Obesity – Who’s Fault? The Relationship Between Restaurants and Obesity

America – The Land of the free and also… the Land of the Fat! The stark reality is that the USA is possibly the fattest country in the world!


Over the past thirty years, the prevalence of obesity and obesity-related diseases in the U.S. has risen sharply. Since the early 1970s, the share of children age 6 to 19 classified as overweight has more than tripled, from 5 percent to 17 percent, while the share of adults classified as overweight or obese rose from one-half to two-thirds of the population. Over this same period, the number of fast food restaurants more than doubled. Exposes such as “Supersize Me” and “Fast Food Nation” along with reports in the popular press have frequently suggested that fast food is at least partly to blame for the U.S.’s rising obesity rates.

Despite the popularity of this view, it has been difficult to empirically establish a definitive link between fast food and obesity. The simple fact that fast food restaurants and obesity have both increased over time is insufficient proof of this connection, as are studies that rely on differences in fast food consumption across individuals, since people who eat more fast food may be prone to other behaviors that affect obesity.

Of course, over the recent years the US media has gone to great lengths to share the risks of obesity and the new concept of wellness, but while there’s a better awareness of the side effects of eating, there is little to show in the way of statistical improvements.

So what’s the problem?

Interestingly, while Americans point the finger at the fast food restaurants, it’s probably not so much the fast food restaurants that are at fault but the consumers themselves and, believe it or not, technological advancement. Remember – a free economy is set up where supply meets demand not the other way round, and there is no economy as free as the USA!

However, lifestyle is also to blame. Greater economic demands on families have generated enormous lifestyle challenges for individuals and families. America’s consumer driven economy is largely to blame. The economic realities of running a home in the US usually require that the husband and wife work in full time jobs. Single parent home generally have broad pressures as well, so the US consumer lifestyle requires a fine balance between work and family time. This balancing act is what created an entirely new food culture – fast, affordable and tasty – wrapped up in one single word: “Convenient”. Since the end of WW2, Americans have migrated towards anything that shaves time from their busy lives.

Bear in mind that the US restaurant industry captures 49 percent of Americans’ food dollar, according to the National Restaurant Association. So these restaurant groups have a big influence on what we eat.

Additionally, the government is taking an interest, and there are a number of government sponsored proposals in place which are intended to help consumers make up their minds; among the most controversial of the recommendations: Communities could consider a tax on sugary sodas and offering price breaks for healthier beverage choices.

However, the big change, as with many things these days has been driven by the internet. The internet is a restaurant’s best friend and its worst nemesis. Love it or hate it, the internet has been the largest platform to channel concepts such as Wellness, healthy eating, and the health implications of fast food and pre-packed / processed products.

The information age, which has accelerated the consumers understanding of good food and bad food, has driven two major changes:

1) Consumer awareness has forced changes in demand – McDonalds now serves salads!!

2) Underground movements have become mainstream – for example the ‘Farm to Table’ movement has created its own websites and associated restaurants [which are becoming chains]. Any well-known chef in the US is promoting sustainability and locally farmed produce, meats and fish, as well.

Over the past decade, obesity rates stayed about the same in women, while men experienced a small rise. That increase occurred mostly in higher-income men, for reasons researchers couldn’t explain.

About 17 percent of the nation’s children and teens were obese in 2009 and 2010, the latest available data. That’s about the same as at the beginning of the decade, although a closer look by the study shows continued small increases in boys, especially African-American boys.

A Cream For Rashes – How To Remedy Your Eczema

You can’t just select any cream for rashes. Insisting on doing so only puts you at risk of causing even more irritation to your skin. At worst, the rashes may spread to more areas of your body – and rashes aren’t all that attractive. On a visit to the dermatologist, try viewing dermatitis pictures taken from different patients. What you should see is that each patient develops a different set of symptoms. Some may have rashes like yours, and others may have rashes that look completely different from the ones you have. So, when dealing with an eczema rash, you need to be careful of your choice of eczema creams.

Before moving onwards on how to choose the best product for skin rashes, there are a few misconceptions that need to be clarified – one being the confusion between the terms “dermatitis” and “eczema.” By definition, dermatitis is the inflammation of any or all of the skin’s three layers which includes the epidermis, the dermis, and the subcutaneous layer. Eczema has a more specific definition in which it is the inflammation of the skin’s exposed layer – the epidermis. There is actually a very thin line between the definitions of dermatitis and eczema but to make things simpler, eczema is basically a form of dermatitis.

Another fact that needs to be clarified is the question that arises because of the common traits of dermatitis and eczema, and that is whether or not dermatitis creams are effective for an eczema rash and if eczema creams will work on a dermatitis rash. Well, it actually depends on the situation. Because eczema is a type of dermatitis, there are a few similarities in their symptoms. Shared symptoms between these two include redness, swelling, and skin irritation which are characteristic of an inflammation.

However, dermatitis is a very broad term and is not a specific diagnosis that dermatologists give. It may constitute of inflammation of both the dermis and epidermis or might even go as far as the subcutaneous layer. And because the skin rashes associated with eczema only affect the epidermis, eczema creams that are specifically built to counteract inflammation in this layer may not have wondrous effects for dermatitis that goes beyond the epidermis. If it so happens that dermatitis is only present in the epidermal layer, then that is the only time that eczema creams may work against dermatitis rashes.

Because dermatitis may involve the inflammation of all three skin layers, dermatitis creams are nonspecific and target inflammation in any of these areas. Hence, unlike the eczema cream which has a limited scope, a dermatitis cream has broader treatment coverage and could therefore treat an eczema rash. Ultimately though, the best way that you can choose the appropriate cream for your rashes is to have yourself diagnosed by a licensed dermatologist before buying any OTC eczema or dermatitis creams at the local pharmacy. Eczema is but one type of dermatitis and eczema itself has many different types with different symptoms that require varying treatment approaches.

Once you have your exact eczema diagnosis and were informed by your doctor of the symptoms associated with your specific diagnosis, it is only by then that you can choose which eczema cream will work best for you.

An eczema rash may present itself as flat and itchy dry patches of skin, as red blotches on skin, or as red bumps that itch – depending on what eczema you have. With a rash from dry skin, moisturizing rash creams are the best options that can relieve the skin’s dryness and the itch that it causes. As for the presence of obvious inflammation like redness and swelling, there are creams for eczema that target these symptoms in particular. These creams may or may not contain steroids which are established anti-inflammatory agents. However, a steroidal cream should only be used with swollen rashes that rarely recur because long-term use of steroids has negative effects on the body. It also can’t be used for children and babies with eczema so it’s best to avoid steroidal cream for rashes.

However the safest choice to relieve your symptoms is to select creams that contain natural compounds such as, Blueberry leaves and Aloe Vera. These ingredients from nature have the ability to relieve the itch, redness, and swelling associated with eczema. The best part about nature-based creams is that they provide nutrition to the skin that a synthetic cream for rashes can’t give.

Remedies For Red Cracked Corner of Mouth Sores

Having a cracked corner of mouth is a painful and embarrassing thing. Although this happens to many people during the dry, cold months of winter, it can strike at any time. Angular Cheilitis is a problem that people of all ages have to deal with. It’s hard to know exactly what to do to help alleviate the redness and chapped skin. There are some remedies that not only minimize the appearance of this common skin condition they also help take away the discomfort.

One thing you must do if you have cracked corner of mouth skin is to avoid getting that area wet. A common misconception about Angular Cheilitis is that, liked chapped lips, putting lip balm on will bring some relief. That’s not true at all. In fact if you use lip balm on the redness at the corner of your lips you are actually making the problem worse. You want to keep this skin as dry as you possibly can. That means avoiding lip balm and any lipstick.

People who have dentures are prone to developing a cracked corner of mouth sore. If your dentures are ill fitted you are more likely to drool when you sleep which can just make the issue even worse than it is. It’s a great idea to have your dentures adjusted from time to time.

You may also be suffering with a vitamin deficiency if you have regular bouts of Angular Cheilitis. People who have cracked corner of mouth sores may have low levels of Vitamin B12 and iron. You can begin taking a supplement or a better approach is to add foods that are high in Vitamin B12 and iron to your diet. Although this may not cure your current issue, it will help prevent further problems from developing.

Psoriasis And Parasites – Is There A Connection?




















Foot Fungus And What To Do About It

The fungus that causes Athlete foot is named Trichophyton and is a skin infection.

Athlete foot is caused by the ringworm fungus (“tinea” in medical jargon). Athlete foot is also named tinea pedis. The fungus that causes Athlete foot can be found on floors and in socks and clothing.

The symptoms of Athlete foot include itching and burning feet. The skin frequently peels and, in particularly hard cases, there may be some cracking, discomfort and bleeding as well. When the feet, or other areas of the body, remain moist, warm and irritated, this fungus can flourish and infect the upper layer of the skin.

When the skin is injured by the fungus, bacteria can also invade the skin. Those bacteria can cause a bad odour. Bacterial infection of the skin and resulting inflammation is also known as cellulitis. This is especially expected to take place in the elderly, individuals with diabetes, chronic leg swelling, or who have had veins removed, and patients with week immune systems.

The treatment of Athlete foot can be split up into two parts. The first, and the most important part, is to make the infected area less suitable for the Athlete foot fungus to grow. This means keeping the area clean and dry. The second part of

treatment is the use of antifungal creams. Numerous medications are available including miconazole, clotrimazole, etc. Ask your health care professional or pharmacist for a counsel. Treatment should be continued for 4 weeks.

If you notice any redness, increased swelling, bleeding, or if your infection is not clearing up, see your healthcare practitioner. If a bacterial infection is also occurring, an antibiotic may be required.

Allergies – Causes and Effects of Allergies

What is an Allergy

Allergy is a reaction that occurs in individuals who are sensitive to certain substances such as cosmetics, animal hair, pollen food, medication or to certain climactic conditions like heat or sunshine that in others may be harmless. An allergic reaction may come about anyplace on the body: in the eyes, on the epidermis, the lungs or the digestive tract. Although an allergy can arise at any time, symptoms suffered in childhood tend to let up with time and many go away completely. An inclination to allergic reaction is mostly genetic, while the character of the allergy might be different from generation to generation.

The Genetic Factors

Allergies, such as asthma, nasal allergy, hay fever, eczema and some types of allergic headaches incline to run in the family. One family member might suffer from asthma whereas another might suffer from eczema. Allergists have noticed a heritable inclination in acquiring allergy. When both parents suffer an allergy, every one of their children holds approximately a 75 % probability of acquiring one as well. When only one parent suffers from an allergy, chances are 50 % or less.

Food Allergy

Some allergies are caused by foods which contain or release histamine during the chemical transformation process. Such foods include tuna or other canned food. Others which stimulate such allergy are food additives like coloring, preservatives and flavor enhancers. Allergy is basically the result of defective reaction of the system’s immunity, which responds to an allergen with the fabrication of antibodies as though the substance were harmful. Today, 1 in 12 children under the age of 6 show signs of food allergy and 1 in 25 have a verified food allergy present.

Histamine Effects

Firstly, an allergic reaction increases the permeatation of the minor blood vessels making the fluid component of the blood serum escape into the tissues. Such a condition brings on blisters, puffiness, and irritation of certain tissues like the nose, the eyes or the epidermis.

Secondly, it causes muscle spasm, particularly in the bronchi. This brings on heavy respiration and asthmatic attacks. In intense instances, sensitivity to insect stings, a nonhuman antitoxin serum or penicillin may bring on an anaphylactic reaction (unexpected shock) that may be life-threatening.

Approximately 15% of the population in the U.S. suffers from some allergy or other. However, why a specific allergy develops is yet a medical enigma. Although allergies cannot be completely cured, there is available treatment which can build up resistance to certain allergens.

Soft Drinks


o Isotonic drinks help to replace lost fluid and energy very quickly after vigorous activity


o Can be high in sugar, which may contribute towards tooth decay

o Acidic drinks can erode the enamel on your teeth

o Ii is possible to consume excessive amounts of caffeine if you drink too many cola drinks, as well as coffee

Most sweetened soft drinks provide empty ‘calories’; they supply plenty of energy, but no other useful nutrients. Typically, a 330ml (10½fl oz) can of a regular, non-diet cola drink contains just over seven teaspoons of SUGAR. Too many sweet drinks can therefore contribute to weight problems as well as to TOOTH AND GUM DISORDERS.

There are, however, an increasing number of low-calorie, sugar-free soft drinks now available. Some of them claim to be good for you. Isotonic drinks, which are specifically produced for sports enthusiasts, are designed to boost energy – and to replace the electrolytes (mineral salts such as sodium, potassium, magnesium and chloride) that are lost through sweating. The isotonic drinks usually contain 5 percent sugar, which allows the water in the drink to he absorbed much more quickly by the body than from a glass of pure water.


The original cola drink was invented in 1886 when John Styth Pemherton, a pharmacist in Atlanta, USA, concocted a mixture of coca leaves, cola nuts and caffeine to sell as a cure for headaches and hangovers. Today, regular colas contain only about one-third of the caffeine found in a cup of coffee, and there are also decaffeinated versions. The sugar con- rained in diluted squashes ranges from a single teaspoon per glass to four or even more in the case of some blackcurrant drinks, but these may also provide useful amounts of vitamin C. The sugar in soft drinks is broken down by bacteria growing on teeth – to produce acid. If you sip sugary drinks over long periods, this increases the risk of tooth decay by prolonging the time that enamel-destroying acids are in the mouth. Acidic fruit-juice cordials can also erode your teeth. Try to drink soft drinks at mealtimes, and clean your teeth regularly. In a recent survey, researchers at Southampton University found that some children are gaining almost half their daily energy intake from sugary drinks, and that these empty calories are leading to irritability, loss of appetite, poor weight gain and diarrhoea. And doctors who treated eight toddlers referred to Southampton General Hospital with eating or behavioral problems found that the children’s symptoms disappeared when their consumption of sweetened soft drinks was reduced.


Made with artificial sweeteners, low- calorie drinks are suitable for almost everyone, including diabetics. They do not contribute to tooth decay by promoting the formation of plaque, or to weight problems. Sparkling waters with added herbs, minerals and gins eng claim to act as a natural pick-me up, but tend to be more expensive than other soft drinks. They arc usually sweetened with fruit juice.


Some ADDITIVES used in soft drinks, such as the azo dyes sunset yellow (El10) and tartrazine (E102), found in some orange, lemon and lime squashes, have been alleged to cause allergic reactions in susceptible individuals. The symptoms can range from skin rashes and upset stomachs to irritability and hyperactivity.

Depression – Who is Most at Risk of Depression and Anxiety?

According to the World Health Organisation (WHO), depression is a common mental disorder that is the leading cause of disability and the leading contributor to the global burden of disease. By 2020 WHO predicts that depression will rise to the number two contributor to global burden of disease. Who would have known?

WHO Depression Facts (from WHO):

  • Depression is common, affecting about 121 million people worldwide.
  • Depression is among the leading causes of disability worldwide.
  • Depression can be reliably diagnosed and treated in primary care.
  • Fewer than 25 % of those affected have access to effective treatments.

So what is Depression?

Depression is a common mental disorder that manifests itself in the form of depressed mood, a loss of enjoyment of living, low self esteem, inability to sleep properly, loss of appetite, low levels of energy, and poor concentration. It affects people of all ages and from all backgrounds. Some experience severe symptoms and are unable to function day to day and fatalities account for about eight hundred and fifty thousand lives yearly.

So who is most at risk?

The statistics suggest that women are more susceptible to depression than men. Approximately one in six women will experience depression at some stage in their lives while men have a one in four chance. Whilst there are factors that affect women more so than men, the numbers mask a real issue for men…

There are factors that impact on women that contribute to depression such as child birth (post natal depression), hormone changes and the multiple roles women have in day to day life (like raising children, running a home and holding down a job, all at the same time).

One of the known issues with the statistics is that men are known to be less likely to seek support for their depression. The social stigma placed on men prevents them from seeking help and consequently the numbers may be skewed. Many men consider depression as a weakness, or at least they perceive others to do so and therefore they are reluctant to step forward and admit their illness. Although this is improving today, there are still an unknown number of men who do not present for support.

Children who experience depression are more likely to have a family history of the disorder. Often one of the parents will have experienced depression at some stage in their lives. Adolescence is a period when depression seems to affect a greater number of people, particularly girls. They too have a higher than normal likelihood to have a family history of depression although not to the same extent as children.

What are the Risk Factors?

A number of factors have been recognized as increasing the risk of contracting depression. These include such things as stress, marriage breakup, relationship break down, a loss of a loved one, onset of chronic illness such as diabetes, abuse or neglect or some other traumatic event.


Depression is a major mental disorder that is prevalent everywhere, in all ages, races and genders. There seems to be a higher incidence in women but the numbers could be somewhat misleading. There are several known contributing factors, including family history of the disease.

According to WHO, depression will be a growing problem for many years to come.

Fear of Authority Figures in the Workplace Isn’t Just Social Anxiety

People who seek help with their social anxiety often have difficulties dealing with individuals who have “power,” perceived power or authority. These can be authority figures, those with high status, or those in parental roles. However, you do not have to have social anxiety – fear of being negatively evaluated, embarrassed or humiliated, found inadequate, and rejected – in order to become anxious in the presence of someone with authority.

In general, we have been taught to respect all authority. As a consequence, we also have a deeply buried sense of guilt about possibly being caught doing something authorities dictate we should not be doing. Consider how you feel when you are driving and a police car appears. For most of us there is an immediate and automatic surge of adrenaline that not only races your heart but also lifts your foot from the accelerator.

Like social anxiety, fear of authority figures can be the result of factors such as

– Strict, critical or overbearing parents who made you feel inadequate and powerless to do other than as they directed.

– Traumatic incident involving a person in authority whom you felt embarrassed, humiliated, rejected, or punished you in some way.

– Conditioned response to feeling negatively evaluated, judged, and rendered powerless over time by an authority figure.

As a result, you tend to see authority figures as having more value and being more deserving of power than you because you are less worthy by comparison. You see this as the reason they have that role, the power, and the discretion to use that power as they see fit… and you do not.

These factors can leave you perceiving any person in an authoritative role as having the right to judge you and the special power to arbitrarily threaten or act against you. You are left with the feeling that a person in this role cannot be trusted to have your best interests at heart. Therefore, you feel you must appease them and seek their approval so they will not use their power against you. Where this fear shows itself most often is in the workplace.

While it is understandable that no one wants to feel at risk of losing their job, when you fear your boss or anyone in that role of authority, you cannot do your best. Your performance suffers because your thoughts and emotions are focused on how you are being evaluated and how you can survive it. Your thoughts are not focused on your being as productive as you need to be. Instead, you constantly analyze everything that happens on the job and worry about what it means. You begin to feel hypersensitive to what your boss says and does with respect to your value and position at work.

If given the choice of interpreting what you see and hear as positive or negative, you will tend to spin it negatively. This is because you have to keep yourself vigilant of potential dangers in order to protect yourself. The result is that you hold yourself in lower esteem than your boss. You see yourself as needing to do whatever is necessary to be a “good little cog in the wheel” but, at the same time, stay off the boss’s radar. Of course, the problem with acting in this fashion is that you are sabotaging yourself. You are acting in total contradiction to what you need to do to be seen as an important, productive, necessary member of the team that the boss would not want to lose.

What can you do to address this difficult problem? You need to follow a program that addresses all the components of your fear – cognitive, emotional, and physiological. You need to

1. Assess your positive attributes (talents, abilities, experience, work successes, and expertise) and your value as both a worker and a human being

2. Assess your boss’s positive attributes and value as both a worker and a human being

3. See that comparing yourself to your boss is like comparing apples and oranges – that you two have different roles requiring different attributes and behaviors – that one is not “better” than the other – only different

4. See that your boss has authority and power by virtue of his/her role only

5. Examine your past successes in general and your work successes in particular to see your work’s value and to regain your confidence that you have something worthwhile to contribute

6. Dispute automatic negative thoughts about your perceived inadequacy and your boss’s arbitrary use of power against you

7. Stop yourself when you start analyzing fear-related situations

8. Stop yourself when you start feeling hypersensitive to what your boss says and does

9. Learn to deeply relax yourself in anxiety-provoking situations so you can think more clearly and rationally

10. Displace negative emotions with humor to keep you more positive and on an even keel

11. Visualize your boss as a mere human being and peer in fun or silly social situations

12. Visualize yourself calmly meeting with your boss, asking a question, making a comment, or sharing information

13. Look for colleagues who act confidently with your boss and model yourself after their behavior

14. Recognize that only you have the right to judge and validate your worth as a person

15. Assess your own decision-making power as a human being and competent worker

16. Decide what you want to achieve on the job for yourself and make a plan you will follow to achieve it.

Anxiety Atenolol – How Good Is It



For anxiety atenolol dosage should be taken on a regular basis. There needs to be at least 8 hours between each dose. Should a dosage be missed and it is near the time of your next dose, you must take only that dosage and not a double or even an extra dosage.





For the sufferer from constant anxiety atenolol tablets might just be the one thing that can help you cope with a world gone awry so talk to your doctor to find out whether atenolol is the best thing for you and think seriously on the possible side-effects.

Living With Insomnia – A Guide For the Bleary Eyed

Insomnia. This is when you lose the ability to get asleep each night. Or you might get asleep but you’ll wake again shortly afterwards and you won’t be able to get back to sleep. When it starts off first insomnia is just annoying – you wind up feeling very tired for the first few days of it. It’s only when you’re in your second or third week of insomnia that you start to realize just how much this sleep disorder can affect your emotional and mental health. Plus you simply won’t be able to function in work and you’ve probably found yourself dozing off during the day.

Why Is Sleep So Important?
Your body needs time to rest and regenerate – that’s why you sleep. Your body basically spends the time you’re asleep fixing itself and regenerating the parts of yourself that you wore down or damaged during the day. Not only is it important to sleep but it’s important to regulate how much or how little sleep you get. Ideally you should be sleeping 7 – 8 hours per night. Any more or any less than this can lead to long term health problems. One study showed a 15% – 20% potential increase in the mortality rates of people who sleep more than 8 hours or less than 6 hours per night over the long term. That’s why I feel like slapping people who boast about sleeping 12 hours per night – you are literally wasting your life away – physically and metaphorically.

Types Of Insomnia
There are 3 basic types of insomnia that you can suffer from. The first is transient insomnia which means you’ll suffer from the sleep disorder for less than 7 days. The second type is acute insomnia which means the problem could continue on for up to 4 weeks. Chronic insomnia is where you’ll suffer from this problem for more than 4 weeks.

Personally I’ve suffered from chronic insomnia – the condition lasted for almost 3 months and left me a wreck at the end of it. The first few weeks were tiring but as the problem got worse I found myself really struggling to cope with sleeping 1 or 2 hours per night. Or even worse was when I’d be awake for up to 72 hours straight- I would literally pass out from exhaustion. But the condition did pass and my life got back to normal.

What Can Cause It?
Insomnia doesn’t have any one single cause which makes treating it that bit tougher. The first, and most common, cause is stress. If you have a lot on your mind at the end of the day you’re going to find it difficult to sleep. You then spend the next day tired and you still have stuff on your mind so the following night you wind up over-tired but not being able to sleep. Then you’re into the vicious, downward spiral of stress related insomnia.

Other things that can cause this sleep disorder are psychoactive drugs (ecstasy/MDMA/E) and amphetamines (speed) – if you’re a party person then that’s your choice but taking either of these is going to mess up your sleep pattern and vital body organs too. Accept the repercussions of putting this junk into your body.

Changes in your hormone levels (menopause or menstrual cycle for example) or in your shift pattern in work will bring on an attack of insomnia quicker than you’d think. Frequent changes in your working shifts is bad for your health overall and it’s like waving a red rag at the sleep disorder bull.

You also need to make sure your bedroom is as quiet and restful a place as possible so make sure you eliminate any loud noises or light that you can – this is basic good sleep hygiene. Without it you’re going to have trouble sleeping full stop.

How Can You Treat Insomnia?
The key to treating this problem is identify the root cause. Treating the symptoms with a pile of sleeping pills isn’t a long term solution for a number of reasons. If you’re finding that you can’t sleep because your mind is distracted then you need to deal with that by talking to a trusted friend or a professional about what’s bothering you. The more you think about a problem the more it gets buried in your long term memory.

The best way to cure your insomnia is to remove or deal with any emotional, psychological or drug issues that could be causing it. Once you’ve dealt with the root cause the next step is to get yourself as relaxed as possible before you go to bed. Try taking a warm bath and drinking some valerian tea one or two hours before you sleep. Or learn some basic meditation and breathing techniques to help slow down your mind and heart rate. Once your body is relaxed sleep will come naturally – there’ll be no need for sleeping pills.

Ingrown Toenail Removal Coding Confusions? 11750 Answers Them

In a particular case, a patient presents for a follow-up of an ingrown toe nail. The podiatrist finds that the patient now has two ingrown toenails – one on each foot. He removes both from each toe and also did a silver nitrate cauterization. How should I report this? Should I report 99212-25?

Well, the answer is yes. Besides coding 99212-25, you should bill 11750 (Excision of nail and nail matrix, partial or complete [example, ingrown or deformed nail], for permanent removal) appended by modifier 50 (Bilateral procedure).

Logic for evaluation & management: Since the diagnosis is new to one toe, you could justify 99212 (Office or other outpatient visit for the E/M of an established patient which requires at least two of these three key components: a problem focused history; a problem focused examination, and straightforward medical decision making; Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service). The patient presents for follow-up of one ingrown toenail. However, the podiatrist has not examined the other (new) ingrown toenail earlier.

Adding modifier 25 (Significant, separately identifiable E&M service by the same physician on the same day of the procedure or other service) to 99212 indicates the podiatrist carries out a significant, separate service from the ingrown toenail removal.

Logic for incision: You should report each toenail removal: 11750 for the first complete removal and 11750 for the second removal. Using modifier 50 to the second removal tells the insurer that the podiatrist carries out the toe removal as bilateral procedure.

For more specialty-specific articles to help your podiatry coding, stay tuned to a medical coding resource like Coding Institute.

First Aid For A Sprained Ankle

Sprained ankles are one of the most commonly seen sports injuries. They are usually caused by sudden movement or twist that overstretches and tears the supporting ligaments of the ankle joint, causing swelling and pain. This is a common injury especially with athletes and sportspersons who participate in activities that call for a lot of running, jumping and changing directions while playing.

Symptoms And Treatment For Sprained Ankle

Symptoms of a sprained ankle include swelling, which is usually immediate and pain in the ankle joint even with the slightest movement and especially when walking.

It is best to see a doctor if your ankle gets sprained but rendering first aid immediately after the injury goes a long way in helping the ankle heal faster. The most effective first aid for this injury is the RICE treatment.

RICE: General Ankle Treatment

Generally your doctor will advise using the RICE method for treatment. This is an acronym standing for rest, ice, compress, and elevate which refers to the standard form of treatment.

Rest: In the first 24-48 hours you need to remain inactive and avoid using your injured ankle unless you can maintain a natural gait as you walk. Crutches will help you to get up and sit down.

Ice: In the first 48 hours you’ll need to apply ice to your injured ankle for 20 minutes (never exceed 20 minutes! Tissue damage may occur!) about every 3-4 hours.

Compression: You’ll need to apply pressure to the area to help it recover and the best way to do this is with an ankle wrap. Cover the ankle from your toes all the way to the upper portion of the calf muscle. Make sure the wrap is snug fitting but not so tight that it cuts off circulation (you’ll know you’ve cut off circulation if your toes or foot turn blue, cold, or starts to feel numb).

Elevate: Keep your injured foot elevated above your heart as much as you can, especially when you’re asleep. Always use care when standing after elevating the injured foot.

It is important to remember that the RICE treatment will help if it is a simple sprain. However, it is not always possible to determine whether the swelling is a result of a sprain or whether the ankle is fractured. If you are unable to put any weight at all on the foot, there is a higher chance that the bone may be broken. In this case, you need to seek immediate medical attention and get an X-Ray done to determine whether there is a fracture so that you can get the appropriate treatment.

Signs of Diabetes – Slow Healing Bruises Or Cuts

“This cut is not healing.”

“I am unable to wear shorts because of ugly cut on my calf.”

“I do not know how I got this bruise.”

“I cannot wear sleeveless shirts because of ugly bruise on arms.”

“This bruise is taking the longest healing time.”

“Finally I have understood that I should never wear shorts and sleeveless shirts in public.”

You are not alone if you make or think such sort of statements. There are many who are puzzled like you because of these cuts and bruises. At times the person is unaware of the reason of the particular cut. The thing which is known for sure is that his cuts and bruises are taking longest healing time.

Let me put something clearly on your face. It is a hard truth; these slow healing cuts and wounds are one of the signs of diabetes. If you doubt that you are diabetic then it is vital that you learn about this chronic ailment as much as you can. Ignorance is not good as far as diabetes is concerned. Let me make it more clear that slow healing cuts and wounds symptoms diabetes.

The diabetics are at an increased risk of getting a cut or wound. The good thing is that a person can avoid these cuts or speed up the recovery process of these cuts. Above all with proper knowledge a person can delay the onset of diabetes.

“I haven’t got any cut but I don’t want it to happen”

“My grandpa has cuts on his leg but he never thought that he could be diabetic.”

If ever you have made these statements then congratulations as you are at the right place.

Diabetes is a disease which is easier to prevent then to treat. Recurrent infections are common in diabetes. Treat the infection before it starts to hinder the healing process. Regular exercise also speeds up the healing process of cuts. Increased blood sugar levels are dangerous and may cause even severe infections in cuts. It is important to check the infections carefully.

“I am diabetic; is there anything that can help me?”

“I am experiencing signs of diabetes; is there any product that can help me?”

Herniated Discs in Dogs and Treatment Options

What a Herniated Disc Is

The disc that sets between the spinal vertebrae ruptures when the dog has a herniated disc. When the disc ruptures the gel-like material on the inside of it seeps out. This material then can become hardened and calcified, which lessens its shock-absorption ability. Pressure can cause this hardened substance to explode or bulge into the spinal canal nearby, where the spinal cord is located. This is the process that is known as herniation. This can result in pain and elevate to feeling loss or paralysis.

Treatment Options for Herniated Discs in Dogs

There is more than one treatment option for the dogs when a herniated disc happens. If the dog is still moving then prednisone can be given to the dog. Treatment with this will lessen the swelling around the spinal cord which is causing the pain and making it unpleasant for the dog to move. This treatment can take the place of surgery sometimes. The dog should not however stay on this treatment too long because steroids like the prednisone can have negative side effects that can cause the dog problems.

The veterinarian could instead recommend limited activity and rest for the dog. This will decrease the amount of stress that dog’s back is being put through. Of course this treatment and the prednisone are only for mild cases where the dog can still walk.

In the event your dog cannot walk or other treatments have not worked, the doctor will most likely want to operate. He will order various diagnostic procedures to be preformed first though. This surgery will help take the pressure off the dog’s spinal cord which is brought on by the hardened gel and other debris.

A great percentage of the dogs do quite well with the surgery, if the nerve damage is not too severe and it is caught soon enough. Rehabilitation is also part of this treatment. Rehabilitation for dogs could involve exercises and underwater treadmills to improve muscular strength. This could also improve how the dog in functioning neurologically.

The major problem with herniated discs is that they can keep happening. As long as there is a healthy disc left it can become herniated. There are some breeds of dogs that have more of a tendency towards this problem than others. The body weight should be kept down in the dogs that are predisposed to this problem. Any dog is good physical health can recover from this problem better than one in poor physical condition.

Also instead of regular neck collars use the chest harness kind. The neck collars can cause stress on the neck. The dogs also should not have jarring motions happen to the back such as jumping off of the furniture.

When you are suspecting problems contact the veterinarian immediately.