Archive for February, 2010

Misconceptions About Mesothelioma Disease And Lung Cancer

There are many misconceptions about malignant mesothelioma disease. Many classified malignant mesothelioma disease as a lung cancer.  The fact is mesothelioma is a not a lung cancer. Mesothelioma disease usually originates in the pleural lining of the lung. Mesothelioma may cause similar respiratory symptoms as lung carcer. But it is not actually lung cancers.

It is not true that only those who worked with asbestos can develop malignant mesothelioma disease. The fact is majority of malignant mesothelioma patients are those who have asbestos exposure in their line of work. There have been reported cases of workers  who handled asbestos regularly, where their spouses and childen do suffered from mesothelioma as well. It is because these workers contaminated asbestos dust or fibers on their work clothes, hair or work gear and they brought them home.

People believe it is safe to be exposed to small amount of asbestos fibers. Please be informed that no matter how small the amount of asbestos exposure, it is still hazardous to your health. In fact just a few asbestos fibers lodged in the pleural lining of the lung is enough to cause you to have malignant mesothelioma disease and other asbestos related disease.

It is not true that only smokers can be affected by mesothelioma. Smoking does not cause mesotheliom. The simple fact of the matter is that anyone who is exposed to asbestos for a period of time could be the next mesothelioma victims. While smoking definitely exacerbates the possibility of contracting malignant mesothelioma disease.

You are helpless and there is no form of assistance available for families of mesothelioma victims. No, that’s not true. There are many different forms of assistance available for families of mesothelioma patients, which includes financial compensation from the employer of ones workplace. Most malignant mesothelioma disease victims are affected because of negligent occupational conditions. This is where you need to hire mesothelioma attorney to file for financial settlements. Then there are social and medical consultations available in many cancer centers.

Question and Answer


Doug Lester

Read more about diagnosis mesothelioma and other free articles on mesothelioma disease.

Categories : Healthcare
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Feb
18

Healthcare Plan Savings Discussed

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Healthcare Plan Savings Discussed

During these times when hospital bills and professional doctors fee are high, medicines are expensive, and temptations for foods, drinks and vices are everywhere, staying healthy is a must. While some are gifted with good and healthy body, others struggle to maintain a healthy body. And with the price of healthcare plan contributing to the expenses we already have, there is a great need and knowledge on how to somehow cut the cost of healthcare plan.

Although you cannot do anything to bring down the price of your healthcare plan, you can manage to acquire significant saving by following these steps.

Stay Healthy – Yep! The golden rule if you want to live longer. Skeptical? Well, nobody blames you but if you would like to give you body a great chance of living beyond your life expectancy, staying healthy is worth the shot. If you aim to get a cheaper healthcare plan, then this is also a great way to achieve it. Since healthcare plan companies base the price of their plan on the status of the health of the individual, don’t be surprised if some might get higher rate than others. If you are conscious about it, then maintaining a healthy life could spare you from high healthcare plan rate.

Quit Smoking – Now that’s difficult! But if you are a kind of person who will do anything just to keep the healthcare plan rate to the minimum, you can always start by kicking the habit away. So what does it have to do with low healthcare plan? A person who smokes is more prone to healthcare claims than those who do not. And if you understand the business, you would realize that healthcare plan companies receive more claims from smoking plan holders. The tendency is to sanction higher healthcare plan rates to those who smoke. Think about it! If you quite smoking, you save from healthcare plan bills, spare you from the cost of your everyday cigarette consumption, and give you a better chance to live cleaner and longer life.

Exercise and Lose Weight- If you are part of the growing number of Americans who can either be classified as overweight or obese, then expect to have a higher healthcare plan price. It is wise to keep a normal body size and maintain it with regular exercise so you can get a desired healthcare plan rate.

Good healthcare plan selection – If it’s cheap, it does not necessarily mean it’s really “cheap.” Never let the price be your basis in taking a healthcare plan. As much as possible look for plan that gives you more benefits at the price advantageous to you.

Maximize other existing plan – If you presently have health insurance plan, make sure that you avoid getting another one with an identical coverage. This would surely drain your pockets by having unnecessary benefits you can never use. Also avoid buying unnecessary healthcare plan if you already have enough plan.

Know the type of plan you are buying – If you are buying healthcare plan for the first time, you should identify first the type of coverage you want. In this way, you can eliminate those unnecessary coverage you think you can never use. Remember that every coverage is paid so making sure that you can the healthcare plan that fits your need.

Question and Answer


Healthcare becomes universal then what happens to people like me that work in healthcare?
If healthcare gets revamped will I get CUT IN PAY? I am a X-ray tech. When everybody can afford healthcare, will I loose money?
I am confused if revamping healthcare is bad or good for me. I am for everybody getting great healthcare, but not for a pay cut that I worked hard for!

Robert Thatcher

Robert Thatcher is a freelance publisher based in Cupertino, California. He publishes articles and reports in various ezines and provides healthcare plan resources on www.your-healthcare-plan.info.

Categories : Healthcare
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Feb
16

Must Do Tips to Burn Fat Fast

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Must Do Tips to Burn Fat Fast

If you’re serious about losing weight, these are the must do tips to burn fat fast. If you follow these steps, you are guaranteed to lose weight.

Eat 6 meals a day

This is by far the most important thing that you must do if you want to burn fat quickly and efficiently. Keeping you body supplied with food requires your body to burn calories to digest it. This continuous work by your body starts to add up quickly, which allows you to burn more calories than you normally would.

Exercise 4 times a week

I know many of you still cringe when you think about exercising, but whether you like it or not, you got to work up a sweat. Thirty to forty minutes is all you need, but if you have the time, pushing it to an hour is even better. Cardio exercises are great, but it you want to look nice and tone with tight look muscles, you need to resistance train as well. Free weights are the best, but rubber bands are also a good alternative if you can’t get to the gym or you just want to do something at home.

Keep a Positive Attitude

Unfortunately, it’s easy to get discourage when it comes to losing weight and getting into shape, especially at the beginning. That is why it is very important to keep a positive attitude. If you’re 50 pounds or more overweight, don’t expect to lose all of it in a day or even a week. After all, you didn’t put on that amount of weight in a day. Be patient and positive that your routine will get you to your goal. Regrettably, to many of you guys just give up when, if you would have just persisted, you would have eventually reached your goals.

In short, follow these tips and you will burn fat fast.

Question and Answer


Burn fat….?
I am 5'4 and 115lbs I have two kids and I have been going to the gym everyday to tone my body. I am at the right weight for my height but i have no muscle. So all the weight is fat. I am afraid that I will build muscle under my fat. Can this happen? What are good ways to burn fat and in the right areas such as stomach and thighs?

John C White

Are you tired of searching all over the web for information and advice on what you need to do to lose weight quickly and easily? Then check out http://www.How-to-Burn-Fat.com Be sure to sign up for our newsletter to receive your free report on Fat Burning Foods and while you’re there, calculate your target heart rate zone to get the most out of your workouts.

Categories : Healthcare
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Feb
16

Power of Lean Healthcare

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Power of Lean Healthcare

As healthcare costs increase at a faster rate than other products or services, healthcare providers, in particular hospitals, are under continuous pressure to dramatically improve service, reduce costs, improve patient safety, reduce waiting times, and reduce errors and associated litigation.

However, hospitals are not making the necessary improvements in cost, quality, and safety. A report by the U.S. HHS Office of the Inspector General finds that 20% of consecutive inpatient stay sequences were associated with poor quality care, unnecessary fragmentation of care, or both. The current organization and management of hospitals is an imperfect system that cannot effectively address these issues. Major projects to restructure hospitals, dramatically reduce cost, and improve customer care have had little impact on quality or cost.

In simplistic terms, current healthcare systems are not designed to make the process or ‘value stream’ of care flow smoothly. Healthcare services are often ‘batch and queue’, with patients spending most of their time waiting until the Healthcare Professional is ready i.e. push versus pull. As the population matures, patient cycle times in the hospitals, post-care facilities, and laboratories become key measurements that need to improve.

Our belief is that Lean Healthcare can provide a solution to successfully address some of these concerns with minimal cost but maximum benefit.

Lean in Healthcare

The essence of Lean Thinking is to eliminate waste through understanding how the patient defines value and how to deliver that value. Lean Thinking focuses on creating an efficient, waste-free continuous flow built on a pull vs. ‘batch and queue’ approach aligned with the continual pursuit of a perfect system.

Examples of Healthcare Waste:

o Redundant capture of information on admission

o Multiple recording of patient information

o Excess supplies stored in multiple locations

o Excess time spent looking for charts

o Patient waiting rooms

o Excess time spent waiting for equipment, lab results, x-rays etc.

o Excess time spent dealing with service complaints

Hospitals are made up of a series of processes with diverse lines of business. As a consequence, they need to build their delivery systems with these lines of business in mind. Hospitals need to know the businesses that drive 80% of their value proposition. They need to streamline their organization systems and processes to fully support the process required to deliver high quality care.

Commitment and support for any lean initiative needs to not only come from top healthcare management but, even more critically, from the ‘bottom up’ for implementation. Decision making and system development need to be pushed down to the lowest levels of any healthcare organization.

Management consultants are normally engaged as Lean change agents rather than as Lean facilitators. Healthcare staff should lead any Lean implementation program. These people are best equipped to understand the work environment, issues, challenges, what will work and what won’t. An empowered and knowledgeable team is therefore essential to achieve sustainable improvements and long-term success in any Lean initiative. Put simply, Lean will not work without an educated workforce.

Examples of Lean Healthcare Performance Metrics

o Improved patient satisfaction

o Increased operating room utilization

o Reduced time between procedures

o Lower tools and supplies inventory

o Reduced laboratory space

o Improved cost effectiveness

Lean Healthcare Accreditation

A new Lean Healthcare Green Belt Certification program (www.leanhealthcareservices.com) was recently developed to enable effective staff empowerment.

The on-line program represents the first International Healthcare Certification of its kind, and provides an essential ‘first step’ to not only understanding the theory but also the application of Lean tools and practices through detailed work assignments, in-line assessments, and final examination.

The program has been designed in association with the Irish Institute of Industrial Engineers, the Canadian Professional Logistics Institute, Lean Experts, and Healthcare Consultants in conjunction with the Leading Edge Group. It is open to personnel involved in any organization within the healthcare field, particularly those associated with hospitals, clinics, nursing homes, blood banks, laboratories, and pharmacies. Once these people have the ‘appropriate’ knowledge, they will be able to envisage and achieve results and, most importantly, meet the needs of patients now and in the future.

Please contact Joe Aherne CPA, Chief Executive Officer, Leading Edge Group, jaherne@leadingedge.ie; www.leanscm.com; www.leanhealthcareservices.com

Question and Answer


healthcare?
can i ask about the american healthcare system for my culture project.
1) do you have free universal healthcare, if not how much is it for an individual.
2)what is the most you would pay for a prescription.
3)what is the average life expectancy.
4)are you happy with the healthcare system.
5)what would you change about it.
6)are you afraid universal healthcare would bring socilism.

thank you.

Joe Aherne

Joe Aherne is a Certified Public Accountant, with over 25 years experience in the multinational sector. He also has attained qualifications from the Marketing Institute of Ireland and from CITY Bank in the U.S.

Joe established the Leading Edge Group in 1995 a niche boutique consulting company supporting the US multinational and SME sectors. The company is now recognized as one of the largest independent Lean consultancies in Europe with over 600 projects completed successfully since its inception.

Joe launched in April 2005 the new International Standard in Lean comprising 4 levels of certification and leading to a Masters Degree in Quality Management: Lean Master Black Belt. (www.leanscm.com & www.leanhealthcareservices.com ) He is currently leading a major international drive promoting the adoption of Lean healthcare philosophies and practices

Joe Aherne CPA, Charter House, Cobh, County Cork, Ireland +353 21 4855863

Categories : Healthcare
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Weight Loss Pills – How to Gain and be Safe

Weight loss pills have become popular in the past several years. There are two basic types of diet pills or weight loss pills – ‘prescription’ and ‘non-prescription’ pills.

Prescription Pills :

Prescription weight loss pills are treated like drugs. They require FDA approval and are closely regulated. Some examples of this type of weight loss pills are Xenical (Orlistat), Meridia (Sibutramine) and Phentermine/ Fentermine. To prove their effectiveness in weight reduction, these pills are subjected to a range of clinical tests typically for monitoring health risks and side effects.

Non Prescription Pills

The Non-prescription weight loss pills are also called as weight loss supplements. These drugs can be purchased over the counter as they are subjected to minimal FDA regulation only. Some examples of this type of weight loss pills include pills from Metabolife™ and Herbalife™ as well as fat-burners, herbal weight loss pills, stackers, other sports or diet supplements.

The difference between prescription and non-prescription weight loss pills is becoming narrower. Since some types of non-prescription pills can be just as powerful or dangerous as weight loss drugs. Exception is that these types of weight loss supplements are not regulated similar to prescription weight loss pills. Hence they can be more dangerous if anything. The FDA has issued warnings recently about weight loss supplements that contain ephedra. Hence, many drug manufacturers are now declaring as ‘ephedra-free’ by removing ephedra from their weight loss pills.

Who can benefit from Weight Loss Pills?

Prescription weight loss pills are designed specifically for the treatment of obesity rather than mere weight loss. Despite health risks and side effects, the use of weight loss pills is justified, as obesity is a serious condition associated with serious health risks. Weight loss supplements or Non-prescription weight loss pills should be viewed in similar light.

Do these Weight Loss Pills work?

The answer is both Yes and No. With a proper exercise program and diet in conjunction with medical supervision, weight loss pills or weight loss supplements can be effective in the short term at least. However the benefits may quickly wear off as the body adjusts rather quickly to many weight loss pills.

Weight Loss Trials of Pills clinically:

Clinical weight loss trials demonstrate that by using weight loss pills alone, long term weight control is not possible. A combination of improved diet and physical activity is to be maintained in the long term to maintain weight loss successfully.

Consult your doctor before taking weight loss pills:

You should obtain information from your doctor about the possible dangers and side effects of weight loss pills before taking any weight loss pills.

Side Effects of taking weight loss pills:

Weight loss pills become less effective as time progresses like most drugs and can lead to addiction. If you feel any of the following side effects, taking the pills should be stopped immediately.

Irritability

Anxiety or nervousness

High blood pressure

Insomnia

Heart palpitations and Heart attack

Tightness in the chest

Vomiting, constipation or constant stomach pain

Diarrhea, Fever and Head aches

Dry mouth

Dizziness

Profuse sweating

Blurred vision

Hair loss

Urinary tract problems

Disturbances in sex drive and menstrual cycle.

The long-term effects of these weight loss pills are not known and how they interact with other medications is also not clear.

Question and Answer


Weight Loss?
I'm going to try out for the volleyball, softball, and tennis for extra-curricular activities for high school. Is this good for improving weight loss? If not is their any other sports I can try. Next summer I am going to do swimming. I am somewhat overweight.

Lesley Lyon

Lesley Lyon regularly contributes informative articles on topics such as health, beauty and cosmetics to web guides http://www.healthopts.com and http://www.saunashome.info

Categories : Healthcare
Comments (10)
Feb
12

Genetic Risk Factors In Breast Cancer

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Genetic Risk Factors In Breast Cancer

Breast cancer is the most common cancer and the second leading cause of cancer deaths in women in the United States.  In 2008, approximately 184,450 patients were estimated to be diagnosed with invasive breast cancer, and an estimated 40,930 were estimated to die of this disease.   Furthermore, over 50,000 female carcinoma in situ breast cases would have been diagnosed.  The etiology of breast cancer is poorly understood with multiple genetic and environmental factors involved in the initiation and progression of cancer. 

 

Scandinavian Twin Study:  For years, there has been a hot debate as to whether the cause of breast cancer is genetic or environmental.  Then in 2000, Lichtenstein and his colleagues at the Karolinska Institute in Sweden published their study of 44,788 pairs of twins from the Swedish, Danish, and Finnish twin registries.  In this study, they looked at cancer risk with 28 different types of cancers and did statistical modeling of genetic and hereditary contributions in eleven different cancer types.  For breast cancer, they clearly showed that only 27% of breast cancers were due to genetic factors.  This was an even lower hereditary component than other common cancers such as prostate and colorectal.  This study and others have confirmed the fact that over 70% of breast cancers are influenced by environmental factors.

 

BRCA genes:  Although much attention has been made about hereditary breast cancer, only two genes are commonly tested for breast cancer risk assessment.  These two genes are tumor suppressor genes named “BRCA1″ and “BRCA2″ that are involved with DNA repair.  These two genes only account for about 5% of all breast cancers.  Because of the Scandinavian twin study, most experts believed that there are other yet to be discovered genes involved with breast cancer.  Because the chance of having a BRCA mutation in the general population is so low, genetic testing is not indicated in most patients.  However, if a patient has a family history of breast cancer, then a mathematical model can be used to determine if BRCA testing is indicated.  The likelihood of being a BRCA carrier increases with the number of relatives who had cancer and if the cancers occurred earlier in life.  For example, in families with four or more cases of breast or ovarian cancer under the age of 60, over 80% are found to have a damaged version of BRCA1 or BRCA2.  If a patient is a carrier of one or both of the BRCA1 and BRCA2 genes, her risk of breast cancer dramatically increases.  According to estimates of lifetime risk, about 13.2% (132 out of 1,000 individuals) of women in the general population will develop breast cancer, compared with estimates of 36-85% (360-850 out of 1,000) of women with an altered BRCA1 or BRCA2 gene.  In other words, women with an altered BRCA1 and/or BRCA2 gene are up to eight times more likely to develop breast cancer than women without alterations in those genes.  The BRCA1 mutation confers a higher risk than a BRCA2 mutation.  Women who inherit a damaged BRCA1 gene have a 60-85% chance of developing breast cancer at some stage in their lives and a 20-40% chance of developing ovarian cancer.  For BRCA2, the risks are 40-60% and 10-20%, respectively.  

 

Family History and Breast Cancer:  Although the spotlight in hereditary breast cancer has been directed on the BRCA genes, the majority of patients with a family history of breast cancer are BRCA1 and BRCA2 negative.  Even in these BRCA negative patients, however, there is an increased risk of developing cancer with a family history of breast cancer.   Six factors (unrelated to BRCA genes) have been studied in patients with a family history of breast cancer.  They are as follows:

 

1.  Degree of relationship:  If the family member with a history of cancer is a first degree relative, the increased risk is much greater than for second degree relatives. 

2.  Number of relatives who have had breast cancer:  People with two or more family members who have had breast cancer are at higher risk than those with only one affected relative.

3.  Age of onset of cancer:  If the relative developed breast cancer at an early age (pre-menopausal), the risk is higher than if the relative developed post menopausal breast cancer.

4.  Bilateral breast cancer:  If the relative has a history of bilateral breast cancer, the risk is greater than having a relative with unilateral breast cancer.

5.  Gender of the relative:  If the family member with breast cancer is a man, the risk is higher.

6.  Other related early onset tumors:  If there is a family history of early onset ovarian cancer, this incurs an increased risk for a person.

 

How to decide whether you need the BRCA gene test

 

The following is an excerpt from the American Society of Breast Surgeons:

1.  Early onset breast cancer (diagnosed before age 50)

2.  Two primary breast cancers, either bilateral or ipsilateral
3.  A family history of early onset breast cancer
4.  Male breast cancer
5.  A personal or family history of ovarian cancer
6.  Ashkenazi (Eastern European) Jewish heritage
7.  A previously identified BRCA1 or BRCA2 mutation in the family

Any one of these features alone indicates a risk for harboring a BRCA1 or BRCA2 mutation.  The presence of more than one of these features raises that risk to greater than 10%, the traditional cutoff for recommending a BRCA test. Such patients should have access to BRCA testing.  A simple risk-calculation model based on the prevalence of mutations seen among women tested for BRCA mutations is available at http://www.brcacalculator.com.

Question and Answer


CANCER??????????????????????????????????????????????????
went to a specialist after months of severe neck pain…and on the Mri it showed a white lump on my neck. The dr didn't seem concerned and had me have a ct scan. He said it was a benign hemangioma and nothing to worry about. This lump has been killing me, feeling like it was twisting my neck, last night I was up till 7:30 am. I also developed chest pain..and pain in my left side, could that be the spleen? I don't know what the problem is, and the dr's don't have a clue either…any ideas? Could this be cancer? Aren't malignant tumors not painful and benign ones painful? If it isn't cancer…then what?? I had lyme disease last year but was treated…is it possible I wasn't on medication long enough? The tick bite has gotten red again…from last year?? Or is this just a coincidence?

I also have severe burning on my left side, by the ribs..and what I assume is the spleen looks enlarged. I have joint pain, and my back burns so much that I thought I had a heating pad on lol…my mom said that means inflamation of the kidneys??? Is this cancer? Lyme disease? IDK
I had lyme disease last year, but was treated. I have joint pain,and the bite where the tick bit turns red on occasional days, but that was last year? I have had some headaches and hearing loss…LYME DISEASE?

Mai Brooks

Dr. Mai Brooks is a surgical oncologist/general surgeon, with expertise in early detection and prevention of cancer. More at www.drbrooksmd.com, thecancerexperience.wordpress.com and progressreportoncancer.wordpress.com.

Categories : Healthcare
Comments (13)
Feb
11

New York Health Insurance

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New York Health Insurance

New York Health Insurance

Health insurance is insurance that pays for all or part of a person’s health care bills. A health insurance policy is an annually renewable contract between an insurance company and an individual. With health insurance claims, the individual policy-holder pays a deductible plus co-payment (for instance, a hospital stay might require the first 1000 dollar of fees to be paid by the policy-holder plus 100 dollar per night stayed in hospital). Usually there is a maximum out-of-pocket payment for any single year, and there can be a lifetime maximum.

The purpose of health insurance is to help people cover their health care costs which usually include doctor visits, hospital stays, surgery, procedures, tests, home care, and other treatments and services.

According to the latest United States Census Bureau figures, around 85% of citizens have health insurance. 59.5% of these people receive their health insurance coverage through an employer, and about 9% purchase it directly from the market. Government sources cover 27.3% of the population. Those without health insurance coverage are expected to pay privately for medical services.

Types of New York Health Insurance (http://new-york.ixs.net/General/New-York-Health-Insurance/index.aspx ) The types of health insurance in New York are group health plans, individual plans, and government health plans such as Medicare and Medicaid. In the United States, government-funded Medicare programs help to insure the elderly and end stage renal disease patients.

Group Health Plans

A group health plan offers health care coverage for employers, student organizations, professional associations, religious organizations, and other groups. The employer may pay for part or all of the insurance cost (premium).

Individual and Family Health Insurance

Individual and family health insurance is a type of health insurance coverage that is made available to individuals and families, rather than to employer groups or organizations. These types of health care plans are sold directly to individuals. For those of you who are unemployed or self-employed, an individual health insurance policy is always an option. Unfortunately rates for these policies are high and the coverage is usually less comprehensive than a managed care plan. The good news is that, in many cases, your insurance premium will be tax deductible. Of course, if you’re married, you can always try to catch a ride on your spouse’s group health insurance benefits plan.

Health insurance can be further classified into fee-for-service or indemnity (traditional insurance) and managed care. Both group and individual insurance plans can be either fee-for-service or managed care plans.

Managed Care Health Insurance

These include HMO, PPO, and POS plans. Managed-care plans typically make use of healthcare provider networks. Healthcare providers within a network agree to perform services for managed-care plan patients at pre-negotiated rates and will usually submit the claim to the insurance company for you. In general, you’ll have less paperwork and lower out-of-pocket costs with a managed care health insurance plan and a broader choice of healthcare providers with an indemnity plan.

There are three main types of managed care plans:

• Health Maintenance Organizations (HMO)

• Point-of-Service (POS)

• Preferred Provider Organizations (PPO)

All of these plans offer substantial health insurance benefits to members and their families. If you’re fortunate enough to have a choice of plan, consider the advantages, and disadvantages, of each. Compare the cost of care, the difference in premiums, deductible amounts and your freedom to choose a doctor outside the plan. There are numerous other coverages to compare as well — from prescription drugs to dental to alternative therapies. Be sure you understand the fine points of each.

Indemnity or Fee-For-Service Plan

Normally it covers the same expenses as managed care. The difference is your doctor is paid for each visit with the claim filed by either the patient or the medical provider. A big advantage– unlike some managed care plans, Fee-for-Service allows the patient a great deal of freedom in choosing which doctors and hospitals to use, but will probably involve higher out-of-pocket costs and more paperwork.

However, you’ll likely be required to pay an annual deductible before the insurance company begins to pay on your claims. An Indemnity plan may also require that you pay up front for services and then submit a claim to the insurance company for reimbursement.

Short-Term Health Insurance

Short-term health insurance plans are designed to protect against unforeseen accidents or illnesses, rather than to provide comprehensive coverage, and, as such, typically do not include coverage for preventive care, physicals, immunizations, dental or vision care. It covers for a limited period of time, and may be an ideal solution for those between jobs or those waiting for other health insurance to start. Typically, short-term plans offer coverage up to six months, although some plans may offer coverage up to 12 months. Purchasing a short-term medical insurance plan will make you ineligible for any guaranteed issue individual health plans commonly referred to as HIPAA (Health Insurance Portability and Accountability Act) Plans. HIPAA plans are usually very expensive and are generally intended for people with pre-existing medical conditions who would have trouble getting health insurance otherwise.

Medical Savings Account (MSA)

Medical savings account (MSA) is the most recent development in the area of health insurance. The principle behind the MSA is to take the bulk of the financial risk, and premium payments, away from the managed care and indemnity insurers, and allow individuals to save money, tax free, in a savings account for use for medical expenses. Individuals or their employers purchase major-medical policies, medical insurance policies with no coverage for medical expenses until the amount paid by the patient exceeds a predetermined maximum amount, such as 2500 dollar per year. These policies have extremely high deductibles and correspondingly low monthly premiums and the participants take the money that they would have spent on higher premiums and deposit it in an MSA. This money accrues through monthly deposits and also earns interest, and can be spent only to pay for medical care

What’s The Best Health Insurance Plan?

There is no one “best” plan for everyone. The best match for you and your family may be different than the best match for someone else. In order to help you answer this question, here are a few things to consider:

1. Are you going to need long-term coverage or just something for the short-term?

If you’re between jobs for 1-6 months, you may want to go for short-term coverage options. Alternatively, if you have no prospects of receiving group health insurance coverage through an employer, you may value the stability and increased benefits offered through an individual and family health insurance plan which will provide longer term coverage.

2. Are you looking for basic coverage or more comprehensive coverage?

Some insurance plans offer basic coverage (i.e., primarily inpatient hospitalization and outpatient surgery coverage) to cover you in case of a major accident or illness. These insurance plans typically have a lower monthly premium than plans with more comprehensive coverage, and may be appropriate for people who intend to use their insurance primarily in the event of a serious accident or illness. Other insurance plans that offer more comprehensive coverage may include benefits such as preventative care, physician services, prescription drug benefits and routine office visits. These insurance plans typically have a higher monthly premium than plans that only offer basic coverage, and may be appropriate for people who intend to use their insurance on a regular basis.

3. Would you pay for your services before you use them or when you use them?

If you choose a health insurance plan with a low monthly premium, you’re likely to have a higher co-payment or deductible. If you don’t anticipate making frequent use of your health insurance coverage, a higher-deductible plan with a lower monthly premium may suit you best.

4. How important to you is easy access to specialists?

Health insurance plans that require you to coordinate your care through a primary care physician typically require that you obtain a referral before seeing a specialist. So, if you prefer easier access to specialists, you may wish to consider a different type of plan.

5. Do you have a specific doctor or hospital that you would like to visit for healthcare?

Some insurance plans utilize provider networks. Pay special attention to the network of doctors or facilities that each health insurance plan utilizes. Also note that networks utilized by health insurance plans can change, so there is no guarantee that your doctor will always be contracted with your chosen health insurance plan.

6. What is the most you could pay out in case of a serious illness or injury?

Health insurance plans typically place limits on how much a member is required to pay out per year for his or her healthcare. This limit is often referred to as an out-of-pocket maximum. Once you’ve contributed this maximum amount toward your healthcare, the health insurance company typically covers all other costs for the remainder of the benefit year. If you’re concerned about what may happen to you in case of a serious illness or injury, you may wish to pay special attention to the out-of-pocket maximums for the health insurance plans you’re considering.

No matter what insurance plan you may choose, educate yourself and understand all the basics of the health insurance before finalizing anything.

For more information about New York Health Insurance visit: http://new-york.ixs.net

Question and Answer


health…………………..?
health and fitness

Maria

Maria hosts http://events.ixs.net and expresses her passion for events through writing and discussion. She works for Less Corporation at http://www.ticketnest.com Copyright Heidi Grumm

Categories : Healthcare
Comments (18)
Feb
10

How A Low Cholesterol Diet Can Help You

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How A Low Cholesterol Diet Can Help You

If you have found out from your doctor or from doing home cholesterol test that you have a high total cholesterol level, one of the first things you need to do is to change your diet to a low cholesterol diet to help you lower your cholesterol. This is because a high cholesterol level is very dangerous for you and might cause you serious heart diseases or even a heart attack.

A low cholesterol diet does not have to be hard to stick to, as you can still enjoy some of the foods you always like. However, you really need to stay away from foods that contain saturated or trans fats, as they are among the major leading causes to having a high cholesterol level.

To have a low cholesterol diet means that you should replace the saturated fat in your diet with unsaturated fat besides eating less high-cholesterol food and choosing foods that are high in complex carbohydrates. You should also make sure that you get more physical activity and try reducing your weight if you are overweight.

Determining What is Low Cholesterol Food and What Isn’t

Before starting on a low cholesterol level, you should first know what low cholesterol food is and what isn’t. This will help you create a diet which is low in cholesterol to help you lower your total cholesterol levels. There are many different types of food that can be classified as low cholesterol foods, so that you do not need to give all the food you love to have a low cholesterol diet.

Cholesterol is most usually found in foods of animal origin, such as meat, poultry, and eggs, including milk and cheese. In animals, cholesterol is part of the cell membrane structure of all cells. That is why removing the skin from a chicken will remove most of the fat, but will not remove all the cholesterol.

However, in dairy foods the amount of cholesterol involved depends on the amount of fat as milk is secreted from animal cells and not made up of cells like meat. Although it has no cholesterol-containing cell membranes, but because cholesterol is fat soluble, it can b found in fats in milk and milk-based foods. That is why if a dairy product contains more fat, it will also contain more cholesterol, so always choose low fat dairy products when sticking to a low cholesterol diet.

Converting To A Low Cholesterol Recipe

If you found out that you have high cholesterol, you must start converting some of foods you love to a low cholesterol version. You must also learn to live without some of the foods that have been causing you to get a high cholesterol level in the first place. Learning how to make your foods using a low cholesterol recipe is one way to lower your cholesterol levels

Converting your food to a low cholesterol recipe is not a very difficult thing to do. All you need is a little bit of willpower and you can start enjoying cholesterol free or lower cholesterol version of your favorite foods. The taste will not differ much as long as you know how to add flavor into your cooking without using saturated fats and other harmful foods that contribute to more cholesterol problems.

The easiest way to get started on low cholesterol recipe is to start with one day’s menu. You can include a safe amount of food fats into your diet at first so that you can ease the transition period from your normal food to the low cholesterol diet, and make this change easier on you.

A good way to start a low cholesterol diet with a low cholesterol recipe is trying a serving of oatmeal, honey, and an apple for breakfast. Mixing oats, fat free milk, and a little honey and chopped apple will make a great delicious cholesterol free breakfast. For lunch, you can follow up with a salmon and tomato sandwich with a side salad. For tasty salad dressing, you can try using lemon juice and black pepper as a low cholesterol option. For dinner, you can have stir-fried chicken breast, veggies, and some rice will make you enjoy your low cholesterol diet. You can also try using brown rice instead of white rice for a lower cholesterol diet.

Make changes one step at a time, and in no time you will start enjoying a healthier life with lower cholesterol level. These changes will prevent you from having heart diseases caused by your diet. You will soon find that you enjoy the low cholesterol food as much as or more than your previous high cholesterol food.

Question and Answer


CHOLESTEROL????????????
Can alcohol elevate your cholesterol??? I don't eat alot… once or twice a day. My Doc said 150 was norm… mine is 350… any ideas???

Cindy Heller

Cindy Heller is a professional writer. Visit Cholesterol Lowering Food to learn more about low cholesterol diet and low cholesterol recipe.

Categories : Healthcare
Comments (18)
To Compare the Role of Glibenclamide and Pioglitazone Drugs in Type 11 Non- Insulin Dependent Diabetes Mellitus Patients


To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.

Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.


Introduction:-

Diabetes comes from the greek word for ‘SIPHON” which one is the first term and implies for a lot of urine is made .The trm “mellitus” comes from a laton word, “met” which means “honey” and was used because the urine was sweet (Wheeler,2004)

Diabetic ketaocidosis is one of life threatening condition requiring some data hospitalization and treatment. Recognition of this condition is of almost importance, because even small delays can have an impact on survival (Nattrass, 2006). Hypoglycaemia are involved in insulin induced episodes in individuals with diabetes. Probably the major factor prescribing, insulin treated patient from achieving the glucose targets needed to prevent diabetic complications. The incidence of hypoglycaemia reflects the inadequancy of current mathods of insulin delievery which lead ot inappropriately high insulin concentration, particularly some persons after eating more foods at night onset of blindness and also a major risk factor heart disease and stroke

(Heller, 2003).


TYPES OF DIABETE MELLITUS

TYPE 1 DIABETES MELLITUS (IDDM):

Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depending on the rate and degree of b -cells failure (Lambert & Bingley. 2005).

Type II diabetes mellitus (NIDDM):

Type II diabetes is a complex metabolic disorder associated with, b -cells dysfunction and with varying degree of insulin resistance primary pathogenic factors leading insulin resistance leading to type 2 diabetes and decreased insulin, secretion which arise from abnormalities with in liver, skeletal muscle and pancreatic b -cells (charles & clark, 1996).


GESTATIONAL DIABETUS MELLITUS

:

Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.


SECONDARY DIABETUS MELLITUS:

Secondary diabetes is due to disease of the pancreatic and endocrime system, genetic disorders, or exposure to chemical agents.

Type – I diabetes formerly known as insluin dependent diabetes mellitus (IDDM), is characterized by the destruction of the pancreatic beta cells that produces inslulin

Type – I diabetes formerly known as insulin dependent diabetes(IDDM),is characterized by the destruction of pancreatic beta cells that produces insulin.Type-1 diabetes occures most often in children and young adults but it can occures at any age.(Anderson et al 2007).

Type-11 diabetes is not straight uprward. A pancreas that does not produce enough insulin. Liver that release too much glucose,muscle cells that do not readily take in glucose.(Carren 2008)

Many genetic factors are involved in the development of diabetes.Because of new genetic methodology researchers are closers to identifying all of the cadidate gene for both non –insulin dependent and insulin dependent diabetes(Bernhard,1995).

Woman who had gestation diabetes are more likely to develop Type-11diabetes themselves.Pergnant women with diabetes are another disadvantaged group.They need much more intensive antenatal care and close monitoring of blood sugar,blood pressure and weight.(jawed2006)

Over weight children the progression of child obesity into adulthood is associated with early develop of complications, including IgpG2 diabetes and cardiovascular disease.Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases,it is currently undergoing world wide epidemic. Type 11diabetes mellitus is caused by body’s infective use of insulin, it is often results from excess body weight and physical inactivity(WHO 2007).


PREVALACES& IINCIDENCE

:

Diabetes mellitus increases with aging, in 200 the prevalance of diabetes,it was estimated to be 0.19% people<20 years old and 8.6% in people>20 years old.There is considered geographic variation in the incidence of both type-1 and type-11 diabetes mellitus.Scavandinvian has the highest incidence of type-1 diabetes mellitus e.g in Finland, the incidence is 35/100,000 per year the pacific rim has a much lower rate in japan and china the incidence is 1 to 3/100,00 per year of type-1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100,000 per year).The prevalence of type 11 diabeties mellitus is highest in certain pacific island, intermediate in countries such as India and the United States, and relatively low in Russia and China.This variability is likely due to genetic, beharioral and enviromental factors(Power 2005).Diabettes mellitus prevalance also arises among different ethic population within a given countries it is common inall ethnic groups its prevalance increased with age and more than 5% of individuals of more than 65 years of age have diabetes mellitus (David Owerback 1988).The World wide prevalence of diabetes mellitus has risen dramatically over past two decades.The prevalence of type11 diabettes mellitus is expected, type 11 diabetes mellitus is more prevalent among Hispanies Native Americas,African,American,and Asians, pacific Islanders than in non- Hispanic whites,the incidence is essentially equal in woman and men in all populations. Type 11 diabetes is becoming increasingly common because people are living longer,and the prevalence of diabetes increases with age it is also seen more frequently now than before in young people, in association with the rising prevalenceof childhood obesity although type11 diabetes still countries with the estimated nubers of cases of diabetes in 2000and 2030.

Rank Country

2000 Individuals country with diabetes (milloins)

Country

2030 Individuals with diabtes (Million)

India

31.7

India

79.47

China

20.8

China

42.3

USA

17.7

USA

30.3

Indonesia

8.4

Indonesia

21.3

Japan

6.8

Pakistan

13.9

Pakistan

5.2

Brazil

11.3

Russian federation

4.6

Bangladesh

11.1

Brazil

4.6

Japan

8.9

Italy

4.3

Philippines

7.8

Bangladesh

3.2

Egypt

6.7

(Wareham& FOROUHI 2OO6)


DRUG TREATMENT OF DIABETIES MELLITUS

:

Biguanides lower blood glucose, they increase glucose uptake and utilize in skeletal muscle there by reducing insulin resistance, and reduce hepatic glucose production (gluconeogenesis).Lower blood glucose, addionally reduces low denisity and very low denisity lipoproteins (LDL and VLDL) respectively. Metformin has a half life of about 3 hours and is excreted unchanged in the urine.Clinically metformin used in type 2 diabetic who are obese and who fail treatment with diet alone.Adverse effects are produced dose related gastrointestinal disturbances e.g anorexia,diarrhoea,nausea,lactic acidosis rare but potentially fatal toxic effect.(Dale,2003).

Improving insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism Rosigilitazone and Piogiltazone are currently approved.Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone,although they are usually taken in combination with sulfonylurease.

In some incouraging studies, thaiazolidiniones have produced very favorable effects on the heart, including reducing blood pressure and improving triglycerides and cholestrol levels including increasing HDL level,the good cholestrol. They may also block a molecule called 11 Best HSK that may play a significant role in metabolic syndrome,as well as diabetes type11. One study also sugessted that Rosiglitazone may even improve beta cells functions and so help prevent progression of diabetes.Anemia, weight gain, increased risk of fluid buildup, may worson heart failure.Troglitazone,was withdrawn after a few reports of heart failure.Liver failure abd death.Current Thiazoldinediones don not appear to pose the same effects on the liver although there have been a few reports of liver injury.

In patients with dietry failur the choice of a sulfonylurea agent or insulin therapy has been controversial and empric in favour of insulin therapy are the studies, who reported marked improvement post receptor diagnostic after intensive short term therapy in untreated type 2 diabetes mellitus (Scarlett et al,1984) Sulfonylureas further classified into two groups or generations based on their potency,duration,drug interaction,side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobes et al 1998).A sulfonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) also recommends that a generic ,drug should be perscribed (Scsade et al1998).


RESEARCH DESIGN AND MATERIAL AND METHODS:

This study was conducted in the deprtment of Pharmacololgy and Therapeutics,Basic Medical Science Institute,Jinnah,Postgraduate Medical Centre,karachi under kind supervision od DRr:GhulamRsool Mashori,Associate Professoer and Head OF Department Of Pharmacology and Therapeutics in colloboration with Medical Outpatient Department Unit111 and Filter Clinic, Medical Department, JPMC,Karachi.

Seventy NIDDM (type-II)diabetic patients were initially enrolled in the study from the filter clinic/ out patient department Medical Unit III ,and diabetic clinic.Out of this 60 diabetic patients were associated in whole period of study, remaining 10 patients were dropped due to poor comlpiance or change in residential place.All the patients were divided in two main groups,groupI and in group II these patients were selected in this study according of inclusion and exclusion criteria.


INCLUSION CRITERIA

:

  • Newly diagnose patients of non Insulin Dependent Diabtes Mellitus.
  • Diagnsed patients of diabetes also including having no any history medication.
  • Having either sex of age between 30 to 60 years.
  • Diagnosed patients who were Non Insulin Depedent Diabetes Mellitus who were treated with Pioglitazone.
  • Diagnosed patients who were Non Imsulin Depedent Mellitus, who were treated with drug Glibenclamide.


EXCLUSION CRIRERIA

:

  • Patients suffering from blood pressure.
  • Patients suffering from liver disease.
  • Patients suffering from cardiac disease.
  • Pregnancies and lactating women.
  • Patient suffering from renal disorders.
  • Patients having serious complications.


MATERIAL:

  1. Lacets.
  2. Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).
  3. Glucometer(Medisense) optilim one touch(Abbotts).
  4. Blood glucose nest trpis (IVD for Invitro diagnostic use (Abbott Labortries,Medisense UK Ltd,Abigngdon,Ox14ITR,Masde in UK). Stored between minimum 30?, (4°-30° C) and Maximum 40°C (39°-86°F).
  5. Weight Machine Model No 1101 Lot No.312. TANTIATA.


DRUGS

Tab:Daonil 5 mg (Aventis Pharma)

Drug category:Sulphonylurea.

Generic Name: Glibenclamide.

MFGLIC:No.000007 RegistrationNO.000220

MFG Date:0-06

EXP Date:7-10

Lot NO:B230

Tab:piozer (Hilton Pharm) PvtLTd.

Tab:Poizer 15mg

Drug category:Thaiazolinedione.

Generic Name:Pioglitazone Hydrochloride.

MFG LIC: O.000136 Registration No.03270

MFG Date:3-06

EXP Date:3-o9

Lot No:6287

Tab: Poizer (Hilton Pharma)pvt ltd.

PARAMETERS:

Fasting Blood Sugar (FBS).

Random Blood Sugar (RBS).

Weight.

Key words:Diabetes mellitus,Non-insulin diabetes mellitus,Insulin depedent diabetes mellitus, Daonil,poizer,Insulin.


RESULTS:


Table 1

Weight and Blood Sugar level observed on baseline day 0

In group1 and group11

 

Group 1

Group 11

 

Pioglitazone n=27

Glibenclamide n=33

Weight

63.37

+ 2.25

¯

62.7

+ 15.56

¯

Fasting Blood Sugar

172.7

+ 13.32

¯

188.42

+ 12.o5

¯

Random Blood Sugar

285.11

+ 15 .532

¯

284.18

+ 17.07

¯

All Values are expressed in Means± SEM.

FIGURE-1 weight and blood sugar levels observed on baseline (day-o)

In table No shpwing the weight (KG’S) and blood sugar (msg/dl0 levels which is observed on baseline (day-0) in both groups 9group: 1 & group11)

Group: 1 Weight in (Kg’s) mean + SEM) IS 63.37±2.25 Fasting blood sugar 172.7±13.32,and Random

blood sugar 285.11±15.32


Group:11

Weight (KG’s0 (mean +SEM)62.7±1.56 Fasting blood sugar (mg/dl0 188.42±12.05, Random blood sugar is 284.18±17.03.

Figure 2: showing the weight and blood sugar levels observed in base line (day-0) in group: 1 and group 11 weight in 9kg’s) its mean values are 63.37,62.7, Fasting blood sugar in (mg/dl) is 172.71, 188.42 Random blood sugar (mg/dl) is 285.11 &284.18.

TABLE: 2

Peroidic Observation In All Parameters Group1

Goup1(Pioglitazon) n=27

 

P-value

 

Day-0

Day-45

Day-90

Day-0to45

Day-45-90

Weight

63.37

±2.25

63.63

±2.26

63.63

±2.23

>0.05

(NS)

>0.05

(NS)

Fasting blood sugar

172.7

±13.32

165.04

±8.98

153.37

±7.59

>0.05

(NS)

0.05

(NS)

Randomblood sugar

285.11

±15.32

279.78

±13.63

255.56

±12.65

>0.05

(NS)

>0.05

(NS)

All values are expressed in Mean±SEM .(NS) Non significant.



TABLE NO:2

Showing the periodic observations in all parameters in group 1 (piogiltazone) (n+27) weight P.value (day 0 to day 45)>0.05 (NS). Fasting blood sugar >0.05 (NS) Random blood sugar >0.05 (NS) P.values day 90 weight >0.05 (N.S), FBS>0.05 (N.S) 7RBS >0.05(N.S) NON SIGNIFICANT

FIGURE:2 Showing the periodic observation in all parameters in group 1 on day0 day 45& day-90.Mean values in weight (Kg) is 63.37,63.26,63.63, fbs (mg/dl) 172.7,165.04,153.37,RBS(mg/dl) 285.11,279.78,255.56.

TABLE NO3

Peroidic Observation in All Parameters Group11

 

Group 11 (Glibenclamide)

N=33

P-value

 

Day-0

Day-45

Day-90

Day-0 to 45

Day-45 to 90

Weight

62.7

±1.56

65.64

±2.10

64.55

±1.92

>0.05(NS)

0.05(NS0

Fasting blood sugar

188.42

±12.05

168.45

±10.99

140.06

±5.68

>0.05(NS)

>0.05(S)

Random blood sugar

284.18

±17.03

220.12

±13.39

170.94

±5.80

<0.005 (MS)

0.002(MS0

(s) significant, (MS) moderate significant

All values are expressed in Mean±SEM.


Table No3:

Showing the periodic observation in all parameter in goup:11, Group:11 containing drug (Glibenclamide),no of patients (n=33).It’s P-value on day 0 to day 45 on weight >0.05(NS),FBS>0.05(N.S) RBS<0.005 (MS) <0.01- AND DAY 45 TO DAY 90 WEIGHT >0.05 (NS) FBS (0.05) RBS <0.002(M.S0 moderately significant.

Figure 3:Shwing the periodic observations in all parameters in Group 11 weight 62.7,65.64,64.55,FBS (MG/DL) 188.42,168.45 140.06,RBS(mg/dl) 284.18 220.12, 170.94 (on day-0-day 45 to 90).


DISCUSSION:

In Denmark Beck-Nielsenet al,skillman TG (1981) published studies demonstation that glyburide increased he number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with diet and in cobination of second generation sulfonyureas agents Wie. The numbers of insulin receptors all patients were measured before and after the treatment.Intrvenous glucose test shows the persistent impairent of insulin secretion afterthe starting of drug therapy.However those patient who were on drug Pioglitazone some results were obtained of insulin secretion in the impairment in early drug drug therapy.Clinical observations have suggested that the second generation sulfonylureas may exert their effects by potentiating insulin released by other primary stimulators Insulin secreting drug.

According to the study of WilliamC Dukworth et al(1972), aftr the chronic treatment with sulfonylureas it is well documented that plasma insulin levels were decreased in response to oral glucose load. This apparently occures even though glucose tolerance is improved over pre-treatment, levels,present study clearly support that study.

The result og group 11 correlates with the research conducted by Bonnie &Kimmel (2005) produces the same results as FBS reduces from baseline, and at the end of study,with an overall 23.44%,reduction,while with the results showed at the end of study peroid p-value were (p<0,001).

Similarly Michael Alvarsson et al (2003) conducted a similar type of study and the found and overall changes of change of 22.11% in Fbs and 40.88% in Rbs at the end of trial p-value were (p<0.001).

However a study conducted by (Stone &Brown in (2003) didnot match to our results in the parameter of FBS and observer a reduction of 26.22%.


CONCLUSION:

In the light of study discussion it is obiovus the glibenclamide was more effective,tolerable and safer than pioglitzone in a short duration.Diabetes Mellitus is chronic prolong disease for whole life.Poor community can afford it easily,on base of marketing of this drug in pakistan diabetes patients easily go and purchase economically,in fact ,mostly people buy it from pharmacy without dr’s perscription,because pharmacist and patient both of know about this disease.Just like dispirin as analgesic,it is famous anti-diabetic drug in our states as compared of other anti-diabetic drugs.


REFERNCES:

  1. Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-
  2. Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3
  3. Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-
  4. Clark CM-Oral therapyin type11 diabetes-pharmacological properties and clinical use of current use of currently available agents-Diabetes spectrum 1998,11(4):211-221.
  5. Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-
  6. David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32
  7. Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.
  8. Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.
  9. Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.
  10. Jacobes D-Insulin-Diabetes 1998;6(3);1160126.
  11. Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.
  12. Natters M-Ketoacdosis and hyperglycemia-Medicine 2006;34(3):104-106.
  13. Power AC-Epidemiology of type11 diabetes Basic facts of diabetes –Diabetes 2005;1(1)7-9
  14. Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.
  15. Schade DS et al A placebo controlled randomized study of glimepiride in patients of Diabetes mellitus- Diabetes 19998, 38(7);636-641.
  16. Warchman and Forouhi-Epidimology of Diabetes- Diabetes basic facts- Medicine 2006 ;34(2);57-60
  17. Wheeler Gd- Aaccident dicovery led to the noble prize for canadian reseachers,2005,01-02.
  18. WHO Report-Health-Diabetes Mellitus-Defiition and types of Diabetes 2007;1:1-4.


Question and Answer


Diabetes ?
I have notice when I eat something with allot of sugar my blood sugar gets really low a few hours later. I get light headed, dizzy, nervous and irritable. I also get thirty and feel really hungry. I get headaches too. When I eat something mainly with allot of carbs it goes back up. If I eat more sugar it goes up, but then suddenly drops again. Could this be diabetes? If so what type?
31 and thin

lalaghulamrasool bhurgri

working>as>assitant>professor>inmmc>mirpurkhas>sindh

Categories : Healthcare
Comments (14)
Imbalance of Ecosystems and Its Effect on Public and Livestock Health

Imbalance of Ecosystems and Its effect on Public and Livestock health

Dr.Kedar Karki M.V.St. (Preventive veterinary Medicine)

Central Veterinary Laboratory Tripureshwor

The health of humans, like all living organisms, is dependent on an ecosystem that sustains life. Healthy ecosystems are the sine qua non for healthy organisms. Yet there is abundant evidence that many life-support systems are far from healthy, placing an increased burden on human health. In some areas of the world, gains in life expectancy and quality of life made during the twentieth century are at risk of being reversed in the twenty-first century. The consequences of ecosystem degradation to human health are numerous, and include health risks from unsafe drinking water, polluted air, climate change, emerging new diseases, and the resurgence of old diseases owing to ecological imbalances. Reversing this damage is possible in some cases, but not in others. Prevention of ecological damage is by far the most efficient strategy.

DEFINING ECOSYSTEMS

An ecological system may be defined as a community of plants and animals interacting with each other and their abiotic, or natural, environment. Typically, ecosystems are differentiated on the basis of dominant vegetation, topography, climate, or some other criteria. Boreal forests, for example, are characterized by the predominance of coniferous trees; prairies are characterized by the predominance of grasses; the Arctic tundra is determined partly by the harsh climatic zone. In most areas of the world, the human community is an important and often dominant component of the ecosystem. Ecosystems include not only natural areas (e.g., forests, lakes, marine coastal systems) but also human-constructed systems (e.g., urban ecosystems, agro-ecosystems, impoundments). Human populations are increasingly concentrated in urban ecosystems, and it is estimated that, by the year 2010, 50 percent of the world’s population will be living in urban areas.

A landscape comprises a mosaic of ecosystems, including towns, rivers, lakes, agricultural systems, and so on. Precise boundaries between ecosystems are often difficult to establish. Often regions slide into one another gradually, over a protracted “transition” zone, as for example between the boreal forest and the Taiga regions of Canada.

ECOSYSTEM HEALTH

It is important to recognize the inherent difficulties in defining “health,” whether at the level of the individual, population, or ecosystem. The concept of health is somewhat of an enigma, being easier to define in its absence (sickness) than in its presence. Perhaps partially for that reason, ecologists have resisted applying the notion of “health” to ecosystems. Yet, ecosystems can become dysfunctional, particularly under chronic stress from human activity.Example for this can be cited the discharge of nutrients from sewage, industrial waste, or agricultural runoff into lakes or rivers affects the normal functioning of the ecosystem, and can result in severe impairment. Excessive nutrient inputs from human activity was one of the major factors that severely compromised the health of the lower Laurentian Great Lakes (Lake Erie and Lake Ontario) and regions of the upper Great Lakes (Lake Michigan). Unfortunately, degraded ecosystems are becoming more the rule than the exception.

The study of the features of degraded systems, and comparisons with systems that have not been altered by human activity, makes it possible to identify the characteristics of healthy ecosystems. Healthy ecosystems may be characterized not only by the absence of signs of pathology, but also by signs of health, including measures of vigor (productivity), organization, and resilience.

Vigor can be assessed in terms of the metabolism (activity and productivity) of the system. Ecosystems differ greatly in their normal ranges of productivity. Estuaries are far more productive than open oceans, and marshes have higher productivity than deserts. Health is not evaluated by applying one standard to all systems. Organization can be assessed by the structure of the biotic community that forms an ecosystem and by the nature of the interactions between the species (both plants and animals). Invariably, healthy ecosystems have more diversity of biota than ecologically compromised systems. Resilience is the capacity of an ecosystem to maintain its structure and functions in the face of natural disturbances. Systems with a history of chronic stress are less likely to recover from normal perturbations such as drought than those systems that have been relatively less stressed.

Healthy ecosystems can also be characterized in economic, social, and human health terms. Healthy ecosystems support a certain level of economic activity. This is not to say that the ecosystem is necessarily self-sufficient, but rather that it supports economic productivity to enable the human community to meet reasonable needs. Inevitably, ecosystem degradation impinges on the long-term sustainability of the human economy that is associated with it, although in the short-term this may not be evident, as natural capital (e.g., soils, renewable resources) may be overexploited and temporarily enhance economic returns. Similarly, with respect to social well-being, healthy ecosystems provide a basis for and encourage community integration. Historically, for example, native Hawaiian groups managed their ecosystem through a well-developed social cohesiveness that provided a high degree of cooperation in fishing and farming activity.

Another reflection of ecosystem health lies directly in the public health domain. In spring 2000, a deadly strain of the bacterium E-coli (0157:H7) entered the public water supply in Walkerton, Ontario, Canada, causing seven deaths and making thousands sick. This small town, with a population of five thousand, is in a farming community. Inadequate manure management from cattle operations was the likely source of this tragedy.

HOW HEALTHY ECOSYSTEMS BECOME PATHOLOGICAL

Stress from human activity is a major factor in transforming healthy ecosystems to sick ecosystems. Chronic stress from human activity differs from natural disturbances. Natural disturbances (fires, floods, periodic insect infestations) are part of the dynamics of most ecosystems. These processes help to “reset” ecosystems by recycling nutrients and clearing space for recolonization by biota that may be better adapted to changing environments. Thus, natural perturbations help keep ecosystems healthy. In contrast, chronic and acute stress on ecosystems resulting from human activity (e.g., construction of large dams, release of nutrients and toxic substances into the air, water, and land) generally results in long-term ecological dysfunction.

Five major sources of human-induced (anthropogenic) stresses have been identified by D. J. Rapport and A. M. Friend (1979): physical restructuring, overharvesting, waste residuals, introduction of exotic species, and global change.

Physical Restructuring. Activities such as wetland drainage, removal of shoals in lakes, damming of rivers, and road construction fragment the landscape and alter and damage critical habitat. These activities also disrupt nutrient cycling, and cause the loss of biodiversity.

Overharvesting. Overexploitation is commonplace when it comes to harvesting of wildlife, fisheries, and forests. Over long periods of time, stocks of preferred species are reduced. For example, the giant redwoods that once thrived along the California coast now exist only in remnant patches because of overharvesting. When dominant species like the giant redwoods (arguably the world’s tallest tree—one specimen was recorded at 110 meters tall with a circumference of 13.4 meters) are lost, the entire ecosystem becomes transformed. Overharvesting often results in reduced biodiversity of endemic species, while facilitating the invasion of opportunistic species.

Waste Residuals. Discharges from municipal, industrial, and agricultural sources into the air, water, and land have severely compromised many of the earth’s ecosystems. The effects are particularly apparent in aquatic ecosystems. In some lakes that lack a natural buffering capacity, acid precipitation has eliminated most of the fish and other organisms. While the visual effect appears beneficial (water clarity goes up) the impact on ecosystem health is devastating. Systems that once contained a variety of organisms and were highly productive (biologically) become devoid of most lifeforms except for a few acid-tolerant bacteria and sediment-dwelling organisms.

Introduction of Exotic Species. The spread of exotics has become a problem in almost every ecosystem of the world. Transporting species from their native habitat to entirely new ecosystems can wreck havoc, as the new environments are often without natural checks and balances for the new species. In the Great Lakes Basin, the accidental introduction of two small pelagic fishes, the alewife and the rainbow smelt, combined with the simultaneous overharvesting of natural predators, such as the lake trout, led to a significant decline in native fish species. The introduction of the sea lamprey, an eel-like predacious fish that attacks larger fish, into Lake Erie and the upper Great Lakes further destabilized the native fish community. The sea lamprey contributed to the demise of the deepwater benthic fish community by preying on lake trout, whitefish, and burbot. This contributed to a shift in the fish community from one that had been dominated by large benthics to one dominated by small pelagics (fish found in the upper layers of the lake profile). This shift from bottom-dwelling fish (benthic) to surface-dwelling fish (pelagic) has now been partially reversed by yet another accidental introduction of an exotic: the zebra mussel. As the zebra mussel is a highly efficient filter of both phtyoplankton and zooplankton, its presence has reduced the available food in the surface waters for pelagic fish. However, while the benthic fish community has gained back its dominance, the preferred benthic fish species have not yet recovered owing to the degree of initial degradation. Overall, the increasing dominance by exotics not only altered the ecology, but also reduced significantly the commercial value of the fisheries.

Global Change. Rapid climate change (or climate warming) is an emerging potential global stress on all of the earth’s ecosystems. In evolutionary time, there have of course been large fluctuations in climate. However, for the most part these fluctuations have occurred gradually over long periods of time. Rapid climate change is an entirely different matter. By altering both averages and extremes in precipitation, temperature, and storm events, and by destabilizing the El Niño Southern Oscillation (ENSO), which controls weather patterns over much of the southern Pacific region, many ecosystem processes can become significantly altered. Excessive periods of drought or unusually heavy rains and flooding will exceed the tolerance for many species, thus changing the biotic composition. Flooding and unusually high winds contribute to soil erosion, and at the same time add to nutrient load in rivers and coastal waters.

These anthropogenic stresses have compromised ecosystem function in most regions of the world, resulting in ecosystem distress syndrome (EDS). EDS is characterized by a group of signs, including abnormalities in nutrient cycling, productivity, species diversity and richness, biotic structure, disease prevalence, soil fertility, and so on. The consequences of these changes for human health are not inconsiderable. Impoverished biotic communities are natural harbors for pathogens that affect humans and other species.

ECOSYSTEM HEALTH AND HUMAN HEALTH

An important aspect of ecosystem degradation is the associated increased risk to human health. Traditionally, the concern has been with contaminants, particularly industrial chemicals that can have adverse impacts on human development, neurological functions, reproductive functions, and that appear to be causative agents in a variety of carcinomas. In addition to these serious environmental concerns (where the remedies are often technological, including engineering solutions to reduce the release of contaminants), there are a large number of other risks to human health stemming from ecological imbalance.

Ecosystem distress syndrome results in the loss of valued ecosystem services, including flood control, water quality, air quality, fish and wildlife diversity, and recreation. One of the major signs of EDS is increased disease incidence, both in humans and other species. Human population health should thus be viewed within an ecological context as an expression of the integrity and health of the life-supporting capacity of the environment.

Ecological imbalances triggered by global climate change and other causes are responsible for increased human health risks.

Climate Change and Vector-Borne Diseases. The global infectious disease burden is on the order of several hundred million cases per year. Many vector-borne diseases are climate sensitive. Malaria, dengue fever, hantavirus pulmonary syndrome, and various forms of viral encephalitis are all in this category. All these diseases are the result of arthropod-borne viruses (arboviruses) which are transmitted to humans as a result of bites from blood-sucking arthropods.

Global climate change—particularly as it impacts both temperatures and precipitation—is highly correlated with the prevalence of vector-borne diseases. For example, viruses carried by mosquitoes, ticks, and other blood-sucking arthropods generally have increased transmission rates with rising temperatures. St. Louis encephalitis (SLE) serves as an example. The mosquito Culex tarsalis carries this virus. The percentage of bites that results in transmission of SLE is dependent on temperature, with greater transmission at higher temperatures.

The temperature dependence of vector-borne diseases is also well illustrated with malaria. Malaria is endemic throughout the tropics, with a high prevalence in Africa, the Indian subcontinent, Southeast Asia, and parts of South and Central America and Mexico. Approximately 2.4 billion people live in areas of risk, with some 350 million new infections occurring annually, resulting in approximately 2 million deaths, predominantly in young children. Untreated malaria can become a life-long affliction—general symptoms include fever, headache, and malaise.

The climate sensitivity of malaria arises owing to the nature of the interactions of parasites, vectors, and hosts, all of which impact the ultimate transmission rates to humans. The gestation time required for the parasite to become fully developed within the mosquito host (a process termed sporogony) is from eight to thirty-five days. When temperatures are in the range of 20°C to 27°C, the gestation time is reduced. Rainfall and humidity also have an influence. Both drought and heavy rains tend to reduce the population of mosquitoes that serve as vectors for malaria. In drier regions of the tropics, low rainfall and humidity restricts the survival of mosquitoes. Severe flooding can result in scouring of rivers and destruction of the breeding habitats for the mosquito vector, while intermediate rainfall enhances vector production.

Ecological Imbalances. Cholera is a serious and potentially fatal disease that is caused by the bacterium Vibrio cholerae. While not nearly so prevalent as malaria, cases are nonetheless numerous. In 1993, there were 296,206 new cases of cholera reported in South America; 9,280 cases were reported in Mexico; 62,964 cases in Africa; and 64,599 cases in Asia. Most outbreaks in Asia, Africa, and South America have originated in coastal areas. Symptoms of cholera include explosive watery diarrhea, vomiting, and abdominal pain. The most recent pandemic of cholera involved more regions than at any previous time in the twentieth century. The disease remains endemic in India, Bangladesh, and Africa. Vibrio cholerae has also been found in the United States—in the Gulf Coast region of Texas, Louisiana, and Florida; the Chesapeake Bay area; and the California coast.

The increase in prevalence of V. cholerae has been strongly linked to degraded coastal marine environments. Nutrient-enriched warmer coastal waters, resulting from a combination of climate change and the use of fertilizers, provides an ideal environment for reproduction and dissemination of V. cholerae. Recent outbreaks of cholera in Bangladesh, for example, are closely correlated with higher sea surface temperatures. V. cholerae attach to the surface of both freshwater and marine copepods (crustaceans), as well as to roots and exposed surfaces of macrophytes (aquatic plants) such as the water hyacinth, the most abundant aquatic plant in Bangladesh. Nutrient enrichment and warmer temperatures give rise to algae blooms and an abundance of macrophytes. The algae blooms provide abundant food for copepods, and the increasing copepod and macrophyte populations provide V. cholerae with habitat. Subsequent dispersal of V. cholerae into estuaries and fresh water bodies allows contact with humans who use these waters for drinking and bathing. Global distribution of marine pathogens such as V. cholerae is further facilitated by ballast water discharged from vessels. Ballast water contains a virtual cocktail of pathogens, including V. cholerae.

Two other examples of how ecological imbalances lead to human health burdens concern the increased prevalence of Lyme disease and hantavirus pulmonary disease. Lyme disease, sonamed because it was first positively identified in Lyme, Connecticut, is a crippling arthritic-type disease that is transmitted by spirochete-infected Ixodes ticks (deer ticks). Ticks acquire the infection from rodents, and spend part of their life cycle on deer. Three factors have combined to increase the risk to humans of contracting Lyme disease, particularly in North America: (1) the elimination of natural deer predators, particularly wolves; (2) reforestation of abandoned farmland has created more favorable habitat for deer; and (3) the creation of suburban estates, which the deer find ideal habitat for browsing. The net result is a rising deer population, which increases the chances of humans coming into more contact with ticks.

By 1995, in the southwestern United States, hantavirus infection was confirmed in ninety-four persons in twenty states, with 48 percent mortality. Variants of the strain that causes hantavirus pulmonary syndrome have also been found in other areas of the country, as well as in Asia and Europe. The virus is apparently asymptomatic in rodents, and it is transmitted in their saliva and excreta. In humans it has a flu-like presentation, which is followed by acute respiratory distress syndrome. The primary reservoir in the Four Corners area of the southwestern United States is the deer mouse. Climatic disturbances, which in recent years are thought to be exacerbated by human activity (e.g., global warming), appear to set up conditions that trigger outbreaks. In the early 1990s, ENSO events initially caused drought conditions to develop in the southwestern United States. This led to a decline in plant and animal populations, including natural predators of the deer mouse. Heavy rains followed the drought in 1993, resulting in a bumper crop of piñon nuts, a major food supply for the deer mouse. Subsequently the deer mouse population greatly increased, bringing about increased contact with humans and triggering the outbreak of hantavirus.

Antibiotic Resistance and Agricultural Practice Antibiotic resistance is a growing threat to public health. Antibiotic resistant strains of Streptococcus pneumoniae, a common bacterial pathogen in humans and a leading cause of many infections, including chronic bronchitis, pneumonia, and meningitis, have greatly increased in prevalence since the mid-1970s. In some regions of the world, up to 70 percent of bacterial isolates taken from patients proved resistant to penicillin and other b-lactam antibiotics. The use of large quantities of antibiotics in agriculture and aquaculture appears to have been a key factor in the development of antibiotic resistance by pathogens in farm animals that subsequently may also infect humans. One of the most serious risks to human health from such practices is vancomycin-resistant enterococci. The use of avoparcin, an animal growth promoter, appears to have compromised the utility of vancomycin, the last antibiotic effective against multi-drug-resistant bacteria. In areas where avoparcin has been used, such as on farms in Denmark and Germany, vancomycin-resistant bacteria have been detected in meat sold in supermarkets. Avoparcin was subsequently banned by the European Union. Another example is the use of ofloxacin to protect chickens from infection and thereby enhance their growth. This drug is closely related to ciprofloxacin, one of the most widely used antibiotics in the year 2000. There have been cases of resistance to ciprofloxacin directly related to its veterinary use. In the United Kingdom, ciprofloxacin resistance developed in strains of campylobacter, a common cause of diarrhea. Multi-drug-resistant strains of salmonella have been traced to European egg production.

Food and Water Security. Agricultural practices are also responsible for a growing number of threats to public health. Some of these are related to inadequate waste management, which has resulted in parasites and bacteria entering water supplies. Others are of entirely different origins and involve apparent transfer across species of pathogens that affect both animals and humans. The most recent and spectacular example is mad cow disease, known as variant Creutzfeldt-Jakob disease in humans, a neuro-degenerative condition that, in humans, is ultimately fatal. The first case of Bovine Spongiform Encephalopathy (BSE), the animal form of the disease, was identified in Southern England in November 1981. By the fall of 2000, an outbreak had also occurred in France, and isolated cases appeared in Germany, Switzerland, and Spain. More than one hundred deaths in Europe were attributed to what has come to be commonly called mad cow disease.

Improper manure management was the likely source of the outbreak of E. coli 0157:H7 in Walkerton, Ontario, Canada. Other health risks associated with malfunctioning agroecosystems include periodic outbreaks of cryptosporidiosis, a parasitic disease that is spread by surface runoff contaminated by feces of infected cattle. This parasite causes fever and diarrhea in immunocompetent individuals and severe diarrhea and even death in immunocompromised individuals.

ECOSYSTEM RESTORATION

Ecosystem pathology in some cases can be reversed simply by removing the source of stress. In cases, for example, where ecosystem degradation is the result of point-source additions of nutrients or toxic chemicals, removal of these stresses may result in considerable recovery of ecosystem health. A classic case is Lake Washington (near Seattle, Washington). This lake had become highly anoxic (oxygen-depleted) owing to a sewage outfall entering the lake. Redirecting the sewage outfall away from the lake reversed many of the signs of pathology.

In cases where it is not feasible to remove the source of stress, more innovative engineering solutions have been tried. For example, in the Kyrönjoki and Lestijoki Rivers in western Finland, spring and fall runoff leads to sharp pulses of acidity. Spring runoff from snowmelt, which releases acid from tilled or dug soils, has been particularly damaging to fish, during the critical time of year for spawning. Fish reproduction is severely curtailed, if not all together eliminated in highly acidic water. Further there have been massive fish kills resulting from the highly acidic waters. One possible remedy is to replace the original drains which take runoff from the land to the rivers with new limed drains that can neutralize the acidity. This solution has been implemented on an experimental basis and appears to substantially reduce acidic runoff.

More radical treatments for damaged ecosystems involve “ecosystem surgery.” In some cases, invading exotic vegetation (such as mangroves in Hawaii) have been removed from regions, and native vegetation has been replanted. In areas of North America where wetlands have been severely depleted owing to farming, urbanization, and industrial activity, efforts have been made to establish new wetlands.

More often than not, however, reversing ecosystem pathology is not possible. Efforts to restore the indigenous grasslands in the Jornada Experimental Range in the southwestern United States provide an example. Overgrazing by cattle has severely degraded the landscape and has lead to replacement of the native grasses by largely inedible shrubs, dominated by mesquite. Erosion by wind and episodic heavy rains have left areas between shrubs largely bare, and subsequently underlying sands have developed in dune-like fashion over a large part of the area. The resulting mesquite dunes have proven highly resistant to efforts to restore the native grasslands, although almost every intervention has been tried, including highly toxic defoliants (Agent Orange), fire, and bulldozing.

Even where it has been possible to restore some of the ecological functions of degraded ecosystems, and thus improve ecosystem health, the restoration seldom results in reestablishment of the pristine biotic community. The best that can be achieved in most cases is reestablishment of the key ecological functions that provide the required ecosystem services, such as the regulation of water, primary and secondary productivity, nutrient cycling, and pollination. In all such efforts, key indicators of ecosystem health (vigor, productivity, and resilience) are essential to monitor progress. Standard ecological indicators can be used for this purpose (e.g., measures of productivity, species composition, nutrient flows, soil fertility) along with socioeconomic and human health indicators.

Experience in efforts to restore highly damaged ecosystems suggests that ecosystem-health prevention is far more effective than restoration. For marine ecosystems, setting aside protective zones that afford a sanctuary for fish and wildlife has considerable promise. Many countries are adopting policies to establish such areas with the prospect that these healthy regions can serve as a reservoir for biota that have become depleted in the unprotected areas. Yet this remedy is not without its limits. Restoring ecosystem health is not simply a matter of replenishing lost or damaged biota. It is also a matter of reestablishing the complex interactions among ecosystem lifeforms. Having a ready source of healthy biota that could potentially recolonize damaged ecosystems is important, but it is only part of the solution.

PREVENTION OF ECOSYSTEM DISRUPTIONS

Given the difficulties in reversing ecosystem degradation, and the many associated human health risks that arise with the loss of ecosystem health, the most effective approach is simply the prevention of ecosystem disruption. However, like many common-sense approaches, this is easier said than done. In both developed and developing countries there is a strong inclination to continue economic growth, even at the cost of severe environmental damage. Apart from selfish motivations, the argument is made that economic growth has many obvious health benefits, such as providing more efficient means of distributing food supplies, providing more plentiful food, and providing better health services and funding for research to improve standards of living. These are indeed benefits of economic development, and have led to substantial increases in health status worldwide.

However, at the dawn of the twenty-first century, the past is not necessarily the best guide to the future. The human population is at an all-time high, and associated pressures of human activity have led to increasing degradation of the earth’s ecosystems. As ultimately healthy ecosystems are essential for life of all biota, including humans, current global and regional trends are ominous. Under these circumstances, a tradeoff between immediate material gains and long-term sustainability of humans on the planet may be the only option. If so, the solution to sustaining human health and ecosystem health becomes one of devising a new politic that places sustaining life support systems as a precondition for betterment of the human condition.

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Question and Answer


HEALTH????????????????????????
1. Are health costs lower for people who maintain high levels of functional health?

2. are guidelines that can help you avoid crime or threatening situations to let someone know where you are going and when you expect to return?

3. Is hypertension considered to be the #1 risk increasing the likelihood of strokes?

4. Is jogging 30 minutes an example of cardiovascular or aerobic activity?

Dr.Kedar Karki

Senior Vet.Officer,Central Veterinary Laboratory Kathmandu Nepal M.V.St. Preventive Veterinary Mrdicine

Categories : Healthcare
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