Glycemic index of a food and its importance

Whenever we talk about carbohydrates we just discard them absolutely for a diabetic patient. But all carbohydrates are not alike and have a different effect on blood sugar level after eating.

The effect of carbohydrate or any food having potential to raise blood sugar level is measured in terms of what is called glycemic index of the food.

How glycemic index is measured

Glycemic index of any food is measured taking glucose as a reference. Glucose after taking orally gets absorbed quickly and its glycemic index is considered as 100. For measuring glycemic index at least 10 person is fed with the food to be measured and blood sugar is measured at every 15 minutes interval for first hour and every 30 minutes. A graph is plotted and compared with blood glucose level after standard 50 gm of glucose taken orally.

Glycemic index of any food can be low, moderate and high. A low glycemic food is considered when glycemic index is upto 55 and moderate when it is between 56 to 69 and high glycemic index is when it is above 70.

The food having low glycemic index is slowly absorbed and the there is slow and steady rise in blood sugar after its intake and lowers down steadily after a time interval. While food with high glycemic index is absorbed quickly and there is sharp rise in blood sugar level and keeps fluctuating. The insulin level of the body too tends to fluctuate and in a diabetic patient it is difficult to adjust a dose of anti diabetic drugs and insulin if the patient have high glycemic index food.

Benefits of low glycemic index diet

It is understood that a diabetic person should concentrate on food having low glycemic index while a hypoglycemic patient should take high glycemic index food. Though a person with sedentary life style should always prefer diet having low glycemic index.

Alow glycemic index diet not only helps to control diabetes but also increases sensitivity of insulin. Even a non diabetic person having obesity should prefer low glycemic diet as it curbs many heart diseases and even helps to curb down obesity. Females with PCOS is recommended to have low GI foods.

Which type of foods have low glycemic index

Not going details on the chart, it should be noted that salads, nuts, brawn and fruit juices baring a few like mango juice are of low glycemic index. Among milk soya milk is considered as best. Most of the person use to have cornflakes in the breakfast but it has a high glycemic index of about 83. Spagetti is ideal food for one who prefer pasta. 
Glycemic index of bakery products

The3 bakery products are generally of high glycemic index and should be avoided as far as possible. Brown bread can be taken as it contains more fibres. All kind of wafers, biscuits even it is not sweet lies in medium or high glycemic index.

Glycemic index of Cereals

Among cereals bran is considered as best, pearl barley, instant or parboiled rice or kernel wheat should be preferred. Millets have the highest glycemic index among all cereals.

Glycemic index of dairy products

Most of the diabetics do not touch dairy product having a misconception that it may be of high glycemic index, but a fat free skimmed milk is ideal for them, yoghurts if taken without sugar is of very low glycemic index.

Glycemic index of Vegetables and fruits

All green vegetables with exception of broad beans are of low GI. Among fruits which should be avoided in diabetic or are of high GI are watermelon, mangoes, apricots, pineapple and raisins.

Though only carbohydrate content doesnt affect glycemic index, in fact there are a number of factors on which glycemic index of a food depends like its fibre content and viscosity of fibres, protein contents etc.

Finding A Fitness Boot Camp Downers Grove

When people in Westmont, IL, truly want to lose weight and are not quite sure how to do it, they will of course need to look for a course of action that will help them. By going to fitness boot camp Downers Grove residents can make progress toward their goals. They will no longer be shy about showing off their bodies at the beach or the pool during the summer.

Cardio workouts will be the focal point of the workouts. When men and women ensure that their heart and lungs receive a proper workout, they will improve their fitness considerably. Running and jogging are the usual cardio activities, but hiking and even swimming might also be introduced if there is some free time on certain days.

Mud runs can also be set up with ease. In fact, this is part of the fun of attending boot camp. Men and women can run through an obstacle course to test their prowess. The obstacle course will usually be set up in different configurations each day so that individuals do not know what is coming. People can run through the course and get stronger as they go along.

Weight-lifting should always be a crucial part of the process. Camp instructors can set up strength training programs that are tailored to the needs of their participants. Smaller women, for example, will be asked to lift less weight than larger men, but this is to be expected. The goal is to build muscle and burn fat whenever possible.

In some instances, men and women will be allowed to stay in dormitories that have been set up for them. This way, people can rise at the same time each day and get to work. As long as they rise with the sun, they will have a full day of exercising and socializing. Staying in dormitories will also allow people to build friendships with each other so that everyone sticks with the program.

When individuals complete the program, they will be well on the way to looking better. They will no longer have to worry about masses of protruding fat that are sticking out from under the shirt. Whenever individuals head down to the local pool, they will be able to show off their bodies in bathing suits and bikinis without feeling bad.

Better dietary choices should also be made. Eating more fruits and vegetables will help out quite a bit. Whole grains and legumes can also be worked into the mix. The goal is to eat as healthy as possible for most meals. The body will respond, and the fat should be eliminated from trouble regions before much more time has passed.

In the end, people will want to choose one of these camps because of their benefits. If they have been struggling with losing weight and getting fit for many years, they will of course need some professional assistance as they go along. By sticking to their program, participants can continue to make progress toward their goals without feeling as if they are overwhelmed as they are doing it.

CVP Installation

1. Consult a physician for drug delivery of low-dose heparin for high-risk clients until he ambulation. (Low-dose heparin therapy will result in blood viscosity and thrombosis decreased holding capacity and allows the risk of embolism)

2. Keep track of the signs and symptoms of pulmonary embolism

a. Acute chest pain and clear
b. Dyspnea, fatigue, cyanosis
c. Decrease in oxygen saturation
d. Tachycardia
e. Jugular venous distension
f. Hypotension
g. Acute dilatation of the right venrikel without parenchymal disease (on chest X-ray)
h. Mental disorder
i. Cardiac dysrhythmia
(Pulmonary artery occlusion disrupt blood flow to the lungs resulting in hypoxia distal)

3. If these manifestations occur, perform the protocol on the shock:

a. Keep the IV catheter (for the administration of fluids and drugs)
b. Give the gift of liquids treatment in accordance with the protocol
c. Replace indwelling catheter (Foley) (to monitor the volume of circulation through urine output)
d. Perform EKG monitoring and invasive hemodynamic monitoring (to detect dysrhythmias and treatment guidelines)
e. Give a vasopressor to increase peripheral resistance and increase blood pressure
f. Give sodium bicarbonate as indicated (to correct metabolic acidosis)
g. Give the drugs digitalis, diuretics IV and arrhythmia agents as indicated
h. Give a low dose of morphine IV (lower anxiety and reduce the need for metabolism)
i. Prepare client for procedure angiography and / or perfusion lung Scanning (to confirm the diagnosis and detect the extent of atelectasis)
(Due to massive pulmonary embolism deaths occur within the first 2 hours after awitan, immediate intervention is very important)

4. Give oxygen therapy via nasal catheter and oxygen saturation monitor. (With this action will increase the circulation of oxygen by rapidly)

5. Monitor electrolyte values, GDA, BUN, DL (this laboratory to help determine the status of perfusion and volume)

6. Do thrombolytic treatment, eg urokinase, streptokinase in accordance with the program physician (thrombolysis can cause embolic lysis and increased pulmonary capillary perfusion)

7. After treatment with intravenous thrombolysis, did the provision of treatment with heparin. (IV continuous or intermittent). (Heparin can inhibit or slow down the process of thrombus formation and helps prevent the formation and recurrence of clots.

Skinny Jeans Health Hazards

It is known to all that skinny
jeans are not only meant for women. Many of the males in the society today, the
teenagers in particular, are becoming obsessed in wearing tight jeans since it
is in the current fashion trend. But little did they know that such type of
apparel bring some health hazards.

Just this morning, while browsing
online, I found this worth-sharing article featured in regarding
skinny jeans. It was stated that according to medical experts, there is an increase
in injuries being caused by wearing of skinny or tight jeans.

For men, it is
said that this particular type of denim pants is causing testicular torsion – a
condition wherein the spermatic cord to a testicle is being twisted. Once the
testicle is twisted, it cuts off the blood supply resulting to pain, swelling,
and worse; gangrenes of testicle. Aside from affecting the testicle, men who
are fond of wearing skinny jeans could also experience a weak bladder, urinary
tract infections, and low sperm count.

image source:

Meanwhile, for women, wearing of skinny jeans could increase their chances to have a vaginal yeast infection.

Apart from the aforementioned
side effects of tight or fitted jeans, this particular style of pants is also
found to reduce blood circulation in legs and thighs, which then results to augmentation
of cellulite. It could also cause lateral femoral cutaneous nerve entrapment
that causes tingly sensation in the thighs. This condition happens when the wearer
habitually put cellphone in the front pocket. Digestion problem is another
side effect of high waisted skinny jeans and pressure on the urethra for low
rise skinny jeans.

Knowing all those negative
effects of constantly wearing skinny or fitted jeans, would you still put style
before your health?

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Tips on Caring for The Body With a Wide Range of Bathroom

Tips on caring for the body with a wide range of Bathroom

According to the study, was not only good bath to cleanse the body of impurities and avoid stress, but also plays an important role in enhancing the immune system, helping to avoid skin diseases such as eczema and even cure serious medical problems. So, what are the benefits and how long should a shower bath?

The following information about bathing a fun and healthy.

1. Removing Toxins.
Washing with warm water around 32-35 degrees Celsius can open the pores, which can help remove toxins in the body. Warm bath can also help lower blood sugar levels, heal sore muscles, and helps keep the colon working properly. The recommended time is 10-20 minutes for a shower.

2. Overcoming Stress.
If You again really stressful, cold shower may be the right answer. Cold water bath is very good for relieving tension as it can accelerate blood circulation and raise blood sugar levels. The recommended water temperature is 12-18 degrees Celsius.

3. Overcoming Eczema.
If You are affected by skin diseases such as eczema, rash, or hives, add baking soda or sodium bicarbonate into the tub can make a big difference because the sodium bicarbonate can act as an anti-septic. Fill the tub with lukewarm water, add about half a pound of baking soda and stir until blended. Soak for 10-20 minutes.

4. Overcoming Infection.
Infection can be overcome by adding three tablespoons of apple cider vinegar into the bath and soak for 15-20 minutes. Of apple cider vinegar is also good for removing toxins from the body because the vinegar can balance the acid.

5. Overcome Flu and Headache.
Soak feet in warm water can help cure colds and headaches as well as refresh tired legs. How to enter and warm water into the tub until it can cover the ankle, and then add a few drops of oil, such as lavender oil, peppermint, or lemon. Soak your feet for 10-20 minutes. Once done, rinse with cold water.

6. Overcoming Insomnia.
Soaking the feet in cold water is very good for those who suffer from insomnia or have trouble sleeping. The trick, soak feet to feel cold. This treatment is also useful for tired legs, nose bleeds, cold, and constipation.

7. Smooth Circulation.
Try soaking the feet alternately in warm water and cold water if the blood circulation is less smooth. Start by soaking the foot for 2 minutes in warm water, then 3 minutes in cold water. Trying to do for 15 minutes.

Vitamin D and cancer – nine facts "they" won’t tell you

by: Aurora Geib
Before, to be diagnosed with the big C seemed to be an implied death sentence. Patients even go through a stage of self-denial. Who can blame them? Conventional medicine paints a rather bleak future for cancer patients and the remedy it offers does nothing to improve their quality of life, nausea and falling hair not to mention.
However, the recent breakthroughs in science have allowed a peek into the true nature of cancer, allowing researchers to consider the concept of nutritional care. They are now faced with the idea that preventing and maybe even reversing cancer may not necessarily involve the development of expensive drugs but something already available in nature: food and sunshine! (
Just the facts
If something so powerful is actually available for everyone, why wouldn’t someone take advantage of it?
The recent discovery that the body, with the help of vitamin D, possesses the capacity to fight many chronic illnesses has spurred the interest of many researchers – especially on the possibilities the sunshine vitamin can offer with regard to the prevention and reversal of diseases like cancer. A brief rundown of some facts, revealed by recent studies, can give us a perspective on how vitamin D can help.Read more…

Moving On to New Website

Thanks for following my blog which since 2007 has provided a home for my thoughts and musings about the challenges for doctors and patients to get the right care each time. This blog was the starting point for my first book – Stay Healthy, Live Longer, Spend Wisely – Making Intelligent Choices in America’s Healthcare System.

I hope you continue to enjoy much of the terrific content here as well as follow me to my new home which features the latest commentary and insight at Davis Liu, MD as well as my newest book – The Thrifty Patient – Vital Insider Tips For Saving Money and Staying Healthy.

Of course you can still follow me on Twitter @davisliumd


Davis Liu, MD

“Tag Busters” collaborative opportunity is no longer accepting registrations.

“Tag Busters” an infection prevention and antimicrobial stewardship collaborative opportunity is no longer accepting registrations.

We appreciate the interest that many communities have had in participating in the online collaborative. Due to the popularity of this opportunity, we would like to announce that the collaborative has reached capacity and is no longer accepting registrations. At this time we will not be maintaining a waitlist. 

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AIDC: Future of Electronic Health Records

Key Blocker in usage of EHR’s
Clinicians are always under
pressure, in any given visit be it as a part of an outpatient clinic visit or a
bed side round. They are expected to make eye contact, listen empathetically,
process nonverbal cues, keep lab tests, allergies, and medication lists in
mind, and formulate differential diagnoses. The same clinician is also required
to document clinical notes granularly enough to support clinical coding and
enter data in a structured way to comply with data quality and regulatory
With widespread usage of EHR’s it
has become common to see clinicians and other allied professionals staying
after hours to do just data entry into EHR’s to comply with mandated data
entry. This is reducing physicians and other providers into data entry clerks
and is detracting them from being productive to provide quality care. This
ended up making data entry as the largest potential obstacle to the effective
use of EHR within clinical settings. Physicians at Yale and the University of
California recently argued that EHRs are becoming detrimental to the care of
patients as physicians spend twice as much time in front of a computer compared
to face time with a patient.
However there are other multiple
studies which proved that real time entry of patient data will make the current
data available to clinicians and help them target the right patients to provide
care. But real time entry of data adds additional burden to the clinicians
taking their valuable and critical time away from providing care to patients
and often leading to missing and erroneous data impacting patient outcomes and
creating administrative overheads.
Currently there are some tools
and work arounds within clinical settings to lessen the burden of data entry.
Intuitive User Interface: Clinicians have been complaining about quality
of the interface they were forced to use since the inception of EHR’s. The user
interfaces were often found to be not intuitive and required countless keystrokes
and they found it difficult to align their work process with what was needed to
be entered into the EHR.  Even today the
best of the EHR’s in the market have sloppy user interfaces, but vendors are
making effort to create user interfaces by designing based on human behaviour principles
and by working, observing and consulting with end users.  The intuitive user interfaces need to be accompanied
by proper education, training and support to aid in easier use of EHR by users.
EHRs with intuitive user
interfaces aggregate information pertinent to the problem at hand and are
designed using data visualization techniques for optimal display. But intuitive
user interfaces has its own limitations in terms of space on screen,
expectations of varied users and affordability and human senses.
Digital Dictation: To reduce clinician’s workload related to data
entry in EHR’s lot of organisations use digital dictation tools with voice-to-text
capability to speed up data entry. EHR providers are increasingly incorporating
and integrating voice-recognition software into their products to allow clinicians
to directly narrate into the system. There is an overhead of narrated notes
need to be reviewed for accuracy and then approved, but clinicians are found approving
their entries without reviewing them. This increases the risk of inaccurate
data and mistakes. The art of converting narrative into structured data and
incorporating semantic workflow to support the narrative is quite complex.
Natural Language Processing: Natural language processing (NLP) is increasingly
considered as a viable technical solution for improving clinical outcomes and
simplifying data entry. NLP deciphers doctors’ notes and other
unstructured information generated during patient visit into structured,
standardized formats. However NLP suffers from the similar issues as digital
dictation and text is often ungrammatical, consists of “bullet point” telegraphic
phrases with no semantic context.
Internet of Things (IoT) is a concept
that basically connects any device with an on and off switch to the Internet.
IoT’s offer Automatic identification and data capture (AIDC) technologies, AIDC
refers to the process of automatically identifying and collecting information about
patients and logging this information in an application such as EHR.  AIDC refers to a range of different types of
data capture devices such as barcodes, biometrics, RFID (Radio Frequency
Identification), magnetic stripes, smart cards, OCR (Optical Character Recognition)
and sensors.
What AIDC can do for EHR’s is
briefly discussed below.
Digitising Written Notes:
Many clinicians are still more comfortable working with paper and asking them
to enter data electronically can lead to resistance against an EHR
implementation. Automated document and data capture technology can be leveraged
to enable doctors to continue to utilize paper encounter forms with a new EHR
system. AIDC allows setting up bar codes (2-D or 3-D) automatically and assign
them to patient’s record by scanning and digitizing their back files and
integrating them with the EHR system to have a single view of an entire patient
history. OCR/ICR technology is typically incorporated in document and data
capture software applications that also have features like image processing for
improving the quality of scanned documents; forms recognition, to identify the
type of form being scanned; and forms processing, which enables the software to
identify and capture specific pieces of data.
Improving Efficiency: One
of the most important aspects of AIDC is to improve efficiency of an
organisation by assisting in equipment tracking, inventory management and patient
tracking. This is done using solutions involving RFID and mobile scanners which
will help organisation track assets, providing real-time information about
assets (drugs and consumables) ensuring hospitals have what they need, where they
need it, when they need it.
One of the good examples of improving
efficiency using AIDC technologies apart from the usual inventory management
and equipment tracking  is  bed management where bed occupancy sensors
provides an early warning by alerting that the user has left their bed and not
returned within a pre-set time period, indicating a possible fall. These sensors
can also be programmed to switch on lights, helping as digital signage devices.
Managing Patient Care: To provide better patient care, clinicians need access to medical
equipment and access clinical data which is increasingly being collected using
mobile devices and other wearable technologies. Mobile devices and wearable
sensors are a part of IoT solutions and they allow clinicians to gain
access to the information in real-time to improve patient experiences and
outcomes. The wearables and other wireless devices and sensors allow monitoring
patient temperature, Parkinson’s disease, post-surgery awakening, etc. These
applications require asset tagging and patient tracking. The proliferation of
IoT devices allow data being automatically collected and fed into EHR systems
with vendors of IoT devices proving  interfaces to integrate them with EHR’s
thereby helping organizations gather more data and deliver better care.
How widespread is usage of AIDC?

Automatic identification &
data capture (AIDC) technology in healthcare has greatly promoted the
error-free data collection and improved patient safety. It is helping reduce
medication errors and related healthcare expenditure. Growing focus on patient
safety, technological revolution, and rising government legislations on the use
of barcode & RFID technology are further expected to boost the growth of
the global healthcare automatic identification & data capture (AIDC)
Automatic Identification & Data
capture (AIDC) market within healthcare industry is mainly segmented into
clinical and non-clinical applications. The non-clinical application segment
holds the largest share, owing to the higher adoption of barcode & RFID
technology in the non-clinical applications such as supply chain management and
medical staff & asset tracking, though the clinical application segment is
also growing fast. Global Healthcare Automatic Identification & Data
Capture (AIDC) Market is expected to reach USD 3,122.7 million by 2022
supported by a CAGR of 15.4% during the forecast period of 2017 to 2022.
The Wythenshawe Hospital used a
traditional paper-based process to manually enter patient information into
patient records. This process is known to be less reliable than automated entry
and can cause major health concerns for patients as a result of the opportunity
for human error. For the medical facility, error that leads to the injury or
even death of a patient opens the door for major legal complications. The
Wythenshawe Hospital staff also found the process to be time-consuming, as
doctors and nurses had to take time away from patients to enter data, recall
patient records or refill prescriptions manually.
Wythenshawe Hospital decided to
implement a system based on bar codes and bar code scanning devices to support
staff in scanning codes on patient records. By automating this activity, the
staff is able to automatically retrieve a patient’s Electronic Medical Record
Six trusts which include
Salisbury NHS Foundation Trust, Plymouth Hospital NHS Trust and Leeds Teaching
Hospital have been selected as a part of Scan4Safety project which used
barcoding to better identify and match patients, products and locations.  Across the six demonstrator sites, early signs
of benefits are extremely encouraging, with over £700,000 of savings
already being identified:
Stock reduction/one off stock holiday –
Reduction in wastage/obsolescence –
Non-clinical pay efficiencies – £46,000
Based on these initial findings, it is estimated that for a typical NHS
Hospital trust, the benefits could be:
Time release to patient care – equivalent
to 16 band 5 nurses per trusts, that’s 2,400 band 5 nurses across the NHS.
A reduction of inventory averaging £1.5
million per trust, £216 million across the NHS.
Ongoing operational efficiencies of £2.4
million per trust annually, that’s £365 million across the NHS.
What are the challenges with AIDC?
AIDC devices and technologies interfaces with
EHR are not ‘plug-and-play’. The devices will need some kind of interface to be
installed that will translate the measurement data from the device into a
format that the EHR database can understand and use
AIDC devices provide high volume of data which is
required to be captured and processed at high speed
Unlike manual data capture the data coming from
AIDC devices need to be categorised into wanted and unwanted data categories
ISO/IEC standards such 16022 Data Matrix and 18004
QR Code
ISO/IEC 29161 Unique Identification for IoT
ISO 17367 Supply chain applications of RFID –
Product tagging
ISO/IEC WD 30101 Sensor Network and its
Interfaces for Smart Grid System
GS1 Global Specifications,
HIBC Health Industry Bar Code,

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Should you eat only low fat or no fat dairy products? The answer may surprise you.

This advice plus other advice to limit
saturated fats rapidly led to a massive shift in America to use of low and no
fat dairy products from whole fat diary. Unfortunately, for whatever reasons,
today America has an epidemic of obesity, overweight, metabolic syndrome, diabetes
and perhaps now an increasing incidence of cardiovascular disease.   

Was the dairy advice correct or not? A recent perspective
article in the J of the American Medical Association asked experts and suggests
that the answer is simply not clear. 

One observation is that Americans use
cheese primarily to create pizzas, cheeseburgers and junk foods, while
Europeans use cheese as cheese itself.

What is known about the health benefits or non-benefits is
based on observational studies which amount to associations rather than clear
cause and effect as would be found in a randomized trial where some group gets full
fat diary and the other does not. Still, observational studies at least give directions
for consideration. 

In the PURE study of 136,000+ individuals 35-70 years of
age, a higher intake of dairy fat was actually associated with lower risk of
cardiovascular events and mortality. “Whole fat dairy seemed to be more
protective than nonfat or low-fat dairy”

Another approach is to look at biomarkers, in this case by
examining the blood content of three specific fatty acids are primary derived
from dairy products. It turned out that when 16 such studies were pooled with
63,00 participants, those with higher levels of the three fatty acids were less
likely to develop diabetes during the time of the trial. 

What about weight gain? It turns out there is no clear-cut
evidence that full fat dairy is more likely to lead to weight gain than low fat
or no fat diary consumption. An expert quoted in the article noted that there
is no strong data to show that full fat diary leads to more weight, more cardiovascular
disease or more metabolic syndrome. Rather observational studies suggest just
the opposite. 

Another expert interviewed suggested that the key is not to worry
about any one ingredient in the diet but what is most important is the overall dietary
pattern. This makes good sense to me.

Rubin, R, Whole-fat or nonfat dairy? the debate continues, J Amer Med Assoc,
2018; 320:2514-2516

Some 40 years ago, the Dept of Agriculture recommended a
switch to no or low-fat milk and dairy products as part of the effort to reduce
the consumption of saturated fats.