Monday, 14 October 2013

Gout Diet

Gout, a painful form of arthritis, has long been associated with diet, particularly overindulgence in meat, seafood and alcohol. As a result, gout treatment used to include severe dietary restrictions, which made the gout diet hard to stick to. Fortunately, newer medications to treat gout have reduced the need for such a strict diet.

Newer diet recommendations resemble a healthy-eating plan recommended for most people. Besides helping you maintain a healthy weight and avoid several chronic diseases, this diet may contribute to better overall management of your gout.


Gout occurs when high levels of uric acid in your blood cause crystals to form and accumulate around a joint. Your body produces uric acid when it breaks down purines. Purines occur naturally in your body, but you also get them from eating certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.

A gout diet helps to control the production and elimination of uric acid, which may help prevent gout attacks or reduce their severity. The diet isn't a treatment for gout, but may help you control your attacks. Obesity also is a risk factor for gout, so losing weight can help you lower your risk of attacks.

Diet details

A gout diet reduces your intake of foods that are high in purines, such as animal products, which helps control your body's production of uric acid. The diet also limits alcohol, particularly beer, which has been linked to gout attacks. If you're overweight or obese, lose weight. However, avoid fasting and rapid weight loss because these can promote a gout attack. Drink plenty of fluids to help flush uric acid from your body. Also avoid high-protein weight-loss diets, which can cause you to produce too much uric acid (hyperuricemia).

To follow the diet:

  • Limit meat, poultry and fish. Animal proteins are high in purine. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily.
  • Cut back on fat. Saturated fat lowers the body's ability to eliminate uric acid. Choosing plant-based protein, such as beans and legumes, and low-fat or fat-free dairy products will help you cut down the amount of saturated fat in your diet. High-fat meals also contribute to obesity, which is linked to gout.
  • Limit or avoid alcohol. Alcohol interferes with the elimination of uric acid from your body. Drinking beer, in particular, has been linked to gout attacks. If you're having an attack, avoid all alcohol. However, when you're not having an attack, drinking one or two 5-ounce (148-milliliter) servings a day of wine is not likely to increase your risk.
  • Limit or avoid foods sweetened with high-fructose corn syrup. Fructose is the only carbohydrate known to increase uric acid. It is best to avoid beverages sweetened with high-fructose corn syrup, such as soft drinks or juice drinks. Juices that are 100 percent fruit juice do not seem to stimulate uric acid production as much.
  • Choose complex carbohydrates. Eat more whole grains and fruits and vegetables and fewer refined carbohydrates, such as white bread, cakes and candy.
  • Choose low-fat or fat-free dairy products. Some studies have shown that low-fat dairy products can help reduce the risk of gout.
  • Drink plenty of fluids, particularly water. Fluids can help remove uric acid from your body. Aim for 8 to 16 glasses a day. A glass is 8 ounces (237 milliliter). There's also some evidence that drinking four to six cups of coffee a day lowers gout risk in men.

A sample menu
Here's a look at what you might eat during a typical day on a gout diet:


  • Whole-grain, unsweetened cereal with skim or low-fat milk, topped with fresh fruit
  • Whole-wheat toast with trans-free margarine
  • 100 percent fruit juice
  • Coffee


  • Lean meat, poultry or fish (2 to 3 ounces) sandwich on whole-wheat bread, with lettuce, tomato and low-fat spread
  • Carrot and celery sticks, side salad or vegetable soup
  • Fresh fruit, such as apple, orange or pear
  • Skim or low-fat milk


  • Baked or roasted chicken (2 to 3 ounces)
  • Steamed vegetables
  • Baked potato with low-fat sour cream
  • Green salad with tomatoes and low-fat dressing
  • Fresh fruit, such as berries or melon
  • Nonalcoholic beverage, such as water or tea

Snacks can be added to this menu as long as you make healthy choices — such as fruits, vegetables and whole grains, and occasional nuts — and you are at a healthy weight or stay within your calorie limit. 


Following a gout diet can help you limit your body's uric acid production and increase its elimination. It's not likely to lower the uric acid concentration in your blood enough to treat your gout without medication, but it may help decrease the number of attacks and limit their severity.

Following the gout diet and limiting your calories — particularly if you also add in moderate daily exercise, such as brisk walking — can also improve your overall health by helping you achieve and maintain a healthy weight. 


The gout diet isn't that different from the healthy-eating patterns recommended by the Dietary Guidelines for Americans. Thus, the risks of following the diet are few, if any. 

Read more:
Gout | NHS Choices
Got Gout but Love Meat? » Diagnosis: Diet

Thursday, 10 October 2013

Attention Deficit Hyperactivity Disorder (ADHD)

What is attention deficit hyperactivity disorder?

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). These symptoms can make it difficult for a child with ADHD to succeed in school, get along with other children or adults, or finish tasks at home.

What are the symptoms of ADHD in children?

Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. 

What causes ADHD?

Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD. 

How is ADHD treated?

Currently available treatments aim at reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, education and training, or a combination of treatments. 


Stimulants such as methylphenidate and amphetamines are the most common type of medication used for treating ADHD. Although it may seem counterintuitive to treat hyperactivity with a stimulant, these medications actually activate brain circuits that support attention and focused behavior, thus reducing hyperactivity. In addition, a few non-stimulant medications, such as atomoxetine, guanfacine, and clonidine, are also available. For many children, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medications also may improve physical coordination.

Tuesday, 8 October 2013

Male Period (Irritable male syndrome)

The irritable male syndrome (IMS) is a behavioural state of nervousness, irritability, lethargy and depression that occurs in adult male mammals following withdrawal of testosterone (T). The negative mood state has been described in men following withdrawal of androgens and is a striking feature in male seasonally breeding mammals associated with the end of the mating season.

IMS in humans
In humans, irritable male syndrome is referred to as the andropause,
Andropause: The Male Menopause
Andropause, also known as the male menopause, is the result of a gradual drop in testosterone and DHEA which are androgens, giving the condition its name. When men get into their early 30s, they begin to gradually start decreasing testosterone levels at a rate of one to two percent a year. It is estimated approximately 4-5 million men have symptoms of low/low-normal testosterone levels and only 5-10% of these men will seek treatment.
Based on World Health Organization (WHO) data, it was found that the testosterone levels in most 70 year old men were 10 percent of the level in males in their early 20s. By early 40s, men can start experiencing symptoms of andropause.

The symptoms of andropause (Irritable Male Syndrome):
  • • Weight gain
  • • Sleep apnea
  • • Memory loss
  • • Diminished libido
  • • Erectile dysfunction
  • • Muscle loss
  • • Depression
  • • Fatigue
The risks and benefits of testosterone replacement need to be evaluated by a qualified medical provider. It is a very individualized treatment based on labs, signs and symptoms.  

Treatment Options
The following treatments have been found to be effective.

Avoiding Irritable Male Syndrome
In order to help balance hormone levels and avoid irritable male syndrome, men should try to eat a well-balanced diet. Men should try to breakdown their diet in the following manner to help balance their hormone cycle:
  • 25 percent fat
  • 35 percent low glycemic carbohydrates (carbohydrates that are digested slowly and that do not cause insulin levels to spike)
  • 40 percent protein. 
In the future I will talk in details about food and diseases


Friday, 4 October 2013

Drug Substitutions, Definitions

Pharmaceutical equivalents:
are drug products that have identical:
  • active drug ingredient (same salt, ester, or chemical form)
  • strength or concentration
  • dosage form
  • route of administration
but may differ in: color, shape, packaging, excipents, preservatives, expiration time, and labeling

Bioequivalent drug products:
are pharmaceutical equivalents that have similar bioavilability when given in the same dose and studied under similar experimental conditions

some drugs may be considered bioequivalent that are equal  in the extent of absorption but not in the rate of absorption

this is possible if the difference in the rate of absorption is considered clinically insignificant, for example, for drugs for chronic use.

two products are considered bioequivalent if the 90% CI of the relative mean Cmax, AUC(0-t) and AUC(0-∞) of the test (e.g. generic formulation) to reference (e.g. innovator brand formulation) should be within 80.00% to 125.00%

Generic substitution:
the process of dispensing a different drug product in place of prescribed drug product
the substituted drug product contains the same active ingredient or therapeutic moiety as the same salt or ester in the same dosage form but is made by a different manufacturer

Automatic Generic Substitution:
means that the pharmacist may dispense either the prescribed product, or they may replace it with a generic or another brand without being required to inform the patient or healthcare professional.

this can not be applied to NTI-drugs "narrow therapeutic index drugs" as patients might receive a generic medicine with effectively 25% more active ingredient than the branded medicine on one occasion and one with effectively 20% less active ingredient on the next, with NTI-drugs this may be lethal

Pharmaceutical alternative:
are drug products that contain same therapeutic moiety but as different salts, esters, or complexes. e.g. tetracycline phosphate or tetracycline HCl equivalent to 250mg tetracycline base are considered Pharmaceutical alternatives

different dosage forms and strengths within a product line by a single manufacturer are also considered Pharmaceutical alternatives. 

e.g. an extended-release dosage form and a standard immediate release dosage form of the same active ingredient. 
e.g. ampicillin suspension and ampicillin capsule

Therapeutic alternatives:
are drug products containing different active ingredients that are indicated for the same therapeutic or clinical objectives

active ingredients in the therapeutic alternatives are from the same pharmacological class and are expected to have the same therapeutic effect when administered to patients for such condition of use
for example, ibuprofen is given instead of aspirin; cimetidine may be given instead of ranitidine

Main Ref: Biopharmaceutics and pharmacokinetics, Dr.Hanan Refai, MUST, 2011  



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