Antidepressants Blog

Before examining the health and fat loss benefits of carbohydrates it is essential to take a brief look at how carbohydrates are digested and absorbed in the human body. First we need to start with the gastrointestinal tract (GIT). The GIT is a long tube stretching from the mouth to the anus. The digestion of carbohydrate starts in the mouth, where enzymes in saliva start to break some of the bonds between saccharide units. After swallowing, carbohydrate enters the stomach ready to be released into the small intestine in small quantities. In the small intestine various enzymes perform the major part of carbohydrate digestion by breaking the bonds and releasing monosaccharides for absorption. Once absorbed, carbohydrate, in the form of glucose or fructose, goes to the liver where it is stored or put into the bloodstream as blood glucose for energy production or for storage in the muscles as glycogen.

Dietary fibre meets a somewhat different fate. Most fibre resists the digestive enzymes of the intestine and passes through to the large bowel. Here, some of it is metabolised by bacteria that produce the specific enzymes necessary for breakdown. This process is known as ‘colonic fermentation’. The end products include the gases carbon dioxide, methane and hydrogen along with volatile fatty acids called short chain fatty acids (SCFAs). The SCFAs are absorbed from the large bowel, enter the bloodstream and are transported to the liver. The degree of fermentation in the large bowel depends on the type of fibre and varies between individuals. This explains why some people produce a lot of gas and others produce very little following consumption of fibre-rich foods. Soluble fibres are entirely digested by bacteria and produce most of the SCFAs. Insoluble fibres are digested to only a small degree and the amount depends on the time spent in the large bowel before excretion.

The term resistant starch is a relatively new addition to the fibre scene. This is used to describe polysaccharides which are resistant to normal enzymatic digestion. This means that a portion of the starch eaten in foods will pass through the stomach and small intestine to the large bowel where it is fermented in a similar way to fibre. For this reason most nutritionists currently regard resistant starch as a component of dietary fibre. Resistant starch can occur naturally, such as in raw potato or bananas, be formed in partly milled grains and seeds, or can form following heating and cooling of cooked potatoes, bread and cornflakes. The approximate resistant starch content of specific foods. Food manufacturers have been able to incorporate resistant starch into white bread and other foods without affecting the sensory qualities of texture and flavour. This is a major advantage as consumers can eat foods that are higher in this fibre-like substance, but not radically different from more accepted forms.

This new dimension in carbohydrate physiology has stimulated another broad classification of carbohydrates. Nutritional scientists now use the terms ‘available’ (sugars and most starches) and ‘unavailable’ (resistant starch and fibre) when referring to the nutritional implications of carbohydrates.

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Less than a decade ago those who were infertile due to endometriosis may have been destined to never become pregnant. Due to the advancement of drug therapies and programmes such as in-vitro fertilisation (IVF), gamete intra fallopian transfer (GIFT) and related programmes, infertility does not necessarily mean that you will never conceive.

Establishing infertility

Usually the first thing is to try to conceive for a year without using contraception. A Melbourne IVF specialist says that approximately 10% to 15% of couples will not conceive in that time. ‘At that stage we feel that it is time to start investigations and try to pinpoint any problem’, he said.

The first step is to get a referral to a gynaecologist. Most women with endometriosis will already be under a specialist who may also manage their infertility investigation but they may be referred to an infertility specialist.

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A physical examination usually involves:

testing a specimen of your urine

taking your blood pressure

examining your breasts

examining your abdomen

a pelvic examination (sometimes also known as an internal or a vaginal examination).

The purpose of the pelvic examination is to try to determine whether there are any indications that you may have some endometrial implants or cysts present. Sometimes, the pelvic examination will suggest the presence of endometriosis but often nothing abnormal will be found, especially in the early stages of the disease.

Knowing what is involved in a pelvic examination will help to relieve any anxiety that you may have and help you to relax and therefore make the examination more comfortable for you and easier for the doctor. Ask your doctor to explain the procedure to you before she or he begins.

It is best if you empty your bladder just before the examination as a full bladder will make it difficult for the doctor to perform the examination satisfactorily.

During the pelvic examination you will usually be asked to lie on your back with your legs spread apart, knees bent and feet together.

While the doctor is examining you it will help if you tell him or her when you can feel any pain or discomfort. A pelvic examination may cause a little discomfort but it should not be painful. If the examination does cause pain ask your doctor to stop for a moment to allow the pain to subside while you relax again. After the examination has been completed ask the doctor to describe what he or she felt.

The doctor will begin by examining the external genitalia, which includes the vulva, clitoris and labia, for any signs of inflammation, irritation or infection.

The doctor will then insert an instrument, known as a speculum, that holds the sides of the vagina apart to examine the vagina and the cervix. The doctor may also take a Pap smear or a sample of any unusual discharge using a cotton swab or a wooden spatula. Once a thorough examination has been made the doctor will remove the speculum and perform a bimanual pelvic examination.

In the bimanual examination the doctor inserts two gloved fingers into your vagina and places the fingers of the other hand on your lower abdomen in order to feel the outline, shape, size and location of the pelvic organs between his or her hands. The doctor will also feel for any nodules, lumps, growths, enlargements or areas of tenderness.

During the examination the doctor may be able to feel nodules of endometriosis in the Pouch of Douglas, on the utero-sacral ligaments or in the recto-vaginal septum. It may also be possible to feel if the ovaries are enlarged, which may indicate cysts on the ovaries. The doctor will also be able to feel if the uterus is lying in the normal position or if it is stuck in a retroverted position.

Occasionally, the doctor may feel that it is necessary to perform a recto-vaginal examination if you are complaining of symptoms involving the bowel. This examination is similar to a bimanual pelvic examination but the index finger is inserted into the vagina and the middle finger into the rectum. The fingers of the doctors other hand are placed over the lower abdomen to help outline the organs and feel for any enlargements or growths.

If a pelvic examination does not indicate anything abnormal and if it was not performed near the time of your period it may be worthwhile having another examination just before, or during, your period when the endometriosis is most active thus making the implants more tender, larger and easier to feel.

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Originating in ancient India, yoga involves spiritual, mental and physical discipline for the unification of the mind and body. Its physical aspect, a series of postures or asanas, is now widely practised around the world and is popular as a means of managing stress, building strength and maintaining physical flexibility.

Many people with medical conditions such as heart disorders, or diseases of the respiratory system like asthma and bronchitis, will benefit from regular yoga practice as will those with muscular or nervous disorders. Some postures are designed to tone and stimulate internal body organs and glands. There is no high impact aspect to yoga nor any sense of extreme aerobic exertion. Rather, strength is built through muscle control, balance and body awareness. Breathing is very important as the embodiment of the life force or prana. Like T’ai-chi, many of the postures are derived from the movements of animals and birds.

Yoga requires little equipment although a lot of people like to work on a rubber mat. Belts and frames are sometimes employed to maintain postures without straining the body. Your clothing need only be loose and comfortable. As with most physical and mental disciplines, it is recommended that you seek ongoing instruction from a qualified teacher. Select a school with an emphasis on the aspect of yoga which most interests you. Hatha yoga concentrates on physical discipline while Raja yoga places more emphasis on controlling the mind. Bakti is the devotional aspect of yoga.

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Depression cuts into a person’s ability to function so that some of the failure that they perceive does have a basis in reality Mental processes slow down and it is difficult to concentrate, to focus or to get things done. Work inevitably suffers; chores remain undone; things get botched up, leaving you with feelings of failure and inadequacy, many of which may be exaggerated but some of which may be true. It is easy to forget how competent you have been at other times and how much you have accomplished before. All these things seem insignificant when you are depressed. Dr Kay Redfield Jamison, in her wonderful memoir An Unquiet Mind, describes the difficulties in thinking she experienced during one of her depressions as follows:

Everything – every thought, word, movement – was an effort. Everything that once was sparkling now was flat. I seemed to myself to be dull, boring, inadequate, thick brained, unlit, unresponsive, chill skinned, bloodless, and sparrow drab. I doubted, completely, my ability to do anything well. It seemed as though my mind had slowed down and burned out to the point of being virtually useless. The wretched, convoluted, and pathetically confused mass of gray worked only well enough to torment me with a litany of my inadequacies and shortcomings in character, and to taunt me with the total, the desperate, hopelessness of it all.

This description of severe depression conveys many aspects of a depressed person’s thinking. In the years that followed the depression described above, Dr Jamison went on to succeed enormously as a psychologist, researcher and writer, but such a future is unthinkable when you are in the depths of a depression. It is important to realize how misleading the conclusions reached in a state of depression can be. Nevertheless, when you are depressed, the difficulty in thinking and functioning is real and has its consequences. Failure that occurs in the context of some of the symptoms of depression described here should therefore be considered a tell-tale sign of depression in its own right.

Failure occurs in the workplace, but also in personal dealings. Relationships require a capacity to attend to another person and an ability to feel engaged with that person, both of which are sorely impaired in depression. Others may well feel put off, and withdraw in response to the reclusiveness of a depressed person.

If you find you have been failing at work or in your personal relationships in a way that has not always been typical for you, and this has been going on for more than a few weeks, consider the possibility that you may be clinically depressed.

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Synthetic chemicals are found throughout the environment, but especially in home janitorial supplies. To rid the house of unnecessary air pollutants, start by looking under the sink. One can usually find there an accumulation of chemical products of all kinds: paints, solvents, laundry and dishwashing detergents, waxes and polishes, insect sprays, turpentine, shoe polish, and so forth. Whatever is not absolutely necessary should be dispensed with. Essential items, such as detergents, should be transferred to glass bottles with tight-fitting caps. One should save bottles for such a purpose. All questionable items should be stored outside, in places such as a garage or storeroom.

The same rule applies, naturally, to any other area in which toxic products accumulate. Conduct a careful house search, cleaning out drawers, broom closets, hobby areas, and medicine chests. It is amazing how much dangerous junk piles up in a house over the years, silently polluting the environment. One should be careful, however, not to allow any of these items to spill as they are being disposed of, or this may precipitate an acute attack of symptoms in susceptible people.

The human nose is an extraordinary instrument. Ecology patients tend to be either acutely sensitive to smells, or, conversely, lacking in the sense of smell altogether (in advanced cases). If you have a good-to-excellent sense of smell, you can identify noxious smells in the house by going out for a brisk walk in an area with fairly clean air and then returning to your house to perform a quick “sniff” test. If something has an offensive odor, get rid of it. Do not wait a day, or even a minute, since the nose will quickly adapt to the ill-smelling item. After being exposed for a short while, one can no longer fully smell the offending odor. Many patients report a cleaner feeling in the air after they have rid their homes of these hidden pollutants.

Several engineers and otherwise qualified experts now make “house calls” to inspect the homes of patients for chemical contaminants. They bring not only their expertise, but exceptional ability in “sniffing out” danger spots for patients, based on their own chemical-susceptibility problems. (The organizations listed in Appendix C can provide names of such experts.)

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Until some time early in this century, pewter was made by mixing tin with lead, the British Medical Journal (291:1701) reports. Although the risk of lead poisoning from old pewter dishes is minimal, pewter tankards, mugs, or cups are much more dangerous because, if used repeatedly, their fluid contents dissolve a lot of lead. Since modern pewter vessels contain no lead, they can be used without risk.

Nonetheless, the Western Journal of Medicine (143:357) reports, modern pottery colored with lead-containing pigments may not be safe, even if the covering glaze appears to be intact, since it often becomes scratched off or cracked. Furthermore, even some glazes contain lead. People who color pottery or paint with lead-containing pigments (such as cinnabar) are also at risk and must wash their hands before touching their mouths or handling food.

Symptoms of lead poisoning from such sources include mood changes, headache, aching of the limbs, constipation, and bouts of colicky abdominal pain. Since lead poisoning is quite common, anyone having these symptoms should ask a doctor to check them over with this cause in mind.

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Symptom: Tiny pink or red eruptions each surrounding a skin pore on the cheeks, neck, shoulders, in skin creases, and in nappy area.

Home care:

Keep the child as cool as possible, preferably in an air-conditioned room.

Cool baths and careful dusting with corn flour or baby powder help relieve discomfort.

If the rash is on the face, rest the child’s lace on an absorbent pad placed in the crib.

Be careful not to overdress the child.

Use prickly heat powders during warm weather.

Precautions:

-    Use powder carefully; if a baby inhales large amounts of powder, lung inflammation can occur.

-    Overdressing a baby is a frequent cause of heat rash; the baby need be dressed no more warmly than you dress yourself.

-    The use of detergents and bleaches on bed linens and clothing may aggravate heat rash.

-    Avoid using bubble baths, water softeners, or oily lotions on a child with heat rash.

Heat rash is a mild skin condition caused by temporary blockage of the sweat gland openings on the skin. Heat rash, also known as prickly heat or miliaria, is the most common of all rashes in children of any age. Almost all babies get heat rash during hot weather. Heat rash can even occur in cold weather if your child is overdressed either during the daytime or nighttime. Fair-skinned children (redheads and blonds) get heat rash more frequently than other children, and they suffer the most from it.

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The Hard-Hat Zone

When Joseph B. Strauss designed and engineered America’s second-largest bridge across the Golden Gate Strait, he was determined that this San Francisco project would be the safest in bridge-construction history. Local safety equipment manufacturer Edward W. Bullard developed the first “hard hat,” workers were fed a special diet to prevent dizziness, and a safety net was suspended below the floor of the bridge from end to end. That net saved a total of 19 men, proving that safety measures worked. Then in 1937, a few months before the bridge was to open, a section of scaffold carrying 12 men fell and ripped through the safety net, killing 10 of them-proving also that construction was, is, and likely always will be inherently dangerous.

Today, falls remain a leading cause of death and disability at construction sites. In one year alone, it’s common to have more than 40,000 disabling falls. When those falls happen from roofs, scaffolding, or other temporary platforms, workers often don’t get back up. Making matters on the construction site even worse are vehicular accidents and electrocutions, which account for almost as many fatalities as falls.

With more than 309 deaths in 1995-or a rate of 39-5 for every 100,000 workers-being a construction laborer ranks as the sixth deadliest occupation in the United States. No doubt, we’re always going to need bridges and buildings, but we need to keep our construction workers safe. Here’s what experts recommend.

Strap on protection. There is no shortage of products on the market to help prevent a construction worker’s fall. “Some fasten the workers to a stable part of the construction site. Some work like a seat belt and ‘catch’ the worker should he suddenly slip.” But according to some safety professionals, many of the daredevils in these fields don’t want to wear them. For example, roofers have actually fought to be exempt from fall-protection regulations because they maintain that the equipment contributes to falls rather than preventing them.

Work along the curve.

“Being new on a job increases your chances for getting hurt”. “The newness of the work, the lighting, and the conditions all put you at risk when you start a job, no matter what your age. It’s best to be aware of that and respect your learning curve.”

White-Collar Woes

If you’re among the legion of button-down desk jockeys or other non-laborers in the workforce, you don’t have to worry much about death by toppling trees or by falling hundreds of feet from scaffolding. Your coworkers are another story. One in three workplaces has been the site of a violent episode. Every day two or three workers are fatally shot at work.

Assaults and violent acts comprise 20 percent of fatal occupational injuries. When they happen at work, your employer takes a certain amount of responsibility for them and they are logged as occupational “intentional deaths” – the safety industry’s word for not being an accident. Right now, getting shot is the biggest risk for some white-collar workers.

Though this occupational risk seems more out of the victim’s control than, say, strapping on a safety belt, that doesn’t mean that you’re helpless from preventing these events from occurring. For example, I can remember back in the 1970s, anybody could just walk into the federal building where I worked. But circumstances have changed. Now we have employee identification and access cards to restrict entrance of potential perpetrators of violent acts in the workplace.

If your workplace seems vulnerable to outside invasion, safety experts suggest that your employer install a security system, especially if your job involves handling money. Employers often take these suggestions seriously.

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RHEUMATIC FEVER

Bursitis

Bursitis is the name given to the situation where an inflammatory condition of the bursae exists. The bursae are’ closed sacs’ which are lined with a special membrane and which facilitate the movement of muscles and tendons over bony surfaces. Housemaid’s knee is possibly one of the most commonly known forms of bursitis but there are others which affect areas such as the elbow or the heel. There are several causes for the various types of bursitis, ranging from too much kneeling in the case of housemaid’s knee, through direct injury and the introduction of organisms in septic bursitis, to abnormal deposition of calcium around the rotator tendons in calcareous tendinitis (bursitis of the shoulder).

Tennis elbow

Tennis Elbow is a condition not truly named because it is not restricted to tennis players. Any occupation which involves frequent and repeated extension of the wrist can bring on this condition. It is, again, an inflammatory condition with associated pain and restriction of flexibility. Whilst the affected region is principally the elbow, the problem can involve the muscles on either side, depending on the cause. For instance, if the condition occurs after playing tennis or squash, the outer side of the elbow would be the region most likely to be affected. If it occurred after, say, golf or cricket, then probably the inner side would take the strain and be the one to be affected.

Psoriatic arthritis

Psoriatic arthritis is a form of the disease in which two conditions exist. The first is psoriasis, which is an inflammatory condition of the skin, and the second has features which are very similar to rheumatoid arthritis. The two conditions are believed to be associated and not merely coincidental. It is also quite probable with psoriatic arthritis that heredity may be a significant feature in its occurrence.

Rheumatic fever

Rheumatic fever is a different kind of disease altogether and we have some knowledge of its causes. This condition may result in an attack on many organs of the body. If the heart is the organ affected, then the results may be fatal. If the particular area attacked by the fever involves connective tissue or an articular function, the arthritic association becomes apparent.

Fortunately with the development of better health and sanitation standards throughout the world the incidence of this disease should decrease. This is because rheumatic fever occurs as the result of infection by bacteria of the type known as the Streptococci. It should be pointed out that not all infections by Streptococci result in rheumatic fever. Only a certain group of these bacteria are effective and even then there may be other factors, besides the presence of these pathogenic organisms, which are necessary for the condition to develop. Although Streptococcal infections can occur even amongst the best regulated populations, the probability of any bacteriological infection is reduced with good hygiene and public health standards.

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