How to Reduce Bad Cholesterol

Well everybody knows what cholesterol is and what it does.To simplify matter  we all agree that it is bad for us. But is that the whole truth? If it is so then how or where is the proof? By now all of us know that there is a good cholesterol and a bad cholesterol. But the fact remains unchanged that all of us require cholesterol in one form or the other for normal maintainance of our health. For the optimum functioning and for the production of hormones like sex hormone and adrenal hormones and vitamins like D which is synthesized in our body cholesterol is essential. It helpsproduce bile acid . Atherosclerosis and arteriosclerosis  and gallstones are the result of increased levels of cholesterol in  blood.

Although we have been advised to watch what we eat when we are diagnosed as having high cholesterol, some medical authorities believe that these increased levels are not necessarily due to the diet that we consume. Their theory is stress and genetics being the real culprits. Some theories advocate adding raw vegetables and fresh fruits to  diet. Some  advocate drinking lots of water might help in long run. Some studies claim that Vitamin C helps in combating dangers of high cholesterol.

Basically, balancing nutritius diet with vitamins that imitate in a way the nature’s way may possibly lead to the disappearance of high cholesterol. If left untreated then the increased levels of cholesterol  can lead to heart disease, even death due to stroke can occur.

So are we doing enough to save ourselves from the bad effects of harmful cholesterol?

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Sand Sculpture in Orissa

It has been a common site to find beautiful art works by famous oriya sand sculptures to display their works in the beautiful sea beaches of Orissa.  Puri the abode of Lord Jagannath sports the most famous of them all. The sand sculpture artists like Sudarshan Pattnaik and Ballav Pattnaik are displaying their works just because they love it without any moetary gains.

This is a video showing a sand sculpture by artist Ballav Pattnaik. Hope you enjoy.

Well as you can see the video is in Hindi. The artist explains that the video is about depicting good over evil. The symbolism is an excerpt from Hindu mythology. Goddess Durga has this Lion. Mahishasura was a very powerful deamon. Goddess Durga killed Mahishasura. So the face is that of Mahishasura and depicts evil whereas Lion is the depiction of Goddess’ power and good.
You can find more about this mythology by Clicking Here or searching for Dussehra, Durga Puja, Navaratri etc. in search engines.

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10 Tips to Deal with Anger-The Anger Management Guide

Anger is an emotion that needs control. Many find it hard to control. I though being a doctor am not immune to this personality problem. Many a times I find it hard to control my anger when the workload increases, when patients do not comply. But as every one discovers after the storm is over that the damage has been done, so did I.
But the silverlining is that now I am minimizing my anger by following some of the following strategies.

1. Know when you are angry.
This is very important to halt the cascade. Otherwise when anger starts and you express it, it will go on a roller coaster ride, untill you know that it is over. It is important to know that you are getting angry. The only way to know is to take actions slowly. This takes practice, patience and perseverance. Dont do anything in hurry. Always think about the pros and cons. This way your actions will take more time, but you will have a window to think about. The tripping point if avoided will actually save you from loosing a full afternoon. So Take actions slowly after thinking atleast twice.

This is vital. Practice it every situation.

2. You are the creator of your own destiny, remmber You are in control.
I have never known a person who was not aware that he was angry when he was using foul language purposely. What I mean to say is many a times though we are aware that we are getting angry, still we knowingly let it go. Now that is loosing control. We can change our destiny, why can not we change a simple decision of ours? After all it is we, who are getting angry.

3. Deep breaths and Counting do they help?
I dont know. Both of them actually increase my anger as I think I am doing all this because the person who is making me angry is also forcing me to do all these things. So it does not help me. So how to control anger then. Well read on.

4. Move out.
It is actually not the best idea for anger management, but the first one you can achieve easily. Just get out from the scene. If it is not possible then simply change your posture. It may sound weird, but it helps a lot. Change the chair. Just walk out to a distance. The idea is to move out from the position that triggered anger within you.

5. Vent your anger without expressing it.

Think about the filthiest word that you can think to use against the person, but are not going to use because of its profanity. Well you know that he has not done anything so bad. so you will feel pity on him. Remember I am not using the old forgiving startegy. I am actually using the opposite strategy. Give the
person the worst scolding in your mind. OK your mind gets a little hot. Still you will feel either of two emotions. He deserves this. Come on he is not that bad, he is just another looser. Word of caution use only one word that comes to your mind. If you think of more than one word then you are in trouble.

So just one word.

6. Do not stop what you were doing before getting angry.
Now this is quite difficult. Still it is the most effective way for many. It not only diverts our mind from getting further angrier, but also it prevents people knowing that you got angry. But the word of caution is do things slowly. Most people if are told to do work then they do it in a jerky and forceful way, that we want to avoid. So do it slowly, normal anger will speed it up a little. The effective speed will be the same as before.

7. Dont take any decisions, do not drive when you know that you are angry.
Most decisions in anger are regretted. In occasions I ahve been angry with shopkeepers and instead of demanding a refund I have just left. So leave the scene, but be in vicinty. Not driving when you are angry is a no brainer.

8. Get a physical way to channel out not vent your anger and no calling names.
What I mean is do some physical work. Anything like exercise, running, boxing with a punch bag. Hand washing clothes. gardening, sweeping your room. BUt all have to be done when you have moved out from the scene.

9. Use philosophy.
This principle is when everything is working or if everything is failing. Be philosophical. Think about the bigger picture. Consider the responsible one being tried when the time comes for his guilt. Forgiving is an age old philosophy. Be positve. You will find opportunity in disguise of a frustrating experience.

10. Stop getting angry.
As this is easier said than done so I am putting this last. I know it is quite difficult. So I will first apply the
principles on myself then I will write about those principles.
So for now have a nice day. And manage your anger effectively.

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Urban Health Training Centre Posting

So I have been posted in Urban Health Training Centre and Dispensary in Jobra, cuttack. Yesterday I gave there my joining letter. Though this is part of Department of Community Medicine still I had to give a separte joining letter. First thing I did was to collect list of all the drugs that are present in the dispensary’s inventory.
Patients coming to this dispensary are poor, just like in most part of India. they can not afford to buy modern medicines from local pharmacies. so dispensaries are set up by state governments to provide them free of cost medications.
So I was there writing my first official prescriptions. My first case was an anemic lady. she was complaining of head reeling for last 1 week. She had low blood pressure. Her BP was 106/70.

I have posting there from 1st November to 3rd november 2008. So I will be getting out from here on Monday. Hope I diagnose correctly and make people healthy, for which I have been trained of course.

Bye for now.

I am getting a message that opera 9.6.2 is available for download. I am downloading it , So check it out.

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Anti Rabies Vaccination Clinic Posting and Updated Thai Red Cross Regimen

I have just now completed my 3 day posting in Anti Rabies Vaccination Clinic (ARVC)as an intern. This
clinic in our hospital comes under the administration of Department of Community Medicine in which I am
posted for 3 months from 24th October 2008 to 23rd January 2009. ARVC posting is one of the 3 clinics that I have to attend before I go for my PHC and CHC posting in Salipur. The other two are Urban Heal and Traing Center (UHTC) in Jobra and Immunisation clinic Hospital itself. So from 29th October to 31st October I was posted in ARVC. It was a worth while experience.

Bite of any rabid animal is fatal. So it is of paramount importance that any mammal bite should be taken seriously. In India we have plenty of unimmunised dogs and cattles that roam around freely in streets. So it is quite natural that there are plenty of dog bite cases to treat. The rule of thumb that is considered to assess if the dog is rabid or not is to ask the victim if it was an unprovoked or provoked bite. If it is an unprovoked bite then it might have been a rabid one.

So the questionnaire is as follows:

1. What has bitten – mammal or not.
2. Provoked or unprovoked bite – unprovoked might be rabid one.
3. Pet or Stray animal. rabid animal dies within 10 days for sure, so in case of pet animal one can assess.
4. If any local medications has been applied like ointments, lotions etc.

After this assessment of severity of the bite is considered.
WHO categorization for treatment of animal bite is as follows:
Category I: Superficial licking on unbroken skin – No treatment required.
Category II: Wound is deeper but limited to dermis only i.e not deep enough to cause bleeding – Give Anti Rabies Vaccine only.
Category III: There has been bleeding from wound site or there has been a bite i.e teeth mark – Give Anti
Rabies Vaccine and Immunoglobulin both.

Updated Thai Red Cross Regimen is followed for Anti Rabies Vaccination.
The schedule is Intra Dermal vaccination on day 0,3,7,28.
The intra dermal vaccine is given 0.1 ml in each upper arm making the dose on each day 0.2ml.  The vaccine comes as a freeze dried powder form which is reconstituted by 0.5 ml of Normal saline solution. So one vial can be given to 2 and half individuals. This makes vaccination at large centers like ours an ideal option. In our Hospital we vaccinate around 100 patients with Anti Rabies Vaccines every day, 7 days a week, throughout the year.

Preliminary treatment:
Wound care: wash the wound site with soap under running tap water.
Take a Tetnus Toxoid if previously unimmunised.
Intra dermal vaccination on scheduled days i.e on the day of the bite, 3 days after, 7 days and 28 days after on both arms.
If Category III wound then take Immunoglobulins as soon as possible.
2 types of Immunoglobulins are available Horse derived and genetic engineered. Difference is higher cost of human immunoglobulin. advantage is less allergic reactions. Under cover of antihistaminics Horse serum derived immunoglobulis have worked very well in all parts of the world.

Immunoglobulin is given half at the wound site and half else where intramuscularly.
Dose is
Equine immunoglobulin 40 IU/Kg body weight
Human immunoglobulin 20 IU/Kg body weight

If the dog bite has been multiple then Normal saline upto 2/3rd volume of immunoglobulin can be added to dilute it.

Rabies has NO treatment. So take care.
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