Herbal Health

At the start of any new skin care regime, the prospect of flawless skin can leave us giddy with excitement. As days go by and that dream skin’ has yet to make an appearance, it’s easy to become discouraged and fling those products in the bin, only to start all over again with a new assortment of products. This is all understandable – and I’ve seen it dozens of times with my patients – but trust me when I say that it’ll   , all pay off in the end.

New products, particularly those with collagen-stimulating properties, need ample time to work; there’s no way that this can be accomplished overnight. I advise that people try out their new products for at least a month [two or three months is actually ideal, but I know how impatient we can all be) before moving on to the next thing. The fact is that you aren’t going to see any improvement in your skin after just a few days. Those products that exfoliate the surface of the skin will give you a faster result.

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Many inside and outside the health sciences have wondered, “Why all the fuss about determining the origins of the AIDS pandemic and other outbreaks?” Resolution of where things come from guides decisions about our future, ultimately enabling us to put safeguards in place. Although there is a great deal of concern about the danger of emerging new diseases, the most important incident justifying this attention has been the AIDS pandemic. If it turns out that the AIDS pandemic resulted from polio vaccination, then we have no example from the twentieth century of a new kind of pandemic blindsiding society by arising from a secluded source. Nor do we have an example from the nineteenth century. The closest we can come are recurrences of known diseases such as influenza and cholera. To find a pandemic of a previously unrecognized disease caused by a previously secluded pathogen, we would have to go back to earlier centuries, to the first spread of exotic diseases such as yellow fever, cholera, and syphilis.

If, on the other hand, we can conclude that the AIDS pandemic was caused by a natural process rather than a medical bungle, then we will know that we should be ready for similar occurrences over the next few centuries. This recognition, however, should not distract us from the horrible infectious plagues that were here among us during the decades before the AIDS pandemic and that are still here. We have neglected them because we failed to recognize their infectious character. And we still do.

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Gestational Diabetes Mellitus (GDM)

Screening test: 50 gm oral glucose load, with 1 hour value s 140mg/dl. The ADA recommends that the test be done between weeks 24 and 28 of pregnancy. The American College of Obstetrics and Gynecology (ACOG) recommends that all pregnant patients be screened and that the 1 -hour value of 130 (90% sensitivity) or 140 mg/dl (80% sensitivity) be used as the threshold for diagnostic testing. According to the ADA guidelines, testing is optional in low-risk groups: age < 25 years, normal body weight, no family history of diabetes, and not a member of an ethnic/racial group with a high prevalence of diabetes (Hispanic, African-American, Asian, Native American).

Diagnostic test: 100 gm glucose orally (if screeningiest is abnormal)

Time fasting      Plasma glucose (mg/dl)

Diagnosis of GDM: Any 2 of the 4 plasma glucose values meet or exceed above values.

Hemoglobin A1c as a Diagnostic Test

Pro:   (1) Has a frequency distribution like FPG or 2-hour PG.

(2) Studies have established a level above which the likelihood of developing retinopathy and nephropathy increases dramatically. This level is approximately 6.0%. Con:  (1) Many different methods; limited standardization; limited world-wide availability. (2) Imperfectly correlated with FPG, 2-hr PG. Conclusion:   HbA1 c is not recommended as a diagnostic test at present.

Pre-diabetes

A new condition; pre-diabetes, was defined by the ADA in 2002. A person with IGT or impaired fasting glucose (1FG: fasting glucose of 110-125 mg/dl) is now defined as having pre-diabetes. Such people are at high risk for developing diabetes in the next decade and have an increased risk for coronary heart disease. The ADA has estimated that about 12 million people in the U.S. have pre-diabetes.

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