Glucosamine Chondroitin for Osteoarthritis

What are glucosamine and chondroitin?

Glucosamine and chondroitin sulfate are compounds that are thought to have a protective effect on the cartilage, as well as to help manage osteoarthritis, particularly of the knee. Currently there are still many controversies around the effectiveness glucosamine and chondroitin sulfate in actually preventing the degeneration of joint cartilage. In Europe, glucosamine is a prescription drug with a standardized formula. In the United States and some parts of Asia, glucosamine is sold over-the-counter as dietary supplements.

Both glucosamine and chondroitin sulfate are found in normal joint cartilage and synovial fluid. Researchers proposed that glucosamine may stimulate production of cartilage-building proteins. Glucosamine in supplements is extracted from animal tissues such as crab, lobster or shellfish and marketed as glucosamine sulfate or glucosamine hydrochloride. They are considered to be equally effective, but the hydrochloride form is absorbed more easily by the body and can be taken in lower dosage than glucosamine sulfate.

Chondroitin sulfate is part of a protein molecule that maintains cartilage elasticity and is also thought to have an anti-inflammatory effect. Chondroitin sulfate in supplements is extracted from animal cartilage such as trachea or shark cartilage.

Do glucosamine and chondroitin really work for osteoarthritis?

In reality, some studies have found that either glucosamine or chondroitin sulfate given together or separately may relieve osteoarthritis pain with fewer side effects than conventional arthritis drugs. However, there are also studies that have shown no benefit. Although currently positive reports outnumbered negative ones, the negative ones have been larger and better designed.

The largest clinical trial that studies the effect of glucosamine and chodroitin sulfate is the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT), which is funded by the National Institutes of Health. In 2006, the researchers reported that glucosamine and chondroitin, alone or together, did not reduce osteoarthritis knee pain more effectively than a placebo. Follow up reports from this study also failed to show any promising result.

However, despite this discouraging result many people who take glucosamine and chondroitin sulfate supplements did report subjective reduction in arthritis pain. There are preliminary reports that suggest addition of vitamin C, bromelain, or manganese may enhance the effectiveness of glucosamine and chondroitin sulfate. And because these supplements are thought to have very few side effects, people keep taking them anyway.

Be wise if you decide to take glucosamine and chondroitin supplement.

Severe form of osteoarthritis may require surgery.

So, what to do? If you decide to try glucosamine and chondroitin sulfate supplements after all, give it three months time to evaluate their efficacy. The typical initial dose is 1500 mg of glucosamine and 1200 of chondroitin daily for 6 to 8 weeks. If a response is obtained, the dose can be reduced to 1000 mg of glucosamine and 800 of chondroitin or less. If you feel there is no change in symptoms after three months, these supplements should be discontinued.

If your symptoms are severe, you should stay on your usual arthritis medications even while you are taking glucosamine and chondroitin. As always, consult your physician before taking any form of supplements. Common side effects include stomach upset, gas, soft stools, drowsiness, headache, racing heart, and skin reactions. Patients with diabetes should pay extra caution because glucosamine is an amino sugar that may affect blood sugar levels. Also, because these supplements contain shellfish and other possible allergens, watch out for allergy symptoms.

Tips For Choosing Supplements

Most people in the United States take one or more supplements either regularly or occasionally. Dietary supplements come in forms of vitamins, minerals, antioxidants, enzymes, herbal products, and many others. The preparation can be a tablets, capsules, soft gels, powders, and liquid. Because there are so many varieties out there, choosing the right kind of supplement may be challenging. Here are a few basic tips to consider before you decided to start consuming one.

Do some preliminary background check

Research the benefits and possible side effects of the particular compound you’re planning to take. Always consult a health care professional beforehand. Dietary supplements are products intended to supplement the diet. They are not drugs and, therefore, are not intended to diagnose, treat, cure, or prevent any diseases. Do not believe whatever claims the manufacturer made before doing some research of your own. Some supplements promise to help make us thinner, smarter, stronger or faster without making any other changes in lifestyle. If it sounds too good to be true, it probably is.

Consider the effectiveness of the supplement

Find out how much you need to consume in order to bring out the health benefits for your body without risking the side effects. Many popular products include ingredients in miniscule quantities, just so a much-publicized ingredient can be listed on the label, or vice versa, they include a very high amount of a particular ingredient while in reality our body only needs a minuscule amount. A good, but not perfect guide is to look up the recommended daily allowances (RDA) of that product. However, keep in mind that a product’s chemical formulation and how it is prepared affect how our body is able to take in the ingredients. This is called bioavailability. A high-dosed product, but low bioavailability is not very effective.

Soft capsules generally have a better bioavailabilty than traditional tablets.

Be aware of safety and risk issues

The term ‘natural’ doesn't always mean safe. Many supplements contain active ingredients that can have strong effects in the body. Always be alert to the possibility of unexpected side effects, especially when taking a new product. Dietary supplements can also interact with certain prescription drugs in ways that might cause problems. Watch out for other catch phrases like ‘clinically tested/proven’ and ‘pharmaceutical strength’. Unlike drugs, which must be approved by the FDA before they can be marketed, dietary supplements do not require premarket review or approval by the FDA and the manufacturers do not have to provide any evidence about the claims they made before the product is marketed.

Look for quality assurance

Since the quality of nutritional supplements can vary widely, one strategy is to choose an established brand name, or one that's recommended by a health professional. Not every product uses high quality raw materials, or is manufactured according to accepted good manufacturing practices. Besides the FDA, several independent organizations like U.S. Pharmacopeia, ConsumerLab.com, and NSF International offer quality testing and allow products that pass these tests to display their seals of approval. These seals of approval provide assurance that the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants.

Deep Venous Thrombosis

What is deep venous thrombosis?

Being physically active prevents deep venous thrombosis.

Blood clots can form inside our veins both superficial and deep. If the superficial veins are affected, the condition is called superficial thrombophlebitis which rarely causes any problems. Deep vein thrombosis (DVT) is a condition in which a blood clot (thrombus) forms in a deep vein, usually in the legs. The clots in deep veins are dangerous because they can break loose and travel through the bloodstream to the lungs. Pulmonary embolism (PE) is a life threatening condition where a blood clot blocks the blood flow to the lung.

What are the risk factors to develop deep venous thrombosis?

In the United States around 350.000 to 600.000 people got deep vein thrombosis or pulmonary embolism each year. DVT can affect any person of any age, but the condition tends to happen in the elderly and in people with risk factors, such as:

• Long periods of inactivity such as sitting when traveling by plane or car or being in prolonged bed rest status. If your legs remain, your calf muscles don't contract to help blood circulate, which makes it easier for blood clots to develop.
• Injury or surgery can disturb your blood flow. The general anesthetics used in surgery can widened your veins and makes it easier for blood to pool together and form clots.
• Inheriting a blood clotting disorder
• Pregnancy increases the pressure inside the veins. The increased risk for clot formation continues until 6 weeks after giving birth.
• Cancer and its treatment increase the chance for blood clot formation.
• Birth control pills or hormonal replacement therapy
• Smoking
• Obesity
• Medical procedures that place a catheter or a pace maker through your veins
• A past history and/or a family history of DVT or PE
• Other medical condition such as inflammatory bowel diseases and heart failure

What are the symptoms of deep venous thrombosis?

In about half of all cases, DVT occurs without any noticeable symptoms. When symptoms do occur, they can include swelling, pain, warmth, and changes in skin colors on the affected leg, including in the ankle and foot.

When pulmonary embolism is about to develop, the warning symptoms usually include shortness of breath, chest pain or discomfort, feeling faint or dizzy, rapid pulse, sweating, coughing up blood, and feeling anxious or nervous. If you experience any of these, immediately seek medical assistance.

How to treat and prevent deep venous thrombosis?

Your doctor may perform ultrasonography on your legs, run some blood test, and get a chest x-ray or to help with the diagnosis. Immediate treatment involves blood thinners like heparin and warfarin to prevent the blood clots from growing. You will need to continue taking these medications for at least 3 months. In rare cases, a vena cava filter may be used to filter the blood that returns to the heart and prevent the blood clots to travel into the lungs.

To prevent DVT, move your legs often during long trips and in other situation which you are required to sit or lie down for long periods of time. On long flights, walk up and down the aisle hourly, flex and point your feet every 20 minutes while sitting, and drink plenty of water. Pressure stockings are also helpful to reduce the chance of getting blood clots.

Going Somewhere? Basics of Travelers' Health

Nobody wants to fall sick or get hurt during a trip, but sometimes these things happen. You may not be able to prevent every illness or injury, but you can plan ahead to be able to deal with them. Here's a bit of information to keep in mind whenever you're planning for a travel, especially international ones, in order to ensure a safer, healthier and more enjoyable experience.

Learn about your destination

The Centers for Disease Control and Prevention (CDC) provides health-related information on destination countries which includes disease outbreaks, natural disasters, and other events. Besides the information provided by the CDC, you should also gather as many details as possible about your specific destination. Take into consideration the modes of travel, lodging, food, and activities during your trip.

Seek travel health advice from your physician or travel medicine provider

Ideally, set up a visit 4-6 weeks before your trip because you may need some vaccinations that may take some time in order to be effective. Besides giving required immunizations, during the pre-travel visit, your doctor may recommend some medications to prevent specific diseases (such as antimalaria drugs) and give specific health advice for preventing and treating travelers’ diarrhea and other illnesses.

Consider your health status.

Avoid traveling when you're sick, especially if you have contracted a communicable disease. If you have a chronic medical condition or are taking medications, consult your regular physician for travel advices and be sure to pack enough medications for the duration of your travel. Travelers with infant or young children, those who are pregnant or breastfeeding, and people with weakened immune system may need extra care during their travel.

Know your vaccinations.

CDC divides vaccines for travel into three categories: routine, recommended, and required. Routine vaccinations protects you from diseases that may still be common in other parts of the world even though they rarely occur in your country of origin. Recommended vaccinations are given depending on your destination, whether you will be spending time in rural areas, the season of the year, your age, health status, and previous immunizations. The only required vaccinations are the yellow fever vaccination for travel to certain countries in sub-Saharan Africa and tropical South America and the meningococcal vaccination for travel to Saudi Arabia during the Hajj.

Prepare your personal travel health kit.

Generally in addition to personal medication, a good travel health kit contains:

• Basic medications for fever (acetaminophen or ibuprofen), diarrhea or stomach upsets (loperamide, oral rehydration packs, antacids), respiratory illness (antihistamines, cough preparation), anti-motion sickness medication, and anti allergic medications.
• Basic first aid and wound treatment kit
• Insect repellent
• Sunscreen
• Alcohol-based hand cleaner
• Contact card containing information about remaining family member or close contact in the country of origin, place of lodging, embassy contact number, and other emergency information.

Pay attention to your health during your trip and after you come back home.

Try not to take risks with your health and safety. Be careful about food and water. Wear proper protection such as insect repellants, sunscreen, protective clothing and gears during your travel. Some diseases like malaria and tuberculosis may have a long incubation time and symptoms can occur after you have returned to your home country. So pay attention to any suspicions health related complaints even after you got back.

Eczema: The Grab Bag Diagnosis For Skin Diseases

What is eczema?

Eczema or dermatitis is often used as the grab bag diagnosis for skin disorder. If the skin lesion is red and you can't think of anything else that's causing it, put it under eczema or dermatitis until proven otherwise. That shows how wide the range of symptoms is. The term is broadly applied to a family of skin conditions that causes inflammation to the skin that may result in redness, swelling, itchiness, dryness, crusting, blistering, oozing, or even bleeding. It is a chronic non contagious condition that may flare-up periodically and then subside for a time.

The most common form of eczema is atopic dermatitis. It usually affect infants as early as age 2 to 6 months. According to American Academy of Dermatology, most (90%) of people develop atopic dermatitis by age 5 years. Many people outgrow the condition, but some cases persist until adulthood.

People with atopic dermatitis may have other allergic related conditions such as asthma or hay fever.

The term 'atopic' refers to an allergic tendency of this condition. People with atopic dermatitis may have other allergic related conditions such as asthma or hay fever. The exact cause is unknown, but it's likely due to a combination of malfunctioning immune system, skin irritability, and environmental factors. Stress, dry air, viral illness like common cold or the flu, sudden weather changes, chemicals in cosmetics, fragrances, or soap, skin contact with rough materials like wool, contact with common allergens like pollen, pet dander, or dust mites, long hot baths, and excessive sweating may trigger flare-ups.

What are the symptoms of eczema?

Atopic dermatitis may affect any area of your skin, but it usually appears on the hands and feet, and in bending areas such as inside the elbows and behind the knees. In young children, it may affect the face (including the eyelids), the scalp, neck, and upper chest. It tends to flare periodically and then subside.

Signs and symptoms of atopic dermatitis may include:

• Itching, which may be severe, especially at night. Often times, scratching the rashes can make it even itchier, causing an itch-scratch cycle that's difficult to break.
• Oozing or crusting blisters, especially in young children.
• Red to brownish patches, usually in older children or adultsThickened, cracked or scaly leather-like skin which occur after long periods of irritation
• Raw, sensitive skin from scratching

What is the treatment?

Early treatment will keep atopic dermatitis from worsening. The more severe it becomes, the more difficult it is to control. Treatment plan aims to reduce inflammation, relieve itching and prevent future flare-ups. In mild cases, over-the-counter anti-itch creams and other self care measures such as avoid scratching and keeping the skin moist with moisturizer or air humidifier may help control the symptoms.

In moderate to severe cases, prescribed medications like topical or oral corticosteroids, oral antihistamines, and antibiotics. Immunomodulators and phototherapy may be given in very severe cases that do not respond to other forms of treatment.

Common Skin Problems

The skin is our body's largest organ. Changes in skin appearance may be caused by something as minor as acne or they can signal a more serious underlying condition. Rashes, strange spots, itchiness, and other changes in texture and color may be the result of infection, allergic reaction, or other chronic skin disorder. Listed below are some common adult skin problems at a glance. Incidence varies depending on your age and other factors like skin types, racial background, and occupation.

1. Acne

Around 80% of Americans will have acne at some point in their lives. Incidence in both men and women peaks in the teenage years is because of hormonal influence. Acne is the most common skin condition especially in young adult, but it's usually the least severe.

Acne is a skin condition that causes pimples which occurs when the tiny pores on the surface of the skin become clogged. When glands produce too much oil, the skin pores can become blocked and dirt, bacteria, and cells build up. Acne may come in many forms such as whiteheads, blackheads, papules, pustules, or nodular and cystic acne which may leave scars. The most common locations affected are the face, neck, shoulders, chest and back.

2. Eczema

Eczema or dermatitis is a term used to describe a group of conditions where skin is inflamed, red, dry, and itchy. It is a chronic noncontagious condition that may come and go over time. The exact cause is unknown, but stress, allergens, chemical irritants like soap or cosmetics, and weather changes can trigger flare-ups.

There are three types of dermatitis: atopic dermatitic, allergic contact dermatitis, and nummular dermatitis. Atopic dermatitis is usually seen in children and many people outgrow it by adulthood. In adult, it often occurs on the hands and feet, and in bending areas such as inside the elbows and behind the knees. Allergic contact dermatitis usually starts in adulthood and is related to allergens in fragrances, cosmetics, or metallic elements. Nummular dermatitis is a condition in which itchy, coin-shaped spots or patches appear on the skin. It usually affects elderly men.

3. Moles

Moles or nevi are very common. Almost every adult, especially people with light skin, has a few moles that generally appears in teenage years until the middle ages. A number of 10 to 40 moles is normal. Moles can grow anywhere on the body in form of black or brown spots. Some moles may undergone changes in size and colors over the years. While most are harmless, some moles have a higher risk of becoming cancerous. If a mole starts to grow, itch, or bleed, make an appointment to see a dermatologist and have it evaluated.

4. Hives

Also known as urticaria, hives are raised, often itchy, red welts (wheals) on the surface of the skin. They are usually an allergic reaction to foods, medicines, temperature changes, and bacterial or viral infections. Hives may appear anywhere on the body varying in sizes and may last from minutes to days. They are generally harmless and disappear on their own, but a small number of cases can develop into severe allergic reaction called anaphylaxis. Seek emergency help if your hives are accompanied by tongue or face swelling and shortness of breath.

5. Psoriasis

Psoriasis causes skin rashes and irritation with thick red plaques covered with white or silvery scales. The condition usually begins between ages 15 to 35 and may come and go throughout life. It usually affects the elbows, knees, and lower back. Certain forms affect particular areas like the hands, scalp or the joints. Psoriarsis is non contagious and the exact cause is unknown. However, the immune system seems to play an important part in the development of this disease and it is now proposed that psoriasis is an autoimmune disorder.

6. Warts

Warts are small, usually painless growths on the skin caused by a virus called human papillomavirus (HPV). Common warts usually appear on the fingers or hands. They usually do not cause pain unless they are repeated rubbed against. Warts spread from person to person or via direct contact or indirectly through things used by a person with the virus. In most cases, warts are harmless, painless, and go away on their own.

7. Shingles 

Shingles or herpes zoster is a painful, blistering skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. It usually starts with burning, tingling, or painful rash which develop into blisters that last about two to three weeks. Shingles may develop in any age group, but elderly people and those with weakened immune system are at higher risk. It can appear anywhere, but often affects the trunk, buttocks, or the face. Most people recover, but sometimes the pain in the area where the shingles occurred may last from months to years.

The Benefits of Antioxidants

What is an antioxidant?

Antioxidant is a molecule that inhibits the oxidation of other molecules, preventing the production of free radicals. Free radicals are produced when our body breaks down food, or by environmental exposures like tobacco smoke and radiation. They can start a chain reaction that eventually damage cells, and may play a role in the aging process, development of heart disease, cancer, Alzheimer's, Parkinson's, and other degenerative diseases.

What are the sources of antioxidants?

Plants and animals can produce its own antioxidants or obtain them from food. Examples of antioxidants are gluthatione, beta-carotene, flavonoids, vitamin A, vitamin C, vitamin E, selenium, lutein, lycopene, coenzyme Q10, and enzymes like superoxide dismutase, catalase, and peroxidases. Antioxidant are also available as food supplements, but these synthetic forms may not have the same effects on the body as antioxidants that occur naturally in foods.

Listed below are a few examples of antioxidants and their natural sources:

• Beta-carotene is found in colorful fruits and vegetables such as carrots, peas, cantaloupe, apricots, papayas, mangoes, peaches, pumpkin, apricots, broccoli, sweet potatoes and squash. It can also be found in some leafy green vegetables, including beet greens, spinach and kale.
• Vitamin A is found in milk, liver, butter and eggs.
• Vitamin C is found in most fruits and vegetables such as oranges, papayas, strawberries, cantaloupe and kiwi.
• Vitamin E is found in wheat germ and vegetable oil, cereal, liver, eggs yolk, green plants, milk, and.some nuts and seeds, including almonds, sunflower seeds, hazelnuts and peanuts.
• Lutein is found in green leafy vegetables, such as spinach, collards and kale, broccoli, corn, peas, papayas and oranges.
• Lycopene is found in pink and red fruits and vegetables, such as tomatoes, pink grapefruit, watermelon, and apricots.
• Selenium is found in tuna, cold water fish (cod, halibut, salmon), turkey, calf liver, barley, garlic, broccoli, and seeds. Brazilian nuts have especially high selenium content.

How does antioxidant benefit your health?

Antioxidants benefit your health by cleaning free radicals out of your bloodstream. Different antioxidants benefit act on different parts of the body. Beta-carotene found maintain eye health and may prevent age related macular degeneration, lycopene can contribute to prostate health, while flavonoids are good for your heart.

Before you decide to start taking antioxidants supplements, remember these supplements are not a replacement for healthy diet or conventional medical care. The best sources of antioxidants are from natural products. A varied diet containing at least 5 servings of fruits and 6-11 servings of grains, including at least 3 servings of whole grains per day will provide you with enough antioxidants to keep oxidative stress away. Be sure to consult your physician before you start taking supplements. High levels of some nutrients, such as vitamins A, vitamin E, or selenium can be harmful for your health.

Beware of Fad Diet Plans - Get Realistic

What is fad diet?

The phrase fad diet, was originally used to refer any eating plans that promote short term weight loss. Food fad or fad diet is a term of popular media, not science. These diet plans claim to be scientific but do not follow the scientific method in establishing their validity. Some of them were downright telling you to starve yourself.

No matter how good it sounds, a diet plan that consists solely of bananas, is not feasible.

The fact is, no one (even the models who are used to advertise these diet plans) is able to stay on these deprivation diet for long periods of time. Even if you did lose some weight, you won't stay that way once you get back to your regular eating pattern. Fad diet plans typically don't result in long-term weight loss and they are usually not very healthy. In fact, some of them might actually be dangerous to your health.

How to identify fad diet plans?

Fad diet usually focuses on a single dietary element such as cabbage or grapefruit. In 1974, the term was defined as three categories of food fads.

• A particular food or food group is exaggerated and proclaimed to cure specific diseases.
• Certain type of foods or food element (fat, carbohydrate, or protein) are eliminated from because they are viewed as harmful.
• An emphasis is placed on eating certain foods to express a particular lifestyle.

Examples of these fad diets are the cabbage soup diet, fruitarianism, the grapefruit diet, fat free diet, and many others.

Why shouldn't you follow these diet plans?

A balanced diet is important, unless you have a medical condition like liver or kidney disease that demands protein restriction. You can't just simply eliminate one of the major elements from your diet and expect there won't be any consequence. For example, if you eliminate fat from your diet and replace it with protein, you'll risk getting a condition called ketoacidosis which can lead to loss of consciousness.

Some fad diet plans claim that you can lose weight without having to exercise. This is a very misleading notion because without studies have shown that people who exercise regularly are more likely to lose and keep weight off. Any diet plan that tells you that you can lose weight without exercise is only telling you what you want to hear, but not the truth. There's no easy way to get your way around and skip exercise.

"Fad diet plans don't result in long-term weight loss and they are usually not very healthy."

Even though the principle of weight loss is to cut down calories, the quality of the food you eat do matter. If you only stick to one type of food for long periods of time, you'll lose other important nutrients like vitamins and minerals even if you actually get enough calories to fulfill your daily need.

The worst thing about fad diets is the emotional consequences they have on those who fail when trying to follow them. Those who start the diet expect that they are going to lose weight quickly and be able to stick with it. Someone who has tried several different diets without success feels like a failure. Unfortunately dieters tend to blame themselves for the failure, rather than recognizing that the diets they were attempting were unrealistic and impossible to stick with in the long term. Before starting a diet, be sure to assess what you expect and whether that is a realistic expectation.

Panic Attack? Keep Calm and Read On

What is a panic attack and panic disorder?

A panic attack is an episode of sudden, intense fear that happens when there is no real danger or apparent cause. It usually lasts for more than 10 minutes and is accompanied with severe physical reactions such as profuse sweating, difficulty breathing, rapid pulse or heart beat, feeling faint, choking, or smothering, trembling, nausea or vomiting, and the subjective feeling of losing control, dying, or going crazy.

"During a panic attack, the fear response is out of proportion for the situation."

an episode of sudden, intense fear when there is no real danger

Panic disorder is a type of anxiety disorder that affects over 2.4 million people in the United States. One out of 75 person may experience a panic attack in their lifetime. It usually begins during the late teens or early adulthood and women are twice more likely to be affected. Most people experience only one or two attacks in their lifetime and the problem usually goes away when a stressful situation ends. However, if you've had recurrent panic attacks and spent long periods in constant fear of another attack, you may be suffering from panic disorder.

The exact cause of panic disorder is unclear, but there is evidence of genetic predisposition and connection with major stress related to life transitions (graduating from college, marriage, or death of a loved one). Drug and alcohol abuse and certain personality types also predispose a person into having a panic disorder.

Diagnosis

Not everyone who has panic attacks has a panic disorder. To be diagnosed with panic disorder, you must meet these criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association:

• Frequent, unexpected panic attacks.
• At least one of the attacks has been followed by one month or more of ongoing worry about having another attack; ongoing fear of the consequences of an attack, such as losing control, having a heart attack or 'going crazy' or significantly changing your behavior, such as avoiding situations that you think may trigger a panic attack.
• The panic attacks are not caused by substance abuse, a medical condition or another mental health condition, such as social phobia or obsessive compulsive disorder.

The major difference between panic disorder and normal fear is that the disorder strikes without warning or a clear reason behind it. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening. After the attack is over, the person may develop persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur.

How to manage?

Management of panic disorder consists of a combination psychotherapy, anti depressant or anti anxiety medications, and behavioral therapy. In addition, relaxation techniques such as breathing techniques and positive visualization, may help a person during an attack. With appropriate treatment, nearly 90% of people with panic disorder can find relief.

Healthy Computing Habit

If you're feeling aches and pain in your neck or lower back after working in front of the computer, you might want to review your computer habits. Following these simple suggestions for healthy computing might prevent you from developing serious medical problem caused by poor posture.

1. Take frequent breaks, at least 3 minutes every 30 minutes. Set a timer to remind if you tend to forget. During the break, preform a simple stretching exercise. For example, lean forward, hold your knees, and push your knees apart while keeping your hands on them or stand up and stretch your neck and shoulders while taking deep breaths from your abdomen.

2. Maintain good working posture. According to the U.S. Department of Labor Occupational Safety and Health Administration, the following are important points to consider while working at the computer workstation. So you might want to adjust your chair or working station to fulfill these:

Maintain good working posture.

• Hands, wrists and forearms are straight, in-line and roughly parallel to the floor.
• Head is level or bent slightly forward, forward facing, and balanced. Generally it is in-line with the torso.
• Shoulders are relaxed and upper arms hang normally at the side of the body.
• Elbows stay in close to the body and are bent between 90 and 120 degrees. You may want to adjust your forearm rest to achieve this position.
• Feet are fully supported by floor or footrest.
• Back is fully supported with appropriate lumbar support when sitting vertical or leaning back slightly.
• Thighs and hips are supported by a well-padded seat and generally parallel to the floor.
• Knees are about the same height as the hips with the feet slightly forward.

3. If you get to choose between a desktop computer and a laptop, choose the desktop. Laptops and netbooks may seem appealing, but they generally don't provide an ergonomic environment. When using a laptop computer over long periods of time, attach it to a docking station or raise the height of your laptop screen to eye level and use an external keyboard and mouse.

4. Center your monitor and keyboard in front of you at arm's length. Your monitor should not be farther than 35 degrees to the left or right. Make sure the top of the screen is eye level when sitting up straight. The preferred distance between the eye and monitor is in the range of 20-40 inches (50-100 cm).

5. Alternate your mouse hands. You can use a symmetrical mouse to make left and right hand pointing more comfortable. Switching hands can be particularly helpful if your shoulder or neck pain happens only on one side.

6. Place frequently used devices such as the phone within your reach. Use a speaker phone or a headset for long conversations.

Premenstrual Syndrome: Men's Worst Nightmare?

It's a common belief (among the guys, of course) that man suffers whenever a woman is having premenstrual syndrome. This is not entirely accurate. True, emotional irritability is one of the many symptoms of PMS, but not every women with premenstrual syndrome experience this problem. And if PMS was to be someone's worst nightmare, it would be more likely to be a woman's.

Premenstrual syndrome: men's worst nightmare?

What is premenstrual syndrome?

Premenstrual syndrome (PMS) involves a variety of physical, mental, and behavioral symptoms related to a woman's menstrual cycle. These symptoms occur during the two weeks before a woman's period starts, known as the luteal phase of the menstrual cycle. Three out of four menstruating women have at least one symptom as part of their monthly cycle. PMS symptoms characteristically become more intense in the 2-3 days prior to the period and usually resolve after the first day or two of flow.

Women who are between their late 20s to early 40s, those who gave birth at least once, and those who have a history of mood disorder are more prone to have PMS. Most women have only mild symptoms, but around 3-8% may have a severe form of PMS, called premenstrual dysphoric disorder (PMDD) with disabling symptoms that affect their daily functions.

What are the symptoms of PMS?

Symptoms varies between one woman and the other, but they usually follows a predictable pattern and recur each month with variable intensity. Physical symptoms include fatigue, headache, joint and muscle pain, weight gain, bloating, acne, and changes in bowel movements. Mental and behavioral symptoms include mood swings, anxiety, irritability, depressed mood, poor concentration, cravings, insomnia, and social withdrawal.

The exact causes of PMS are still unknown, but cyclic changes in hormones level seem to play an important part. Low levels of serotonin, a type of brain chemical, may also trigger PMS symptoms. Stress, depression, poor eating habit can make the symptoms worse.

How to manage PMS?

Management of PMS consists of lifestyle changes, behavioral therapy, medications, and vitamin and mineral supplementation. For most women, lifestyle changes are often enough to control symptoms.

• Drink enough fluids, but avoid alcohol, caffeinated drinks, and soft drinks.
• Eat a healthy, balanced diet and divide the portion into small, frequent meals.
• Regular physical exercise throughout the month will help reduce the severity of PMS.
• Aspirin, ibuprofen, and other non-steroidal anti inflammatory drugs (NSAIDs) may reduce back pain, headache, and cramps.
• Nutritional supplements like vitamin B6 (50-100 mg), vitamin E (400 IU), calcium (1000mg), folic acid (0,4 mg) and magnesium (400 mg) may reduce symptoms in general. 
• In severe cases, your physician may prescribe anti-depressant medications.

Obesity Overview

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. In people of Asian descent, you may be diagnosed with obesity when your BMI is 27.5 or higher. To calculate your BMI, divide your weight (in kilograms) by your height (in meters) squared. Or if that's too complicated for you, use an online BMI calculator found here: http://nhlbisupport.com/bmi/

"Obesity is more than just a cosmetic problem."

A BMI of more than 40 means you are morbidly obese. Morbid obesity carries a very high risk for cardiovascular diseases and severely interferes with a person's normal functioning and quality of life. It is more than just a cosmetic problem.


People who are obese have an excessive amount of body fat. Because muscle weighs more than fat, sometime using only BMI to diagnose obesity can be inaccurate, especially in muscular people like athletes. Therefore, waist circumference is also used to determine the amount of abdominal fat. People who carry too much fat around the middle (central obesity), are more likely to have health problems. Waist measurement greater than 40 inches (101 cm) in men and greater than 35 inches (88 cm) in women are considered to carry increased risk for diseases. In people of Asian descent, greater than 36 inches (90 cm) in men and greater than 32 inches (80cm) in women.

What causes obesity?

A lot of people thinks that obesity is caused simply because one eats too much calories and lacks physical activity. However, there are other factors that also play a role in obesity which include:

• Genetic factor. Obesity tends to run in family. If one's biological mother is heavy as an adult, there is more than 50% chance her offspring will grow to be heavy. This doesn't mean that your genes failed you and convict you to a lifetime of obesity, though. Many people who are genetically predisposed to obesity do not become obese or are able to lose weight and keep it off.
• Age. As your body ages, your metabolism rate slows down and you do not require as many calories to maintain your weight.
• Gender. Women have slower resting metabolism rate than men and thus more prone to obesity. 
• Environmental factors, including lifestyle behaviors, what a person eats, and his or her activity.
• Psychological factors. Many people eat in response to emotions such as boredom, sadness, or anger.
• Medical conditions. There are some illnesses that can cause obesity, such as hypothyroidism, Cushing's disease, and polycystic ovarian syndrome. Arthritis may also cause obesity by restricting physical activity.
• Drugs. Certain drugs such as steroids and antidepressants may cause excessive weight gain.
• Lack of sleep. Getting less than seven hours of sleep at night causes hormonal changes that may increase your appetite.

Obesity affects one's quality of life.

What are the physical and psychological effects of obesity?

Some of the potentially serious health problems you may develop from obesity include: metabolic syndrome, high blood pressure, high cholesterol, type 2 diabetes, cardiovascular diseases, cancer (especially colon and breast cancer), sleep apnea, liver and gallbladder diseases, infertility, and osteoarthritis. Obesity is also associated with low quality of life because of self esteem issues and discrimination that leads to social isolation and depression.

When to seek help?

Contact your doctor or health care provider if you think you may be obese to evaluate your health risks and discuss weight-loss options. You should also seek help if you are having emotional or psychological issues related to obesity.

What are the management options?

Weight loss is usually possible through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight loss surgery may be used under physician's recommendation. Support groups are available to provide help with the psychological aspects of obesity. Stress management and healthy coping strategies are beneficial to increase quality of life.