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Life on earth began in water. Water is the largest molecular constituent of the body. It makes up for about 60% of the total body weight in males and 55% in females.
It provides a medium for metabolic functions in the body. Enzymatic reactions occur in aqueous media. It maintains the form of cells, tissues and organs, helps in digestion, evacuation of body wastes, maintenance of body temperature, lubrication in joints, prevention of infections and many more such functions.
Water Distribution in the body
Of the total body water, 2/3 is in the cells and 1/3 is extracellular. Of the extracellular water, 2/3 is outside the vascular system and 1/3 is in blood.
Regulation of water balance
The osmolality( a measure of solute concentration in water) is held in a very narrow limit in the human body. This typically is 280 to 295 mosm/kg. If the osmolality increases in the body fluids, a hormone called ADH is produced at the base of the brain. This hormone increases thirst and decreases water excretion in the urine thus restoring osmolality.
If excess water is taken, in healthy humans, it is promptly excreted in urine. Even an intake of 8-10 liters in healthy persons may be tolerated.
Water quantities for balance in the body
Body losses of water
Water is required for cooling down of the body by formation and evaporation of sweat. About 1 ml of sweat is required for losing .58 ml kcal of body heat. Thus about 400-500 ml of water is used in this way depending on environmental temperature, wind velocity, dryness of air etc. 100 -200 ml may be lost in the formation of stools. Small amounts are also lost in vapour form during breathing.
Kidneys excrete about 800 mosm of daily solutes in salt and electrolytes, urea etc. Since maximum urine concentration in healthy adults is about 1200 mosm, 2/3 litre of water is lost in this way daily.
Gains of water from outside
Apart from water ingested directly in fluids and beverages, water is also contained in food. Some fruits may have almost 100% water while most will have 50 to 60% water content. Thus 500 ml to 600 ml of water is ingested in foods. Water in similar quantity is produced by metabolism of proteins and carbohydrates in the body.
Thus to maintain a balance a minimum of about 600-800 ml of water is required to be ingested in the liquid form. An intake of 1.5 to 3 l is sufficient for most cases for healthy living. In old people a litre more water results in better function of the kidney and bladder.
For patients suffering from type II /adult onset diabetes :In type II diabetes, diagnosis is often late (after the disease has already been present for some time). In early days T2DM (short for the adult type of diabetes) are often without symptoms. Hence the delay in diagnosis. This means complications will be seen early after diagnosis. Foot Care :
Foot disease in diabetes may lead to difficulty in walking, pain and may lead to infections. If neglected amputation may be required.
Inspect feet with a mirror before going to sleep every night.
Use well fitting shoewear.
Do not walk bare feet even in the house.
Socks should be clean and correct size.
In case of deformities of feet, special shoes can be worn. Eye Care :
It is nowadays the commonest cause of blindness throughout the world. Continue Reading ~ Second Medical Opinion / Advice
Nephrotic Syndrome Kidneys receive approximately 1 liter of blood every minute. Of this, about 100 ml gets filtered in the kidney. This contains, small molecules and few large molecules. This is due to the intricate cellular structure that prevents proteins from getting filtered into the urinary space. A derangement of this filter results in passage of heavy amounts of proteins in urine. This condition is called HeavyProteinuria or Nephrotic syndrome or Nephrosis. Definition:
In the urine, the protein excretion is > 3.5 gm/day or in children, it is >50mg/kg of body weight. In most cases, the serum albumin is <3gm/dl (normal>4), and passage of lipids in the urine. The lipids in the blood increase and swelling of face and feet also occur. Causes of Nephrotic Syndrome:
In children, most cases are due to Minimal Change Disease, FSGS, MPGN etc. In adults, most cases are due to primary illness while upto 30% may be due to secondary illness. Clinical Features:
Apart from Edema, ther…
Asthma or Bronchial Asthma is a common disease. About 75 % cases start in childhood before 10 years of age. A large no of patients stop having symptoms at the time of puberty and some may again have the disease in the later years. It is uncommon after 50 years of age. It can be troublesome, disabling and if not treated properly may be dangerous.
The disease results from heightened reactivity of the airways in response to irritants, allergens, fumes and at times exercise. It is typically intermittent and a person feels well when there is no ongoing attack of asthma. Symptoms:
Symptoms of asthma are shortness of breath, difficulty in breathing, cough and whistling sounds during breathing. These symptoms may also be seen in a no of heart, lung or infective conditions. Hence the diagnosis is usually made by experienced doctors after a few episodes have occurred!
The important markers of the disease are rapid reversibility of the signs and symptoms with appropriate treatment or spontaneousl…