Vascular Surgery: Time For Recognition
DR GAURAV SINGAL M.S,DNB (VASCULAR SURGERY), FIVS(DUSSELDORF, GERMANY)
SENIOR VASCULAR SURGEON AND CHIEF
INSTITUTE OF VASCULAR SCIENCES,IVY HOSPITAL, MOHALI, INDIA
Answers to problems in vascular surgery, like the refinement of diagnostic techniques and the development of biologically better small arterial substitutes, are slowly emerging. But what has so far eluded is independent recognition of vascular surgery as a separate specialty.
In a historical perspective, these problems are not unexpected. For centuries, even millennia, medicine was an undivided unitary segment of human interaction with the hostility of nature. There was no conceivable reason to parcel out the meager factual cargo that encompassed the knowledge of diseases and the (usually fruitless) attempts to deal with them.
A physician was a person whose identity was sharply defined within an unchanging circle of activity. It was only in relatively recent times (some 300 years ago), that the first dichotomy appeared in this image: the recognition of a new type of physician who used his or her hands in treating disease, that is, the surgeon. A veritable deluge of change came as medicine assumed the aspects of science no more than 100 years ago. Internal medicine and surgery assumed sharply distinguished silhouettes during the last 50 years; their further fragmentation has resembled a chain reaction.
This process has forced each subdivision of the large entity of medicine to face the same problem of defining its identity, as we now see in vascular surgery. Elemental and vitally important questions arose: Is the existence of the new subdivision justified by the goal it seeks to achieve? What exactly is the scope of its legitimate interest? Who is entitled to enter it? How does one acquire this entitlement?
The difficulties do not lie only at clinical level; a mundane concern also enters the picture. The practitioners of the parent discipline instinctively resent the contraction of their territory. The interests of the new specialty often conflict with the aspirations of other fields that have been newly created.
The need for the very existence of new branches is often questioned. All these historical conflicts have afflicted the birth and growth of vascular surgery.
Everyone knows about heart diseases, but very few know about vascular diseases. In fact, vascular disease kills and cripples almost as many Indians as does a heart disease or cancer. The sheer magnitude of the problem of vascular disease in India is staggering.
Although there is no accurate vascular registry, the fact that there are over 25 million diabetics in the country is just a small pointer to the vast numbers of the undiagnosed vascular cases. Patients having severe vascular diseases have been treated for low backache and arthritis for years.
It is only the onset of peripheral gangrene which brings to light the fact that arterial pulsations have been absent for long periods of time hitherto unnoticed. Even after diagnosis, the only treatment for these unfortunate cases has been amputations, which leaves the primary vascular problem unsolved. The lack of awareness of the disease is so acute, that even some cardio-vascular surgeons have never heard of a separate, independent vascular surgery department or a vascular surgeon leave aside general practitioners. A truly tragic situation indeed!
From the beginning, the existence of independent vascular surgery as a specialty was challenged by the Medical Council of India (MCI), as in India it is still considered to be a part of the broad speciality of cardio-thoracic-vascular surgery (CTVS). To the exception MCI has granted Madras Medical College, Chennai to start the MCh training programme in vascular surgery, but unfortunately the facility can only be availed by the surgeons of the state, thereby denying valuable training opportunity to the surgeons from rest of the country.
However, all the hope is not lost for vascular patients in India. Thanks to the effort of National Board of Examination (NBE), New Delhi, which understood and realised the magnitude of the problem. With a vision and mission in 2001, the NBE started a two-year fellowship programme in peripheral vascular surgery and hence giving a separate independent recognition to this subject. Presently, this course is available in only three major cities and because of its popularity has been converted into a full fledged 3 years program from 2008 onwards. Not only this Sri chitra institute Trivandrum has also started the Mch program in vascular surgery from 2008 onwards.This suffices to say the growing popularity of this speciality in medical fraternity.
Inspite this, the picture is not clear. Cardiac surgeons in India still claim themselves to be the best vascular surgeons also. No matter, as in reality there operative vascular work is less than two per cent and their CTVS training is focussed only towards cardiac surgery. Infact the approach, diagnosis and therapy of vascular diseases is very much different from the approach to a patient with heart disease.
No reason to blame them .Infact what is required is a separate recognised, independent vascular surgery department, which can take care of peripheral vascular system.
Not only that, to confuse and complicate the issue further we now have general surgeons, thoracic surgeons and general surgeons with some experience in vascular surgery, all claiming to do vascular operations. Now even cardiologists and radiologists are claiming themselves in the race of treating and eliminating vascular diseases.
This conceptual puzzle kept many hundreds of surgeons in resentful confusion for years. Time, however, slowly but surely has begin to sort out this confusion. Hospitals concerned with their professional standing are increasingly inclined to grant vascular privileges to new staff members, only if they are certified by the MCI or NBE as having special or added qualifications in vascular surgery.
The image of the vascular surgery is gradually acquiring formal recognition .Time is not far away when this speciality will get its due and will go on to serve the ailing community.

SUBJECT – pediatric respirations

Complains like – allergic bronchitis or bronchiectasis( throat infection involves bronchii of respiratory tract)

- allergic rhinitis( frequent cold coryza involves nasal track with or without discharges from it)

- allergic sinusitis ( blockage of sinuses from cold cough causes pain of head, throat , face with chronic history of allergic rhinitis)

- bronchial asthma( recurrent bronchitis or bronchiectasis causes difficult in breathing, gasping for breath , taking long breath with mild chest tightness or pain sometimes)

- nasal blockage( chronic sinusitis or rhinitis causes nasal blockage due to that there is a blockage in respiratory passages and faces difficulty in breathing )

- difficulty in respiration( either nasal blockage or chronic bronchitis or bronchial asthama this complain is a common to occure)

- recurrent laryngitis( infection and redness of larynx due to that difficulty in speaking or eating or degluting anything with throat pain)

- recurrent pharyngitis( same as laryngitis but instead of larynx it involves pharynx and causes same throat infections and all the symptoms of laryngitis)

- recurrent tonsillitis( swelling of tonsils causes severe pain of throat with fever and bodyache. Chronic history of it will end in operation of it and removal of tonsils but with homeopathic medicines there is no need of operation of it)

- recurrent aphonia( loss of voice is might be due to overuse of it from loud voice and speaking or reading loudly gradually will end up in complete loss of voice for some time )

- pulmonary fibrosis( lungs get fibrosed and due to that infection high fever with difficult respiration and at the end lung collapsed)

- pulmonary tuberculosis( its also called as KOCH’S disease which is curable now a days with the help of regular course of AKT treatment in allopathic medications and few of the homeopathic medicines are helping in relieving symptoms and sufferings of the patients )

- emphysema( another condition of lungs involvement when disease progresses and causes more damage to lungs its get converted into emphysema this phase is also curable in early detections).

- Pneumonia( most common complain in pediatric age groups generally chronic history of cough cold coryza and bronchitis or sinusitis will end in pneumonia which is curable with some time and proper medications)


PRECAUTIONARY MEASURES FOR ANY RESPIRATORY TRACT INFECTIONS

1. Avoid any dusting or fumes or pollens or smoke or any other allergic agents or polluting agents entering in your respiratory tract
2. for pediatric age group specifically they have to stop taking any of artificially flavoured or coloured food in their food habbit
3. avoid as many sweets / chocolates / ice creams / pastries / curd / cold food / cold drinks / fermented food as they can.
4. some of the pranayam or yoga tricks will help in their respiratory growth and will prevent in getting infected frequently by increasing their immunity
5. avoid direct contact with the kids or adults also who are suffering from any of the respiratory tract infections.
6. give them proper nutritional diet in their daily dieteric habbit like fruits, fruit juices, raw vegetables in the form of salads, green leafy vegetables as much as they can have it.
7. avoid mixing up two thermals at a time like heat and cold alternately in a particular time as for eg. Going directly to sun exposure immediately after having cold bath. Will affect kids and will develop allergic respiratory problems.
8. avoid damp, humid atmosphere like basements, sea shore, airconditioners , etc.
9. add some of the ayurvedic properity noramally available things in your daily food like tulsi, turmeric, ginger, etc.
10. most important is treat any of the disease in the early phase only and that too under medical practitioners observation and prescription only. So that it wont allow disease to progress further and deeper



SOME OF THE HOMEOPATHIC MEDICINES FOR RESPIRATORY INFECTIONS

1. ACONITE – hoarse, dry croupy cough, labored breathing, shortness of breath, larynx sensitive cough worse at night and after midnight. Red dry constricted throat with numb, prickling, burning, stinging pain inside. Tonsils swollen and dry. Allergic rhinitis with runny watery discharge and sneezing and nasal blockage is there. Fever with all the respiratory complains
2. BARYTA CARB – very peculiar medicine for recurrent tonsillitis and throat infections. In any case of tonsillitis this is the first medicine to prescribe. Who catches cold very easily and got throat infections so frequently with total loss of voice due to swelling of tonsils.
3. CAUSTICUM – aphonia, cough with scanty expectorations coryza with hoarseness, nostrils ulcerated. Majority of public speakers or singers gets infected with this kind of complains then we can think of causticum immediately
4. BLATTA ORIENTALIS – specific medicine for asthma of any age especially when associated with bronchitis. Cough with dyspnoea in bronchitis and phthisis. Much pus like mucus.
5. DULCAMARA – dry coryza. Complete stoppage of nose. Coryza of the new born baby. Cough worse in damp weather or in basements or humid atmosphere. With free expectorations, tickling in larynx. Cough hoarse, spasmodic, whooping, dry, winter, teasing. Asthma with dyspnoea. Loose rattling cough especially after physical exertion.
6. GELSEMIUM – dryness of nasal fossae. Swelling of turbinates. Watery excoriating discharge. Acute coryza with dull headache and fever. Slowness of breathing, with great prostration. Oppression about chest. Dry cough, wit sore chest and fluent coryza. Aphonia, acute bronchitis, respiration quickened, spasmodic affections of lungs and diaphragm.
7. HEPAR SULPH – sore, ulcerated nose with catarrhal troubles. Sneezing every time he goes into a cold, dry wing, with running from nose, later thick, offensive, discharge. Stopped up easily. Quinsy , with impending suppuration. Hawking up of mucus. Loses voice and coughs when exposed to dry cold wind. Cough troublesome when walking. Cough excited whenever any part of the body gets cold or uncovered or from eating anything cold. Chocking cough, rattling, croaking, suffocative cough with anxious wheezing moist breathing, asthma worse in dry cold air
8. IPECAC – coryza, with stoppage of nose and nausea. Epistaxis. Dyspnoea, constant constriction in chest. Asthma. Continued sneezing. Wheezing cough, cough incessant and violent, with every breath. Suffocative cough, whooping cough , with nose bleeds, croup, rattling cough. Heamoptysis from slightest exertion.
9. KALI BICH – snuffles of children, especially fat, chubby babies. Pain and pressure at the root of nose, with sticking pain in it. Septum ulcerated. Fetid smell. Discharge thick, ropy, greenish-yellow. Loss of smell, much hawking. Inability to breath through nose. Dryness. Coryza with obstructionof nose. Violent sneezing. Profuse, watery, nasal discharge. Chronic inflammation of frontal sinus with stopped up sensation. Fauces red and inflamed. Dry and rough parotid glands swollen. Uvula relaxed, oedematous, bladder-like. Diphtheria. Voice hoarse, metallic hacking cough. Profuse yellow expectorations, very glutinous and sticky coming out in long stringy and very tenacious mass. Tickling in larynx. Cough with pain in sternum, extending to shoulders, pain at bifurcation of trachea on coughing
10. JUSTICEA – highly efficacious medicine for acute catarrhal conditions of the respiratory tract (used in the beginning). Dry throat, pain during empty swallowing, tenacious mucus. Dry cough from sternal region all over chest. Hoarsness, larynx painful. Paroxysmal cough with suffocative obstruction of respiration. Cough with sneezing. Severe dyspnoea with cough. Asthamatic attaks, cannot endure a close , warm room. Whooping cough.
11. LEMNA MINORA – a catarrhal remedy. Acts especially upon the nostrils. Nasal polypi, swollen turbinates. Atrophic rhinitis. Asthma from nasal obstruction, wore in wet weather. Loss of smell of nose either putrid or offensive. Crusts and mucopurulent discharge very abundant. Post-nasal dropping. Reduces nasal obstruction when it is oedematous condition. Dryness of naso-pharynx.
12. MEPHITIS – a great medicine for whooping-cough. Suffocative feeling, asthmatic paroxysms, spasmodic cough, cough so violent, sudden contraction of glottis, false croup.

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public Hospitals
in India

Dr.
Shriniwas
Kashalikar


Since the public services and especially public health services, affect most of us, it is essential to find out the root causes of their deficiency and try to deal with them. This is one of the intellectual measures of stress management and benefits every individual concerned.

The causes of degeneration of quality of public health services in public hospitals in India; is the prevalence of the two concepts on which these institutions work. These concepts are, free medical care and economic dependence of these institutions on the government revenue and donations.

FREE MEDICAL CARE
The free medical care gives rise to parasitism, beggarly tendency, meekness and irresponsibility towards personal and public health amongst the patients.

The free medical care creates a special and extremely favorable situation and golden opportunity for the powerful, rich and famous individuals to exploit the government revenue and tax payers’ money.

The free medical care leads to zero returns and subsequent deterioration in the facilities given to patients and employees.

The free medical care associated with perpetual absence of returns leads to unjustifiably low salaries, delay in filling the vacancies, excessive working hours and duties, and delay in promotions.

This state of affairs demoralizes the sincere and dedicated employees and promotes irresponsibility, lethargy, absenteeism, corruption etc.


ECONOMIC DEPENDENCE OF THESE INSTITUTIONS ON THE GOVERNMENT REVENUE AND DONATIONS
The public hospitals are not self-sufficient and do not have any productive/commercial projects to support them. Naturally since there are no returns either from patients or from any other source, for what is spent, the public hospitals are always in loss.

This has lead to inadequate progress in terms of inadequate facilities, inadequate salaries, inadequate employment in terms of number of employees in almost every category, protracted duty hours, worsening working conditions, worsening of staying conditions for the employees and crowding of patients due to huge patients/employee ratio.

All these factors have lead to deterioration of the quality of medical care. In fact because of this a large number of lower middle class and even poor patients turn to private practitioners, consultants and hospitals.

This deterioration can be overcome by trying to make the public hospitals self-sufficient. For this, the concept of free medical care has to be replaced by more just system of payment. This would bring adequate revenue to ensure progress in terms of adequate facilities, adequate salaries, appropriate employment which could ensure normal duty hours, improvement in working conditions, improvement in staying conditions for the employees and preventing excessive and many times [because the services are free] unnecessary crowding of patients.

One may raise the objection that this is difficult to implement in case of very poor, helpless, unsupported patients.

It is very true that no sensitive and sensible individual would think of doing it as well. These patients who are in agonies, in emergencies, or helpless etc. should be made exception and a separate arrangement can be made for them. But in most other cases the problem can be overcome by making provision for payment through “services” or soft loans.

Another way to make the public hospitals self-sufficient is by buttressing them with productive / commercial projects. One can think of more innovative plans as well.

This is important because:
A] it would inculcate a sense of responsibility towards one’s own health, towards public funds, towards public services, amongst everyone including the patients.
B] it would generate the sense of accountability, satisfaction and fulfillment amongst the employees
C] It would ensure optimal progress in medical care especially in terms of holistic approach
D] It would improve the lives of patients as well as employees
E] It would make the revenue hitherto squandered on free medical care available for other developmental work thereby facilitating national progress.
F] it would reduce the corruption born of out of injustice
G] it would reduce the crowding and degeneration of private medical care.

DR. SHRINIWAS KASHALIKAR

PCOD ( poly cystic ovarian disease)

P – poly
C – cystic
O – ovarian
D – disease

• That’s what we can call it as PCOD in medical terminology, but now a time it’s a very common for non medico people also with the same PCOD name only.
• It is common to occur in all age groups of girls to ladies
• It is also known as PCOS that’s means Pelvic Cystic Ovarian Syndrom
• Poly means more than 1 or multiple, cystic means it’s a sac filled up with fluid inside, and when this type of condition occurs inside the ovaries of either side it is called as PCOD
• It is a condition where hormonal changes, masculine changes, irregular menses and many more symptoms of menstruating girls or ladies.
• Usually following are the symptoms of PCOD
1. Irregular menses either early or delayed(commonly it is delayed in nature)
2. Increase in weight constantly
3. frequent miscarriage or positive history of miscarriages
4. unwanted hair growth all over the body
5. infertility or difficulty in getting pregnancy
6. hair problems like falling, thinning, dandruff, graying, etc.
7. skin problems like acne, pimples, dryness of skin, small eruptions of face

after a prolong time of having PCOD in body such complications may develop at the later life like.
1. high blood pressure or hypertension
2. diabetes
3. high cholesterol
4. miscarriage

remark – it is an endocrine disturbance that causes primary anovulation and polycystic ovaries due to the continued stimulation of the ovary by pituitary luteininzing hormone. Its also called as
STEIN-LEVENTHAL SYNDROME.

Treatment – IN HOMEOPATHY – it is strongly recommended that PCOD is best treated in homeopathy only and there are various medicines for that few are symptomatic and few are constitutional treatments. Out of them symptomatic treatments gives immediate relieve to symptoms but constitutional treatments treats person as a whole and tries to remove PCOD from the body and will maintain that good health for a longer phase also.

Herewith we are giving some of the names of homeopathic medicines name with witch you can relieve the patients suffering but make sure do consult any of the homeopathic doctor before prescribing any medicine by self.
Ustiligo, belladona, apis mellifica, medorrhinum, lillium tig, graphites, ova tosta, pulsatila, lachesis, arsenicum album, and many more which can treat PCOD but with strict physician observation only.

#Apis mellifica. [Apis]
Few remedies cause as many ovarian symptoms as Apis. It has an active congestion of the right ovary going on to ovaritis, with soreness in the inguinal region, burning, stinging and tumefaction. Ovarian cysts in their incipiency have been arrested by this remedy; here one of the indicating features is numbness down the thigh. It has also proved useful in affections of the left ovary. Tightness of the chest may also be present, with the occurrence of a reflex cough and urging to urinate. Mercurius corrosivus. Hughes prefers this remedy in ovarian neuralgia. Peritoneal complications also indicate it.

#Belladonna. [Bell]
As this remedy is one particularly adapted to glandular growths it is especially useful in acute ovaritis, and more so if the peritoneum be involved. The pains are clutching and throbbing, worse on the right side, the slightest jar is painful, and the patient is extremely sensitive. The symptoms appear suddenly; flushed face and other Belladonna symptoms are present. Platinum. Ovaries sensitive, burning pains in them, bearing down, chronic ovarian irritation with sexual excitement. Much ovarian induration is present. Palladium. Swelling and induration of right ovary. It lacks the mental symptoms of Platinum, such as mental egotism and excitement. Aurum. Ovarian induration. Lilium. Ovarian neuralgias. Burning pains from ovary up into abdomen and down into thighs, shooting pains from left ovary across the pubes, or up to the mammary gland. Staphisagria. Very useful in ovarian irritation in nervous, irritable women. Hypochondriacal moods.

#Lachesis. [Lach]
Pain in left ovary relieved by a discharge from the uterus; can bear nothing heavy on region. Hughes and Guernsey seem to think that Lachesis acts even more prominently on the right ovary; others believe the opposite, the tendency of affections being, however, to move from the left toward the right side. Suppuration and chronic enlargements of ovary may call for Lachesis. Zincum. Boring in the left ovary relieved by the flow, somewhat better from pressure; fidgety feet. Graphites. Swelling and induration of the left ovary; also pains in the right ovarian region with delayed scanty menses. Argentum metallicum. Bruised pain in left ovary and sensation as if ovary were growing large. Naja. Violent crampy pain in left ovary. Dr. Hughes valued it in obscure ovarian pains not inflammatory in nature.

#Arsenicum. [Ars]
Burning tensive pains in the ovaries, especially in the right. Ovaritis relieved by hot applications. Patient thirsty, irritable and restless. Colocynth. Ovarian colic; griping pains, relieved by bending double; stitching pains deep in right ovarian region. It is also a useful remedy,according to Southwick, in ovaritis of left ovary with colicky pains. A dropsical condition may be present. Hamamelis. Ovaritis and ovarian neuralgia. Ludlam praises this remedy in the sub-acute form of gonorrhoeal ovaritis; it allays the pain and averts the menstrual derangement. Ovaritis after a blow. There is agonizing soreness all over the abdomen. An external application of hot extract of Hamamelis acts marvelously in subduing the distress and pain consequent to ovaritis. Iodine. Congestion or dropsy of the right ovary. Dwindling of the mammae; dull, pressing, wedge-like pain, extending from right ovary to uterus like a plug, worse during menstruation. Thuja. Left-sided ovaritis, with suspicion of veneral taint, calls for Thuja. Grumbling pains in the ovaries all the time, with mental irritability, call for Thuja. Podophyllum has a pain in the right ovary, running down the thigh of that side. Numbness may be an attending symptom.

Homeopathy treats the patient not the disease, complete symptoms of the patient(Mental and Physical) are taken into consideration to find the appropriate remedy which is the most similar to the patients symptoms. When prescribed according to the patients symptoms Homeopathic medicine are known to work very fast and without any side effects or complications of any kind and once cured there are no relapse or comebacks 100% cure. For more either post your complete symptoms or better to consult a reputable Homeopathic Practitioner for the successful treat ment of your ailment. Giving just the name of the disease or disorder is showing someone the tip of the iceberg what lays underneath is what you have to treat and cure. And that is the key to the success of Homeopathic Medicine.
for more informations about homeopathic medicines for the same or any other ovarian disease please log on to - www.homeotouch.com

I am so fat. My life has changed since I gained weight. There is almost a universal anxiety about weight. Even if you have a family history of obesity, for instance, don’t accept your obesity whole heartedly.
If you tried and failed, you are not alone. But that doesn’t mean you will not succeed this time.
Are you obese?
Pay a visit to your mirror as this is the best diagnostic tool. Look at yourself honestly without holding in your stomach. If you dislike what you see, you need to slim down. If you wish to be genuinely honest use caliper for a proper and more objective evaluation. If you don’t have it, try to pinch your waist. If you can grab more than an inch, it may be time to seriously think of loosing weight.

Workable diet:
The first step in successful dieting is developing right and positive attitude. Diet is a way of limiting the number of calories you consume every day. It is a tool that assists you in reaching your desired weight. This tool should not be treated as a punishment for crime of being overweight.
Second step in successful dieting is to selecting the right diet. Sometimes it is seen that people who want to shed weight quickly go for a very low calorie diet. Initially they do loose some weight quickly, but than they run into trouble. After prolong starvation they stop loosing weight. The question arises here that why it happens? It is believed that if you drastically cut down on diet. Your metabolism slows down and your body doesn’t burn those calories you feed in. The most hazardous factor of this is that you loose muscle instead of fat. But if you go off the, diet you gain weight back more quickly and that too in the shape of fat not as muscles. And after some time you are fatter than before, you may look older also. So forget crash dieting as too few calories cause the metabolism to rebel and after going of it will cause bingeing.

Foods to limit: Precaution is always better than cure, so first we will discuss the dietary ingredients which should be avoided-

Fats and fried food: It is normally seen that common man who is weight conscious always tries to find substitute for sugar when he really needs a substitute for fat, as fats are the highest source for calories. So the intelligence is to reduce fat content from diet, not the sugar.

Sugar and sweets: you probably are aware that sweets are fattening. Sugar based foods are poor source other nutrients. If we assess it technically, these are empty calories. Simple sugars just stimulate secretion of insulin and thus they stimulate our hunger. Since insulin is related to hunger so you will be hungry in less time.

Protein in diet: The issue regarding protein consumption is a bit confusing all over the world. It is a fact that protein is just required to repair and to build new tissues. It should be kept in mind that we don’t need much protein in routine as we think. It is a proven fact that excessive protein consumed turns into fat. It is observed that it should not be more than 12 to 15 percent of total food intake.

Alcohol: Most of the alcoholic beverages are high in calories. This statement should always be kept in mind. But it is more harmful because of it is an appetizer. That is why people eat abruptly after consumption of alcoholic drinks.

Increase intake of these: There are certain edibles which help us in keeping weight under control. So start eating them quickly-

Fiber rich food: This is the one content of food we don’t relish to have. But it is a super food. Recent researches have proved that it can fight against diabetes, heart disease, cancers of intestines, tooth decay, constipation and obesity. Persons who are non-vegetarians should immediately start switching over to vegetarianism as you are not eating fiber at all. The fiber present in wheat floor gives feeling of fullness as it starts swelling due to tendency of absorbing water. And this fiber present not only helps to control tendency of habitual constipation but helps to smooth evacuation. So it is wise to go for foods which are high in fiber content: bran, peas, brown rice and cleaned but unpeeled potatoes and apples.

Fruits: It is always wise to pacify your craving for sweets with fruits and other foods which are naturally sweet. Natural sweets are low in calories and high in nutrients. Fruits are also a good source of natural fiber and micro nutrients essential for well being of our system. So avoid toffee, chocolate bars, burfy, rasgulla, gulabjamun, jalebi and other popular Indian sweets.

Change your habits: If eating less and exercising more were easy tasks, perhaps everybody has done this. In Practical life, it is seen that these are the habits we grow gradually over a period of 6 to 10 years and if we wish to change them overnight, is very difficult. But if we decide once to change these gradually, is possible. Here are some simple suggestions:

- Good eating habits, proper food and good exercise, all three are equally important.
- Identify first of what triggers your desire to eat. Start ignoring that.
- Avoid buying your favorite dish and keeping in your refrigerator.
- Gradually try to neglect favorite food article or try to avoid for some time or days.
- Stop buying ready to eat food, go for the food which needs cocking.
- Don’t eat while watching, reading, talking and playing as it will land you in overeating.
- Eat small bites and chew longer and let your taste buds to experience the real taste of it.
- Try to avoid sitting in the same place every time as it aggravate your hunger.
- Don’t clean your plate. Leave some for birds and pets.
- Be focused and add some more dos and don’ts to this list to be a winner this time.
- Drink a glass of water or eat salad of mixed vegetables before lunch or dinner.
- Don’t eat when you are extremely hungry, go for a walk instead.
- Talk to others who also are struggling to loose weight.
- Reward yourself if you are slimming down. Buy new outfit or go on vacations.
- Manage your stress as people under stress eat more to relieve it.

Start exercising: Exercise may be as important to weight loss as diet control. Begin to exercise as this is a major element in losing weight. Researches of modern times have proved that exercisers can lose weight without even dieting. Exercise provides the tools you need in day-to-day life as it helps counter emotional triggers. Think positive, behave positive and stay positive. Always remember that it is better to increase physical activity to control excess calories than to reduce energy intake. And of course, the most obvious benefit of exercise is that it burns calories.

Choose the right exercise: There is one exercise everyone can try without investing much and that is walking. You don’t need any expansive equipments or gadgets and without joining a health club. Simple walking burns sufficient amount of calories required for losing weight and body shaping. This is effective for all age groups of men, woman and children. You can gradually increase the distance and speed as per your stamina to get desired results. If you are not interested in it opt for cycling or swimming. Another way to get more exercise is to make part of your daily routine. Start using stairs instead of escalators, avoid car for short distances, park your car in far corner and take your dog for a run. All is up to you, once you decide to infuse exercise in your life.

Yoga: Join nearby group or contact some expert and start practicing yoga postures as they also help to reduce that unwanted flab from your tummy. Deep breathing techniques are also useful to control weight but should be learned well under expert’s supervision.

This article in nutshell:
- Obesity is not accepted even if you have a family history of it.
- Your mirror is best diagnosing tool, that you are obese.
- Start controlling yourself from eating your favorite food items.
- Want to eat sweets. Eat fruits as they are more nutritious.
- Manage your stress. Stressed people eat more.
- Start exercising as early as possible. Walking is good option.
- Exercising is better than diet control. Too few calories are not good in long term.
- Eat slowly, chew completely and enjoy your food fully.
- Increase fiber intake to get good results from your same diet.
- Start walking for small distances and than gradually increase the distance and speed.