Definition

Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.

It is not just a medical problem. It can affect emotional, psychological and social life. Many people who have urinary incontinence are afraid to do normal daily activities. They don’t want to be too far away from toilet. It can keep people away from enjoying life.

Though it occurs more often as people get older, urinary incontinence isn’t an inevitable consequence of aging. If urinary incontinence affects your daily activities, don’t hesitate to see your doctor. For most people, simple lifestyle and dietary changes or medical care can treat symptoms of urinary incontinence.

Our urinary system is made up of the kidneys, ureters, bladder and urethra. These parts do several functions. They filter, store and remove waste from your body. Kidneys are the filters of your body. Waste products are removed from your blood by the kidneys, creating urine. The urine then moves down through two thin tubes called the ureters. The ureters connect to the bladder, where the urine will collect until it’s time to leave the body.

Urinary bladder is like a storage tank — once the bladder is full, the brain sends a signal that it’s time to urinate. Urine then leaves the bladder when a muscle opens up (sphincter), allowing the urine to flow freely out of the body through the urethra.

When this system is working smoothly, we usually have time to get to a bathroom before needing to urinate and we don’t experience any leakage of urine. Urinary incontinence can happen when these parts don’t operate as they should. This can happen for many different reasons throughout your life.

Many people think that incontinence is a normal part of aging that can’t be helped. While it is true that your risk of incontinence increases as we get older, there are also treatments available to help you manage this condition. Incontinence doesn’t have to disrupt your life and keep you from being active.

Symptoms

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

5 Types of urinary incontinence include:

• Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
• Urge incontinence. You have a sudden, intense urge (feel) to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as a neurological disorder or diabetes.
• Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
• Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
• Mixed incontinence. You experience more than one type of urinary incontinence — most often this refers to a combination of stress incontinence and urge incontinence.

Causes

Urinary incontinence can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.

Temporary urinary incontinence

Certain drinks, foods and medications may act as diuretics — stimulating your bladder and increasing your volume of urine. They include:

• Alcohol
• Caffeine
• Carbonated drinks and sparkling water
• Artificial sweeteners
• Chocolate
• Chili peppers
• Foods that are high in spice, sugar or acid, especially citrus fruits
• Heart and blood pressure medications, sedatives, and muscle relaxants
• Large doses of vitamin C

Urinary incontinence may also be caused by an easily treatable medical condition, such as:

• Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate and, sometimes, incontinence.
• Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.

Persistent urinary incontinence

Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including:

• Pregnancy. Hormonal changes and the increased weight of the fetus can lead to stress incontinence.
• Childbirth. Vaginal delivery can weaken muscles needed for bladder control and damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions may be associated with incontinence.
• Changes with age. Aging of the bladder muscle can decrease the bladder’s capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
• Menopause. After menopause, women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
• Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
• Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
• Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone like masses that form in the bladder — sometimes cause urine leakage.
• Neurological disorders. Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

Risk Factors

Factors that increase your risk of developing urinary incontinence include:

• Gender. Women are more likely to have stress incontinence. Pregnancy, childbirth, menopause and normal female anatomy account for this difference. However, men who have prostate gland problems are at increased risk of urge and overflow incontinence.
• Age. As you get older, the muscles in your bladder and urethra lose some of their strength. Changes with age reduce how much your bladder can hold and increase the chances of involuntary urine release.
• Being overweight. Extra weight increases pressure on your bladder and surrounding muscles, which weakens them and allows urine to leak out when you cough or sneeze.
• Smoking. Tobacco use may increase your risk of urinary incontinence.
• Family history. If a close family member has urinary incontinence, especially urge incontinence, your risk of developing the condition is higher.
• Some diseases. Neurological disease or diabetes may increase your risk of incontinence.

Diagnosis

Your doctor is likely to start with a thorough history and physical exam. You may then be asked to do a simple maneuver that can demonstrate incontinence, such as coughing.

• Urinalysis. A sample of your urine is checked for signs of infection, traces of blood or other abnormalities.
• Bladder diary. For several days you record how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes.
• Postvoid residual measurement. You’re asked to urinate (void) into a container that measures urine output. Then your doctor checks the amount of leftover urine in your bladder using a catheter or ultrasound test. A large amount of leftover urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.

3IQ (Incontinence Questionnaire)

These questions are differentiate between these types of incontinence.

Urinary Incontinence Algorithm

Treatment

Behavioral techniques

• Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every 2.5 to 3.5 hours.
• Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
• Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
• Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.

Pelvic Floor Muscles Exercises

Also known as Kegel exercises, these techniques are especially effective for stress incontinence but may also help urge incontinence.

To do pelvic floor muscle exercises, imagine that you’re trying to stop your urine flow. Then:

• Tighten (contract) the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.)
• Work up to holding the contractions for 10 seconds at a time.
• Aim for at least three sets of 10 repetitions each day.

To help you identify and contract the right muscles, your doctor may suggest that you work with a pelvic floor physical therapist or try biofeedback techniques

Medications

Medications commonly used to treat incontinence include:

• Anticholinergics. These medications can calm an overactive bladder and may be helpful for urge incontinence. Examples include oxybutynin, tolterodine, darifenacin, solifenacin.
• Mirabegron. Used to treat urge incontinence, this medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.
• Alpha blockers. In men who have urge incontinence or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder. Examples include tamsulosin, alfuzosin, silodosin.
• Topical estrogen. Applying low-dose, topical estrogen in the form of a vaginal cream, ring or patch may help tone and rejuvenate tissues in the urethra and vaginal areas.

Absorbent pads and Catheters

• Pads and protective garments. Most products are no more bulky than normal underwear and can be easily worn under everyday clothing. Men who have problems with dribbles of urine can use a drip collector — a small pocket of absorbent padding that’s worn over the penis and held in place by close-fitting underwear.
• Catheter. If you’re incontinent because your bladder doesn’t empty properly, doctor may recommend that you learn to insert a soft tube (catheter) into your urethra several times a day to drain your bladder. You’ll be instructed on how to clean these catheters for safe reuse.

Lifestyle and home remedies

• Use a washcloth to clean yourself.
• Allow your skin to air-dry.
• Avoid frequent washing and douching because these can overwhelm your body’s natural defenses against bladder infections.
• Consider using a barrier cream, such as petroleum jelly or cocoa butter, to protect your skin from urine.
• Ask your doctor about special cleansers made to remove urine that may be less drying than other products.

If you have urge incontinence or nighttime incontinence, make the toilet more convenient:

• Move any rugs or furniture you might trip over or collide with on the way to the toilet.
• Use a night light to illuminate your path and reduce your risk of falling.

If you have functional incontinence, you might:

• Keep a bedside commode in your bedroom.
• Install an elevated toilet seat.
• Widen an existing bathroom doorway.

Complications

• Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
• Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.
• Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.

Prevention

Urinary incontinence isn’t always preventable. However, to help decrease your risk:

• Maintain a healthy weight
• Practice pelvic floor exercises
• Avoid bladder irritants, such as caffeine, alcohol and acidic foods
• Eat more fiber, which can prevent constipation, a cause of urinary incontinence
• Don’t smoke, or seek help to quit if you’re a smoker

A note from Bhavishya Clinic+

It can be embarrassing to talk about bathroom habits with healthcare provider. This embarrassment shouldn’t stop you from treating incontinence, though. Often, your healthcare provider can help figure out the cause of your bladder control issue and help make it better. You don’t need to deal with it alone. Talk to your healthcare provider about the best ways to treat incontinence so that you can lead a full and active life without worrying about leakage.

World Stroke Day

When someone has a stroke, every second is crucial. The longer it takes to receive treatment, the more likely it is that damage to the brain will occur.

“The mantra is ‘time is brain’. “The sooner they get treatment, the better patients do.”

World Stroke Day is recognized each year on Oct. 29. The aim is to teach the public about stroke risk factors and stroke prevention, and to raise awareness about the warning signs of stroke so people recognize when a loved one may be having a stroke and can take action.

What is Stroke?

A stroke occurs when a blood vessel bringing blood and oxygen to the brain is interrupted or ruptures (bursts) and brain cells don’t get the flow of blood that they need. Deprived of oxygen, nerve cells can’t function and die within minutes. When nerve cells do not function, the part of the body they control can’t function either. The devastating effects of stroke are often permanent because dead brain cells can’t be replaced.

Types of Stroke

There are two main types of strokes: ischemic and hemorrhagic. An ischemic stroke happens when there is a loss of blood supply to an area of the brain. A hemorrhagic stroke happens when there is bleeding into the brain when a blood vessel ruptures. Eighty-five percent of all strokes are ischemic.

Blood supply to the brain

Blood vessels that carry blood to the brain from the heart are called arteries. The brain needs a constant supply of blood, which carries the oxygen and nutrients it needs to function. Each artery supplies blood to specific areas of the brain. A stroke occurs when one of these arteries to the brain either is blocked or bursts. As a result, part of the brain does not get the blood it needs, so it starts to die.

Possible Effects of Stroke

Motor and sensory function

The human brain is divided into several areas that control movement and sensory function, or how the body moves and feels. When a stroke damages a certain part of the brain that area may no longer work as well as it did before the stroke. This can cause problems with walking, speaking, seeing or feeling.

Functions of right and left hemisphere of the brain

The left side, or hemisphere, of the brain controls how the opposite (right side) of the body moves and feels, and is responsible for how well we can figure out problems with science, understanding what we read and what we hear people say, number skills such as adding and subtracting, and reasoning. The right side of the brain controls the movements and feelings on the left side of the body and is in charge of how artistic we are, including musical and creative talents.

Stages of normal and blocked artery blood flow

• Normal artery: Blood flows easily through a clear artery.
• Blockage: An artery can become blocked by plaque (a fatty substance that clogs the artery) or a blood clot, which reduces blood flow to the brain and may cause a stroke.
• Blockage cleared: The plaque or blood clot breaks up quickly and blood flow is restored to the brain. This may happen during a TIA or mini-stroke, where brain cells recover with no permanent brain damage.

Stroke Symptoms from “Fast to Faster” – देखना, दिखना, हाथ, पैर, बोल, चाल

The acronym FAST (Facial drooping, Arm weakness, Speech difficulties and Time) has been used by the National Stroke Association, American Heart Association and others to educate the public on detecting symptoms of a stroke. FAST was first introduced in the United Kingdom in 1998.

Hindi version of FAST is “Dekhna, dikhna, hath, paer, bol, chal” – could be an easy mnemonic. Any sudden onset disturbance in dekhna, dikhna, hath, paer, bol or chal should raise suspicion of a cerebrovascular event and may indicate prompt medical consultation.

• F stands for Face, which refers to drooping or numbness on one side of the face versus the other. Ask the person to smile to make the droop more apparent.
• A stands for Arms, which refers to one arm being weaker or more numb than the other. Ask the individual to raise both arms up and hold them for a count of ten. If one arm falls or begins to drop, then this could be a sign of a stroke.
• S stands for Stability, which refers to steadiness on your feet. Sometimes individuals will fall, feel very dizzy or be unable to stand without assistance. Difficulty maintaining balance, trouble walking and loss of coordination are all possible stroke symptoms.
• T stands for Talking, which refers to changes in speech including slurring, garbled, nonsensical words, or the inability to respond appropriately. Individuals experiencing a stroke may be difficult to understand, or they may have difficulty understanding others. Ask the person to repeat a simple sentence like “The sky is blue.”
• E stands for Eyes, which refers to visual changes. These visual changes occur suddenly and can include complete vision loss in one eye, double vision, and partial loss of vision in one or both eyes.
• R stands for React, which is a reminder to call nearby health facility immediately if you recognize any of these symptoms. Call even if the symptoms go away and try to remember when they first began..

Identifying and reacting to stroke symptoms quickly is crucial to achieving proper treatment for an individual experiencing a stroke. Recognizing these “FAST” symptoms and getting treatment quickly can minimize damage to the brain and lessen post-stroke complications.

Diagnosis of Stroke

In addition to a physical examination and laboratory tests, physicians may use a variety of advanced imaging diagnostic tests to diagnose a stroke.

In the emergency room, your doctor or stroke emergency team will:

• ask you when the symptoms of the stroke started
• ask you about your medical history
• conduct a physical and neurological examination
• order certain laboratory (blood) tests
• perform imaging tests to help determine what kind of stroke you are having
• request additional tests that might be needed
• request additional tests that might be needed, which could include some of the following:

Imaging Tests

CT scan (computed tomography)

An imaging test of the brain that uses radiation to create a picture (like an X-ray) of the brain. It’s usually one of the first tests given to a patient with stroke symptoms as test results give valuable information about the cause of stroke and the location and extent of brain tissue affected.

MRI (magnetic resonance imaging)

An MRI uses a large magnetic field to produce an image of the brain. Like the CT scan, it shows the location and extent of brain injury. The image produced by MRI is sharp and detailed, so it’s often used to diagnose small, deep injuries and may help determine a possible cause of the stroke.

Echocardiogram

An ultrasound imaging procedure used to assess the heart’s function and structures. It can be used to check for conditions such as heart disease, congenital birth defects, heart failure, pericarditis (an inflammation of the lining of the heart) or disease of the valves which might identify the cause of the stroke.

Blood Flow Tests

Carotid artery ultrasound

A carotid artery ultrasound may be ordered if your doctor hears an abnormal sound over your carotid artery caused by disturbances in the blood flow. This diagnostic test takes images of the blood flowing through the arteries and it can detect how severe the narrowing is from plaque buildup.

Cerebral angiography/cerebral arteriography

A cerebral angiography/cerebral arteriography can be performed to diagnose and show the degree of carotid artery stenosis. This test feeds a catheter from your groin, through your aorta and into the carotid artery. An injectable contrast dye is then inserted into the artery while images of the area are captured. This dye allows your doctor to view the arteries in a more enhanced field of view to detect any vessel abnormality. This test is similar to a catheterization to the heart.

Prevention of Stroke

Many strokes can be prevented in the first place by minimizing risk factors. Maintaining a healthy body weight, staying physically active and controlling blood pressure reduce the risk of stroke. Other stroke prevention steps include stopping smoking, eating a healthy diet and managing blood sugar levels.

What is Digital Health ATM Machine?

Clinics on cloud health kisosk is an aggregtion of CE/FDA/Medical Grade devices combined with HIPPA complaint backened software which solves problem of basic health awarness checkup.

The company has conducted 100 health machines across the state and for this, it had entered into an agreement with ‘Clinics on Round’, firm. Interestingly, this machine can be handled by anyone competently.

People will be able to get their full body check-up done in 10 minutes at a Health ATM. These health ATMs will be installed in parks, markets, hospitals and such places where there is more movement of people. Tests for dengue, malaria, HIV, typhoid will be done.

Efficiently conducting the tests to check corona infection without any help from a doctor, the Hindustan Antibiotics Company Limited (HAL) has come up with the ‘Health ATM’, a digital machine which was one of its kinds in India. The Pimpri based company HAL through this machine will conduct 22 different tests and will give the results within five minutes stating whether you are fit or unfit.

Inbuild Devices in Digital Health ATM Machine: The advanced technology

• Blood pressure
• Glucometer
• Thermometer
• Oximeter
• Hemoglobinometer
• Digital Height Sensor
• Body fat analyser etc.

Total 22 parameters measured in digital health ATM machine:

BMI, BMR, Body fat, Body water, Bone mass fat, Free weight, Muscles mass, Protein, Skeletal muscles subcutaneous mass, Visceral fat, Weight, Physic rating, Metabolic age, Health score, Height, BP, Blood sugar level, Pulse, SPO2, Body temperature and Haemoglobin.

What all can be done

• To install 100 health ATS on an experimental basis
• 10,000 machines to be produced in the first phase
• To be given for emergency services
• Immediate use in the high-risk area
• To store the health information digitally
• HIPPA (Health insurance portability and accountability act 1996) 

Measures to breathe easy this Diwali?

Breathe easy this Diwali which is arguably India’s biggest festival which is synonymous with lights, lamps, colors and of course, firecrackers. However, this is also the time when air quality deteriorates drastically. The air is chocked with various forms of pollutants with the problem compounded by pollution caused by the increased movement of vehicles.

Patients visiting to the hospitals with complaints of severe respiratory disorders during Diwali festival have been increasing for the last five years. These include asthma, ARDS, and exacerbations of chronic lung disorders (COPD), all associated with breathing in polluted and toxic air. The problem of pollution is because of the effects of fireworks in Diwali. It is more severe in cities as the growing number of vehicles adds to the problem.

Air quality takes a deep plunge as the problem gets compounded. Depending on the size of these particles, they cause a variety of illnesses ranging from mild temporary irritation to serious chronic diseases such as cancer.

Particles with a diameter of 10 micrometers (PM 10) and less are considered the most harmful as they are small enough to evade the body’s filters and pass through the entire respiratory system. Travelling from the upper respiratory tract which consists of the nose, pharynx and larynx, the smaller particles end up accumulating in the lower respiratory tract (bronchioles, alveolar ducts, and alveolar sacs) where gas exchanges occur. These are eventually removed by the macrophages of the immune system.

When there is an increased number of particulate matter in the air along with gases, the chances of COPD exacerbations increase. Certain groups of people are particularly susceptible, such as:

Children – Children spend a lot of time playing outdoors and this is the reason why they run a high risk of getting affected by smog. Regular exposure to air pollution (smog) can cause asthma and even other harmful respiratory ailments.

People who do outdoor activities – Anyone who works outdoor is more susceptible to air pollution. Regular exposure and can deteriorate their health causing several respiratory diseases.

People with Asthma & Respiratory disease – People with asthma or chronic respiratory diseases are at a high risk of health hazards caused by smog. They will experience the adverse effects of air pollution much sooner compared to others. Continuous exposure to smog can aggravate lung diseases, heart disease and stroke.

Elderly People – Senior citizens have a weak immune system. Owing to this condition, elderly people are at increased risk of getting affected by air pollution, which can cause cardiac arrhythmias and heart attacks, asthma attacks and many more.

Dry hacking coughs, shortness of breath, chest tightness, wheezing, nasal complaint along with sneezing are some of the common complaints of patients during this time. Air pollution not only affects your lungs but other organs. Thus, it is important to know the health hazards during Diwali time and take precautions accordingly.

1. Upper Respiratory Tract Infection: The Post-Diwali period usually witnesses a surge in the number of people with complaints of irritation in the eyes and throat, dry cough and fever. While last year’s smog lingered in the atmosphere, many people who otherwise remain healthy, also experienced irritation in eyes and chest and a general feeling of suffocation.
2. Bronchitis: The deadly chemicals used in crackers release fumes and gases that can lead to the inflammation of the bronchial tubes leading to acute attacks.
3. Asthma: The condition of asthma patients usually exacerbates during this period because of the toxic fumes in the air.
4. COPD: The risk of Chronic Obstructive Pulmonary Disease (COPD) increases during festivals like Diwali when the level of suspended particulate matter becomes high in the air. It is characterized by prolonged cough with excess sputum.

Persons suffering from asthma, bronchitis and other respiratory ailments should start taking precautions several days before the festive season. Also, it is advisable for affected populations to avoid outdoor physical activities and wait until the levels of fine particles decrease. People suffering from Asthma, if it cannot be avoided should use a N95 face mask, which filters out at least 95% of airborne particles.

A normal surgical mask is of no use as pollutants can pass through it. It is important to keep inhalers handy. If one experiences breathlessness then it is advisable to move away from smoggy surroundings and sit in a room with the doors and windows shut and the air-conditioning on. Patients are supposed to continue their treatment for chronic lung disease regularly and consult pulmonologist at regular intervals. It is important to keep an inhaler or nebulizer at hand to dilate your airways. Rush to a hospital if you don’t feel better after inhalation.

Do’s & Don’ts to Stay Safe and breathe easy this Diwali

DOs

• Use Multi Layered Masks: While going out, ensure that your nose and mouth are covered with a good quality mask to ban the entry of harmful particles in your respiratory tract. If you don’t have a mask, simply use a handkerchief or cloth to cover up.
• Use Air Purifiers: Air inside closed spaces is more polluted than outside air. It’s advisable to install air purifiers in at homes and offices that allow only a little movement of air.
• Use Air Purifying Plants: Your home and office must have plenty of plants that purify the air. A noteworthy point here is that there must be a variety of such plants and they must be spaced appropriately.
• Use Air Quality Checking Apps: Before you go out, check the level of pollution through various Apps. If the air quality is severe, avoid going out at all.
• Moisturize Your Nostrils: Moisturizing your nostrils helps in restricting the entry of fine particulate matter through your nose.

DON’Ts

• Morning and Evening Walks/Runs: Air quality is worst in the mornings. Simply avoid morning and evening walks or running outside altogether till air quality improves.
• Heavy Exercising: Do only light exercises, as heavy exercises require heavy breathing.
• Eating Fried/Junk Food: Ensure you eat light, healthy, fiber rich and fat free food to feel healthier and fresh.
• Travelling on two wheelers: Say No to travelling on two wheelers- this can be hazardous for your health.

Human life is above all and good health is a prerequisite of a happy life. We urge everyone to celebrate Diwali responsibly this year- in a way which makes every face glow with a smile and does not put anyone at any kind of health risk.

“Wishing You All, Happy & Safe Diwali”

Mifflin – St. Jeor Calorie Calculator

How many calories do I need?

An acceptable macronutrient distribution range for carbohydrates (45-65% of energy), protein (10-35% of energy), and fat (20-35% of energy; limit saturated and trans fats). These recommendations are broad and meant to cover the needs of many different people with different dietary situations. This is a much-discussed and debated issue, and the current understanding is that there is no one-size-fits-all recommendation. How many calories you consume and what percent of your calories come from each macronutrient can be manipulated to meet your individual needs and goals. However, consuming adequate protein at or above the recommended amount is necessary to maintain lean body mass.

About

The Mifflin-St Jeor equation is a widely used tool to determine the resting metabolic rate [RMR], which is defined as the number of calories burned while the body is in complete rest. RMR is also known as resting energy expenditure [REE]. The equation was developed by MD Mifflin and ST St Jeor and first introduced in a paper published in 1990. We are using this calorie calculator at our Bhavishya Clinic+

There are several equations for measuring RMR, including the most popular Harris-Benedict equation which was developed in 1919 and revised for accuracy in 1984. A comparative study of four predictive equations found that the Mifflin-St Jeor equation is more likely than the other equations to predict RMR to within 10% of that measured.

Formula

Females: (10*weight [kg]) + (6.25*height [cm]) – (5*age [years]) – 161
Males: (10*weight [kg]) + (6.25*height [cm]) – (5*age [years]) + 5

Multiply by scale factor for activity level:
Sedentary *1.2
Lightly active *1.375
Moderately active *1.55
Active *1.725
Very active *1.9

Basal metabolic rate is the amount of energy needed for your body’s physiological functions at rest, such as your breathing, your heart beating, and your brain activity.

This amount of energy required is measured in kilocalories, or often just denoted as calories. Therefore, BMR is your body’s calorie needs at rest with no extra activity.

In order to measure your exact BMR, you need to be in a lab setting and use indirect calorimetry. This measurement is taken under tightly controlled conditions and not easily accessible to most people.

Caloric expenditure measured by indirect calorimetry can then be added to physical activity energy expenditure to calculate total daily energy expenditure.

What is resting metabolic rate (RMR)?

Resting metabolic rate is the total number of calories burned when your body is completely at rest. RMR supports breathing, circulating blood, organ functions, and basic neurological functions. It is proportional to lean body mass and decreases approximately 0.01 kcal/min for each 1% increase in body fatness.

Hunger Vs Appetite

Lastly, take the time to understand some basic differences between hunger and appetite which are outlined below:

Hunger

It is considered a biological response to replenish the body’s energy reserves.

• Protects us from starvation.
• Usually triggered by an event occurring below the neckline:
  • Low blood sugar.
  • Empty (growling) stomach.
  • Hormone fluctuations.
  • Need to warm body (hypothermia).
• Gradual onset, appearing after several hours without food and typically diminishes after eating.
• It is generally satisfied by almost any food that provides energy (calories).

Appetite

It is considered a desire or interest to eat a specific food.

• Usually triggered by an event occurring above the neckline consciously or subconsciously:
  • Thoughts, emotions and moods.
  • Social (e.g., happy hour)
  • Cultural (e.g., family)
  • Environmental (e.g., walking into a bakery).
• More rapid onset and often independent of hunger.
• Not time-dependent and may persist after eating.
• Usually only satisfied by a specific food (e.g., sweet, salty) which may then evoke emotions and thoughts afterwards (e.g., pleasure, guilt, shame).

While RMR is an important component of TDEE, an accurate measurement remains elusive for many. Subsequently, we resort to mathematical formulas, but considering their potential errors, the values determined should always be considered a general estimate rather than an accurate value. Given this, there may also be value in including other methods as a guide to avoiding starvation. 

Lastly, while we need to acknowledge the fact that RMR is not entirely controllable, there are some influencing factors we can manipulate and should leverage every opportunity to exploit them.

World Arthritis Day 12 October 2022 – Theme, Importance and History

World Arthritis day is a global health awareness event organized every year on 12 October to create awareness about the rheumatic and musculoskeletal diseases, its impact on one’s life and educating people the symptoms & preventive measures and guiding for the early diagnosis to cope up any further complications. The day focuses on bringing people around the world on a single platform to raise voice to create enough opportunity to support and provide better treatment options to the people affected with rheumatic and musculoskeletal diseases (RMDs).

Importance of World Arthritis Day (WAD)

Arthritis is an inflammatory joint disorder, which affects the joints tissues around the joint, and other connective tissues, causing joint pain and stiffness. More than 100 types of arthritis exists, but most common are osteoarthritis and rheumatoid arthritis. Due to the lack of awareness and support, arthritis and its related condition has crippled much life around the world.

There is no specific treatment for the arthritis, treatment option varies based on the types, so it is imperative to understand the sign & symptoms and get early diagnosis to avail appropriate treatment. World Arthritis day (WAD), plays crucial role in encouraging people, concern medical fraternity and government across the world to participate in the awareness campaign to create better opportunity for the affected one.

World Arthritis Day 2022 Theme

This year 2022, the World Arthritis Day Theme is “It’s in your hands, take action“, addressing the world population to join hands for this cause to make this event fruitful for those deprived of the support.

The theme “It’s in your hands, take action” aims to encourage people with arthritis, their caregivers, families, and the general public to avail every opportunity to take action to improve their lifestyle.

World Arthritis Day History

World arthritis day (WAD) was established by Arthritis and Rheumatism International (ARI) and the first event was observed on 12 October 1996. Since then many global communities like Arthritis Foundation has joined the cause to raise awareness to fight the awareness gap, provide support and access to the communities, advocating for strong policies and supporting the research work. 

People living with Rheumatic and Musculoskeletal Diseases

Too many remain undiagnosed in the EU alone with an RMD. With an estimated one-hundred million currently undiagnosed and trying to cope with symptoms that are often overlooked – and frequently misdiagnosed. A large part of the world’s population is affected by diseases that impact their quality of life and participation in society – including access to the world of work. An inability to work reduces the self-esteem of the individual – and increases their dependency on state welfare, the healthcare system and their family and friends. People living with an RMD are therefore left unaware of their symptoms, opportunities for diagnosis and treatment, as well as the way to develop and execute a career plan to achieve independence.

Symptoms of Arthritis

• Joint pain.
• Stiffness and swelling in joints.
• Your range of motion may also decrease.
• Redness of the skin around the joint.
• Unexplained joint pain usually accompanied by fever.
• Difficulty in carrying out daily chores due to joint pain.
• Pain killers also cannot cure joint pains.

Self-care tips to manage Joint Pain due to arthritis

• Include a well-balanced diet with plenty of anti-inflammatory food such as green leafy vegetables, berries, ginger, nuts, legumes, and fibre.
• Prioritize vitamin D and Calcium intake.
• Maintain Your Ideal Weight as carrying excess body weight adds stress to our joints, especially the weight-bearing joints.
• Practice regular physical activity followed by Low-Impact Exercises, which would put less stress on joints. Some of the Low-Impact Exercises that can be practice on daily basis are swimming, walking and cycling.
• Engage in yoga and meditation to help your muscles relax.
• Stop Smoking.