Dr. Sunitha Guptha

When you are suffering from Diabetes, your first concern would be is to keep your sugar level in check. For this, you need to measure your dietary needs and keep your sugar level in control. Carbohydrates are the main source of sugar in your body. While making your diet chart, make sure that you do include carbohydrates, but only those which would not tamper with your sugar levels randomly. There are certain foods which would shoot up your sugar level to an undesired amount. This would in turn cause various other health problems. The question that arises here is, how would you distinguish between good carbohydrates and bad carbohydrates for your body? Well, the easiest way to differentiate is the use of Glycemic Index (GI).

What is Glycemic Index (GI)?
Glycemic index is a measurement of how soon the body changes carbohydrate foods into glucose. It is usually mentioned in the nutritional information segment behind every packaged food. This would help you to understand whether it can be consumed by you or not, keeping in mind your stage of diabetes and other dietary restrictions that your medical practitioner might have asked you to follow. The lower the number is, say fifty and lower, then it is usually safe for consumption as it takes a long time to convert to glucose. But, if the food has a higher number, say, seventy and above, then it becomes difficult for you consume it as it can harm your body. A Glycemic index is important information that you need to check before buying your food in case you suffer from diabetes.

The index can change from individual to individual:
This is an interesting yet unnerving fact that the index may change from person to person. The statistics mentioned on the packaging is just a starting point. Depending on how the food item is later cooked and what ingredients go into it, the Glycemic index may go down or go up. Some of the important factors for the changing index are the time the food is eaten, the way it is prepared as well as other foods that are consumed along with it. Foods break down into chemical compounds within our body. So, it is nothing but a chemical reaction which might increase or decrease depending upon the other variables.

Thus, these are some essential facts that you need to know about the Glycemic index. It is important to check GI, even at a base level, before purchasing your food; so that later on it does not create an imbalance in your diet schedule.

HIV testing in pregnancy should be done early so as standard care can be taken for the pregnant women. The HIV testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with HIV seronegative and also in pregnant women who are at a high risk of developing HIV infection.

Expedited HIV tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for HIV. The results of the test should be available within an hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.

Women who have not been able to get tested for HIV at the time of labor and delivery are suggested expedited screening for HIV. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental HIV tests are negative. In infants with positive HIV, prophylaxis should be discontinued and antiretroviral drug therapy should be started.

In case of acute HIV infection during pregnancy, that is in the intrapartum period, or during breastfeeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (DNA, RNA) are necessary for the diagnosis of the HIV infection. If the mother is HIV positive, then this information must be documented in the infant's medical record and also communicated to the infant's care provider.

The knowledge of an antenatal maternal HIV infection allows the:

1. Women with HIV infection to get the correct antiretroviral therapy along with prophylaxis for the infections, which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
2. When there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the HIV.
3. The HIV-infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the HIV.
4. The HIV women should be counseled about the risk of breastfeeding. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

We can not" stop" negative thinking. Negative thinking is rather" changed. When we try to modify one form of thinking into another one, like from negative to positive, we work on changing, not stopping. 

• Stopping is an action, changing is also an action. When we say, how we can stop thinking negatively, it appears as if we want to put a sudden break on our negative thinking process. This is not possible. In case we do this, this is suppression of thought and the unresolved, negative emotion-laden thought stays in the unconscious mind. This may come out in our conscious mind again. 
• Stoppage of negative thought is rather a" state" of mind, when our automatic thought process pops out positive or healthy thoughts. This state of non-negative thinking is achieved by modifying negative pattern of thoughts. 
• So stopping a negative thought is a misnomer, rather negative thoughts have to undergo a change. Change is the action that is necessary, and later a state of" stoppage" of negative thoughts would be achieved.
• Thinking is a continuous process. It is seamless. Thoughts are like birds flying in the sky. Thousands of them go from one place to the other. They are of all kinds. Black birds. White birds. All colours. They don't leave any footprints behind. It is our choice which thoughts do we pay attention to. Which one's we trap. Which one's we simply let go. The ones that we allow to upset us may need evaluation. They may need modification. From irrational to rational. Harmful to harmless. Less beneficial to more beneficial. Dysfunctional to functional. Rigid to flexible. And so on"
   

Early signs of pregnancy usually resemble the side effects you may encounter just before and during your monthly menstruation cycle. Therefore, you might not realise that you are pregnant. You need to realise that different things other than being pregnant might bring about these signs. So the way that you see some of these signs does not really mean you are pregnant. The best way to tell without a doubt is with a pregnancy test.

However, here are a few signs:

1. Sore breasts: This is an extremely common pregnancy sign. The breast tissue is to a great degree hormone sensitive. Whenever progesterone and hCG begin flooding the body after the egg is prepared, they tend to increase your blood volume, which makes your breasts swell and feel heavier than regular.
2. Cramps: You may feel crampy like you have or are going to get your period. However, this pregnancy sign is really activated by implantation. When the fertilised egg connects to the uterine wall, the uterus might extend a little to prepare for its growth throughout the following nine months.
3. Spotting: Numerous women mix up some light bleeding for a period, yet more than twenty-five percent will spot during fertilisation. In case that you see that your period appears to be way shorter or different in relation to a regular one, it might be an indication of pregnancy.
4. Weakness: If everything you want to do at work is sleep or in case you are excessively tired, making it impossible to stay awake during the day, then it might be one of the soonest indications of pregnancy. Indeed, even at this early phase of pregnancy, the fetus is beginning to go through your calories, which can wipe out your energy very soon.
5. Nipple darkening: Pregnancy hormones additionally influence the movement of melanocytes, or cells in the nipples in charge of their shading. Darker-complexioned women may not see this until some other time in pregnancy - say, around ten weeks or after.
6. Nausea: Morning sickness affects around eighty-five percent of the women. While a full-blown morning sickness does not happen until the later stages of pregnancy, a few women may encounter subtle motion sickness as an early pregnancy side effect.
7. Missed period: The clearest early side effect of pregnancy and the one that leads most of the women to get a pregnancy test is a missed period. Yet, not all missed or postponed periods are brought about by pregnancy. There could be many other reasons including cysts or other hormonal changes. Additionally, women can encounter some bleeding during pregnancy. In case that you are pregnant, ask your doctor what you need to know about it.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Did you know that in addition to your diet, exercise is one of the best ways to make sure that you never lie on a hospital bed with a surgeon treating you for a bone disorder? Medical expertise has constantly pointed out to the fact that regular exercise makes your bones less likely to suffer from wear and tear during old age.

As you exercise, your muscles become stronger, your bone density increases and your balance improves. Of course, it goes without saying that you need to follow certain precautions before you exercise to avoid certain injuries.

Before starting any exercise program, make sure that you prepare your body for exercise. A brief warm up helps you to get your muscles ready for exercise. It also makes sure that your chances of injury are drastically reduced.

Here are some tips to keep your bones healthy:

1. Weight lifting: Weight lifting is a type of exercise that, if done correctly, will be extremely beneficial for your bones. You can opt for simple bodyweight exercises such as pushups and squats, which build muscle as well as strength. Avoid using very heavy weights as it causes back-related problems such as slipped disk.

2. Yoga: Yoga is another method of exercise which is very beneficial for bones and joints. The premise of yoga is static strength building wherein you hold a pose or an exercise for a certain period of time; this helps in strengthening your muscles. Along with your muscles, your bones also become stronger as you get fitter. Yoga is repetitive stress which is good for flexibility and hence keeps your joints supple and muscles in good shape. There are certain asanas which are weight bearing and anti-gravity postures can strengthen your bones. 

3. Swimming: Swimming again is a good aerobic exercise and is good for back and over all fitness but doesn't strengthen bone per se. It is a way to keep you healthy. Swimming is a cardiovascular exercise, which is also known for its calorie burning capabilities. It is also very effective is incinerating fat and keeping your skeletal system healthy. Whereas walking and jogging and running certainly build your bones as they are weight bearing exercises.

4. Pilates: Pilates is a new form of exercise that has been gaining a lot of steam lately. It does not require much equipment, as you can get started with just a mat. It is very effective in working your spine and the hips, thus keeping your lower back strong. A weak lower back increases the chances of bone disorders drastically. If you wish to discuss about any specific problem, you can consult an orthopedist.