All pathy consensus on obesity

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“More than 30% people of the society including children have potbelly abdominal obesity”.

The session was organized by Heart Care Foundation of India in association with All India Radio and India Habitat Centre. The session was organized to mark the occasion of Doctor’s Day falling on 1st July.

Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India was moderating a session on Obesity at India Habitat Centre.

The panelists included Dr Shikha Sharma Wellness Expert, Dr S V Tripathy Ayurveda Expert, Dr Mridula Pandey Homeopath, Dr Praveen Gulati Obesity Surgeon and Dr Ishwar Basavvadadde Senior Yoga Physician.

This was an interaction organized for the first time that involved people from all pathies under one roof. Following points were raised in the seminar:

1. Potbelly obesity is linked to eating refined carbohydrates and not animal fats.

2. General obesity is linked to eating animal fats.

3. Refined carbohydrate includes white rice, white maida and white sugar.

4. Brown sugar is better than white sugar.

5. Refined carbohydrates are called bad carbohydrates and animal fat is called bad fat.

6. Trans fats or vanaspati are bad for health. They increase bad cholesterol and reduce good cholesterol.

7. Reduction in weight can reduce snoring, pain of arthritis, blood pressure and control uncontrolled diabetes.

8. One should not gain weight of more than 5 kg after the age of 20 years.

9. After the age of 50, the weight should reduce and not increase.

10. Surgery is the answer when all other means fail.

Initial dosing of warfarin

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The initial doses of warfarin should not exceed 5 mg/day except in highly selected, stable, reliable patients with a low bleeding risk. But 2008 ACCP Guidelines suggest starting doses in the range of 5 to
10 mg/day for most individuals but reduced initial doses of 5 mg/day or less in elderly patients, and in patients who are debilitated or malnourished, have congestive failure, liver disease, recent major
surgery, or are taking medication known to increase sensitivity to warfarin.

This practice is not as per 2012 American College of Chest Physicians Guidelines which suggest an initial dose of 10 mg/day for the first two days in patients sufficiently healthy to be treated as outpatients.

Guidelines for the treatment of acute bacterial rhinosinusitis from Infectious Disease Society of America

Three features suggest the diagnosis of ABRS:

1. Persistent symptoms or signs of ARS lasting 10 or more days with no clinical improvement
2. Onset with severe symptoms (fever >39°C or 102°F and purulent nasal discharge or facial pain) lasting at least three consecutive days at the beginning of illness
3. Onset with worsening symptoms following a viral upper respiratory infection that lasted five to six days and was initially improving .Patients who meet criteria for ABRS should be treated with an antibiotic.

Start empiric course of amoxicillin-clavulanate (500 mg/125 mg orally thrice-daily or 875 mg/125 mg orally twice-daily) for 5 to 7 days for most patients; doxycycline is a reasonable alternative. Doxycycline or a respiratory fluoroquinolone may be used in patients with penicillin allergy. Because of high rates of microbial resistance, macrolides (clarithromycin or azithromycin), trimethoprim-sulfamethoxazole, or oral second- or third-generation cephalosporins should not be used for empiric treatment.