Dr. Vasanth Parade

Diet in ckd in non dialysis patients:

1. We suggest the following dietary guidelines for most patients with egfr 60 ml/min/1.73 who are not on dialysis:
2. A daily protein intake of 0.8 g/kg. We do not recommend very-low-protein intake (0.6 g/kg/day).
3. A diet rich in vegetables.

The sodium intake varies depending on individual patient clinical features. Among individuals who are hypertensive, volume overloaded, or proteinuric, we suggest a sodium intake of 2 g/day (ie, 5 g/day of salt [nacl]).
For patients who are not hypertensive, volume overloaded, or proteinuric, sodium restriction to 2.3 g/day (5.75 g/day of salt [nacl]) may be of benefit. There are no convincing studies of the general population that have proven that lowering sodium intake to less than 2.3 g per day lowers cardiovascular outcomes or all-cause mortality. The institute of medicine has concluded that there is insufficient evidence to recommend a different sodium intake for ckd patients as compared with the general us population [2].

1. The potassium intake should be guided by serum potassium levels. If the potassium concentration is normal, we do not restrict dietary potassium. If the potassium concentration is high, dietary potassium intake should be restricted. 
2. Some clinicians target a total calcium intake (both dietary and medication sources) ≤1500 mg/day, whereas others prefer a more stringent goal of ≤1000 mg/day.
3. Maximum phosphorus intake of 0.8 to 1 g/day, even if the serum phosphorus concentration is normal; this is because some studies suggest that dietary phosphorus intake may alter circulating fibroblast growth factor (fgf)-23 concentration. The dietary phosphorus should be derived from sources of high biologic value, such as meats and eggs.
4. Maximum caloric intake of 30 to 35 kcal/kg/day.
5. Maximum fat intake - 30 percent of daily energy intake, with saturated fat limited to 10 percent energy.
6. Daily dietary fiber intake for 25 to 38 g/day.

Keeping track of your cycle probably doesn't sound that interesting or important, but you can benefit a lot by doing that. There are changes that your body goes through and there are specific times when you are ovulating; knowing all these would make your life a lot easier, which is only possible by tracking your period.

1. Know about your body: Getting your period every 28 days has always been considered normal but only 15% of women get their periods on the clock. Many factors such as stress, illness, exercise etc can cause your period to delay. This is where tracking your cycle can help you finding the pattern that is specific to your body condition. During your cycle there are lots of changes happening in your body. The hormones cause a change in the fluid produced from your cervix and also lead the basal temperature of your body to increase. Monitoring these changes through tracking your cycle is known as the sympto-thermal method. By this way know about how fascinatingly your body works.
2. Desire to get pregnant: Tracking your cycle will help you get pregnant. During your cycle, there is a specific time which heightens the possibility of conceiving. The fluid production from the cervix due to hormonal change is the cause of such possibility. Knowing your cycle can take out the stress from trying to get pregnant and it can also determine any abnormalities that are preventing your pregnancy.
3. Avoid pregnancy: If you know the time when you are most likely to get pregnant through tracking, you obviously know when not to have sex if you are trying to avoid pregnancy. Using sympto-thermal method for the purpose of birth control has proven to be 99.6% effective, which is higher than birth control medications.
4. Health benefits: You can reap a lot of health benefits by tracking your cycle. Conditions like fibroids, polycystic ovarian syndrome and endometriosis are quite common in women, which can be detected by tracking your period. If anything is wrong in your reproductive system, the cycle will indicate it. If you wish to discuss about any specific problem, you can consult a gynaecologist.

The ovaries are the egg producing organs, an essential part of the female reproductive system, they are responsible for the production of estrogen and release an egg every month. If the egg is fertilized with a sperm it can result in a pregnancy.

Ovarian cysts are quite common among women. Ovarian cysts are known to be small sacs filled with fluid that are situated in the ovaries.

Causes of ovarian cysts: Among ovarian cysts, the most common one is called the 'functional cyst'. This type of cyst is generally formed during the process of ovulation, wherein either the eggs do not successfully release from the sac or the sac (follicle) fails to disintegrate properly after the release of the egg.

Certain factors that can cause ovarian cysts are:

1. Age that is ovarian cysts are more likely to occur in women who have reached menopause
2. Smoking
3. Being overweight or obese
4. Consumption of fertility drugs
5. Hormone replacement therapy
6. Family history of ovarian cysts and cancer
7. Early menstruation, that is, the onset of the period before the age of 11
8. Hypothyroidism

Symptoms related to ovarian cysts: Generally, ovarian cysts show no specific symptoms and are generally located during a physical examination or an ultrasound. But, in case you suffer from large cysts or those that have ruptured, you may experience certain signs like:

1. Pain while having sex. Great discomfort may be felt, particularly when deep penetration is attempted.
2. Pain in the lower abdominal and pelvic region. This pain may be intermittent or persistent. It can also vary from being mild to quite sharp.
3. Irregularity in the menstrual cycle.
4. An uncomfortable pressure in the lower abdominal and pelvic area.
5. Acute pain in the pelvic area and the lower back all throughout the menstrual period.
6. Pain in the pelvic area after a session of vigorous exercise or strenuous physical activity.
7. A feeling of discomfort or pain while urinating or during bowel movements.
8. Nausea, followed by vomiting.
9. Pain in the vaginal area, or light bleeding.
10. Infertility
11. Problems with healthy bowel movements.
12. Bloating

Eat your fruits empty stomach or as an in between meals food. Fruits provide our body with antioxidants, vitamins, minerals, fructose etc. All these nutrients are best absorbed when fruit is eaten empty stomach or as a separate small meal.