pipeline and this should be even more effective at preventing the spread of the disease via the malaria parasite.

There are many drugs on the market that are used to prevent malaria, but the sheer cost of these makes their use in developing countries impossible. A vaccine is a much more cost-effective way of preventing malaria, especially in the long term.

It has been shown that vaccines can be effective against parasites, as well as bacteria and viruses as was previously known. The vaccine works by causing an immune response in the body to the parasite.

It has been in development since the 1980s and $500 million has been spent by the US government, GSK and the Gates foundation combined. Mr Gates also commented, “It has been shown to have a long-term effect of protecting 50% of people. This has the potential to save thousands of lives.”

The cost of the vaccine is currently unknown, but GSK have said that they intend to sell it at 5% above the production costs. The company also said that the profits from the vaccine will be used to research other vaccines for malaria  and other neglected diseases. Discussions will soon begin between donor groups and the drug company.

The most severe form of malaria can kill and this vaccine was found to reduce the chance of developing this type of malaria by nearly 50%. This was only found to be in the one specific age group and outside of that it was less effective. For example in children between five and 17-months old the vaccine was only found to be effective in one third of cases.

Nicholas White a Bangkok-based physician has said, “This vaccine is an incredible achievement, but it is only partially effective. There are also some significant side-effects which occurred in the test groups. Those taking the vaccine were much more likely to develop meningitis.” There are also some other problems with the vaccine, one of these is the logistical problem that it has to be kept cold. This can be a problem when distributing the vaccine in Africa.

If the vaccine makes it to market and donor buyers can be found then Glaxo said that it will probably manufacture the vaccine in low cost countries such as India or Africa. However, until the company knows the demand for the vaccine, it won’t know how much to produce.

One of the best ways today of getting a message across is to release a hard hitting short video that is thought provoking, maybe slightly shocking but really gets the message across. Long used as a marketing medium, other ‘commodities’, such as charities, are also using videos to get their point across, and a new short video from Cancer Research UK certainly pulls no punches.

This animation deals with something most of us have, belly fat, aka a spare tyre. Most of us think nothing of it, despite moaning occasionally the majority of us have a flab on our bellies than any other part of out bodies. These fat cells are far from innocent though, as this video explains.

These seemingly innocent fat cells quickly turn into something called ‘active fat’ which can be very dangerous and the cause of such diseases as cancer, type 2diabetes and heart disease. Three leading health charities have got together to tell us how to beat these vicious active fat cells and this is the first video in a series.

The first step is to get an accurate waist measurement, and it explains exactly how to do this as many of us are confused as to where we should actually measuring. The video tells us that your waist should be measured between the bottom rib and the hip to achieve the most accurate measurement.

It also gives the website address www.activefat.org to check where our waist measurements place us in terms of health, and there are also lots of other help and advice on there regarding fighting back against active belly fat. This is video isn’t pretty, and its not meant to be, as it gets across the message of the possible results of carrying around this belly fat and not doing anything about it.

You may not have had to undergo a blood transfusion yourself, but the majority of us know someone who has at some time had to be given blood as the result of an illness, accident or during surgery. While most think that somewhere deep in the bowels of a hospital there is a never ending supply of blood waiting to be used, this is far from reality.

Yes hospitals have a store, but how do they get extra or rare blood if there is an emergency situation? The answer is through a nationwide team of volunteers who run ‘blood bikes’. These are ordinary people who volunteer in their own time, mainly during the night, to collect and deliver blood wherever and whenever it is needed. They pay for all their own fuel too, thus costing the NHS nothing for this vital service.

A new video has been released showing one of these volunteers. Explains that when the call comes they have no idea who the patient is, or what is wrong with them, they simply jump on their bikes and get the blood from A to B as quickly as possible. The guy in the video tells how he mainly rides at night, and how it feels, at times, to be the only vehicle on the A1 motorway in the middle of the night while everyone sleeps.

The video is sponsored by Honda as this particular ‘blood biker’ uses a Honda as his work bike, due to their speed and reliability. This is an incredibly thought provoking insight into a group of people that many don’t even realise exist. This is true charity work as they get nothing from it except the knowledge that they could have saved another life. After watching this video, you will think very differently about blood supplies to hospitals.

Insulin resistance syndrome is defined as a reduced response of cells of the human body to the hormone insulin.  Above all, the muscles, liver and fat tissue are less sensitive to the hormone insulin.

The concept of insulin resistance has been around since the 1960’s.  It was felt that the pancreas could distribute up to 200 units of insulin and was defined as “severe insulin resistance,” an insulin requirement of more than 200 IU over several days to reach normal blood glucose levels.  Although it is now clear that a normal physiological insulin production is from 20 to 40 units, this old definition is further considered appropriate to differentiate so that patients with severe, unusual insulin have no resistance problems.  Since 1985, the term has a broader scope and refers to a reduced response of cells of the human or animal body to insulin.

Insulin resistance during the day is highest in the early morning.  There is often late in the afternoon a second, less high increase in insulin resistance.

Causes

Insulin resistance is the main cause of type 2 diabetes. The exact mechanisms that lead to insulin resistance in humans are currently poorly understood, but are under intense research.  In this context, and in addition to polygenic predisposition, a number of secondary environmental factors are discussed. These include obesity, metabolic factors, age and lack of physical activity.

Not all scientists see the influence of carbohydrate-rich foods with a high glycemic index as a factor.  The insulin resistance of type 2 diabetic patients is caused primarily by obesity and physical inactivity.  Genetic factors are also a cause.  In people the same age, same sex, same body weight and size, with the same caloric intake and physical activity, they can still have a different effect of insulin on the target cells. These differences are probably due to hereditary factors. Insulin resistance may also be increased by drugs.  Infectious diseases may increase insulin resistance.

Mechanisms of insulin resistance

Insulin resistancy is increased by reducing the number of receptors with permanently elevated levels of insulin by IgG antibodies, which inhibit the biological activity of the insulin increased by enzymatic cleavage of insulin and decreased binding of insulin to its receptors.  There are proteins:  Tumour necrosis factor alpha (TNF-alpha); Plasminogen activator inhibitor I (PAI-1) and Resistin.

Determine the insulin resistance

A first indication of the presence of insulin resistance is the body weight.  In all obese diabetics insulin resistance is assumed.  It is now thought that especially the fat in the abdominal area distributes more substances which promote and strengthen resistance to insulin.

Waist circumference is a measure of supposedly dangerous abdominal fat, and body mass index (BMI), which has starting values of 27 kg/m2, together with an indication of familial predisposition to insulin tolerance.  Furthermore, the blood lipid level (triglyceride levels above 2.44 mmol / l or can 215 mg / dL can be an indication of insulin resistance.

Proinsulin

In the production of insulin, the pancreas is first a precursor molecule – the so-called proinsulin and is synthesized. This is again split.  It then creates the actual hormone insulin, and an ineffective waste product, the C-peptide.  In the context of insulin resistance there is more and more insulin, while disproportionately makes a lot of proinsulin. The latter is split into insufficient insulin and can be higher than that which is detected in the blood.

Therapy

The insulin resistance in type 2 diabetics is best broken up by a strong reduction in caloric intake and by increasing physical activity.  Even a short-term increase in insulin delivery to very high doses is needed in order to force a normnahe glycemic control, breaking through after a few days and insulin resistance, as seen by the much lower dose of insulin is necessary after the treatment. Insulin resistance may also be reduced by drugs: Acarbose; Metformin; Insulin sensitizers such as pioglitazone; Omega-3 fatty acids; ACE inhibitors and Rimonabant.

Insulin resistance and other diseases

Metabolic syndrome is closely associated with insulin resistance, because both diseases have the same origin.  Furthermore, Type-2 diabetes, which develops from insulin resistance, is a risk factor for the emergence of the metabolic syndrome.  Coming to obesity, when two other risk factors – diabetes, lipid disorders and hypertension are added, it is called metabolic syndrome. The metabolic syndrome is the main cause of heart attacks and strokes – the number 1 cause of death in The UK.

With the current financial climate you might have expected that the last thing people want to spend their money on is cosmetic surgery, but you would be wrong.

Figure released by the British Association of Aesthetic Plastic Surgeons (BAAPS) at the beginning of the year revealed that the uptake for a number of sol-called vanity procedures is on the rise, with Breast Enlargement surgeries up more than 10 per cent on the previous year and the number of eyelid lifts carried out increasing by seven percent.

So what is it that drives our hunger for these procedures – and why are more and more women putting themselves through the pain of surgery in pursuit of the perfect appearance?

Plastic Surgery Motivation

Some experts argues that the motivation behind plastic surgeries is on that is serious and psychological with women who are bothered by a physical imperfection suffering a lack of confidence as a result – but the truth is that not all surgeries can be down to debilitating confidence issues, otherwise even more procedures would be authorised on the public purse.

Many of the women who are going under the knife are doing so simply because they can, because, given the option between a pert bust and one that belies the children they have born and life they have lived, they are choosing the better looking breasts.

Would they suffer terribly if they did not undergo the procedure? In many cases no, however in a society that tells us we can have whatever we want as long as we can pay for it, surgically enhanced assets are just another consumable.

And it is not all about perfection either – women are seeking the advice and intervention of plastic surgeons, not simply because they believe their natural attributes are under par or unattractive, but because they feel they do not fit in with the latest physical fashions.

Buttock implants, for example, have seen a rise in popularity as the fashion for a particular size and shape of posterior become prevalent, with women who are already sporting perfectly fine behinds seeking a boost in order to be able to fill out  and look their best in the latest styles.

Tips for Those Considering Cosmetic Surgery

Whether it is confidence or preference that motivates women to seek out the help of a cosmetic consultant there are a number of things that any woman considering a surgical procedure should take into account before committing to surgery. Steps that should be followed include:

• Finding a BAAPS approved surgeon and practice
• Researching the procedures, possible complications and long term maintenance of any surgical procedure – you may be able to afford it today, but can you afford to keep it maintained in the long term?
• Seeking a consultation with a qualified practitioner rather than just a salesperson before consenting to be cut.
• Researching the chosen surgeon’s track record, asking for contacts of previous patients willing the share their experience.

No one considering a cosmetic surgery should feel pressurised into committing and all potential patients should take time to consider the pros and cons before signing that consent form.