In the past, women nave consumed less alcohol and nave had fewer alcohol-related problems than have men. But now, greater percentages of women, especially college-age women are choosing to drink and are drinking more heavily.
Studies indicate that there are now almost as many male as male alcoholics. However, there appear to be differences between men and women when it comes to alcohol abuse. Risk factors for drinking problems among all women include the following:
-    A family history of drinking problems
-    Pressure to drink from a peer or spouse
-    Depression
-    Stress
Risk factors among young women include the following:
-    College attendance: women in college drink more, a more frequently, than they do after they graduate
-    Nontraditional, low-status, and part-time jobs, and unemployment
-    Being single, divorced, or separated
Risk factors among middle-aged women include the following:
-    Loss of social roles (e.g., through divorce, children growing up and leaving the home)
-    Abuse of prescription drugs
-    Heavy drinking by spouse
-    Presence of other disorders, such as depression
Risk factors among older women include the following:
-    Heavy- or problem-drinking spouse
-    Retirement, with a loss of social networks centered с workplace
Drinking patterns among different age groups also differ in these ways:
-    Younger women drink more overall, drink more often, and experience more alcohol-related problems, such as drinking and driving, assaults, suicide attempts, and difficulties at work.
-    Middle-aged women are more likely to develop drinking problems in response to a traumatic or life-changing event, such as divorce, surgery, or death of a significant other.
-    Older women are more likely than are older men to developed drinking problems within the past 10 years
Much needs to be done to accommodate the needs of women seeking treatment for alcoholism. Until recently, most of the research on treatment issues has been conducted as though everybody were a man. It is estimated that only 14 percent of women who need treatment get it. In one study, women cite potential loss of income, not wanting others to know they may have a problem, ability to pay for treatment, and the fear that treatment would not be сconfidential as reasons for not seeking treatment. Another major obstacle for women is child care. Most traditional residential treatment centers do not allow women to bring their children with them.
*38/277/5*

Knowing what weight is right for you depends on a wide range of variables, not the least of which is your body structure, height, the distribution of the weight that you carry, and the ratio of fat to lean tissue in your body. In fact, your weight is often a very deceptive indicator of whether or not you are obese. Many extremely lean, muscular athletes carry a tremendous amount of weight and would be considered overweight based on traditional height-weight charts. Many young women think that they are the right weight based on charts, yet they are shocked when they discover that 35 to 40 percent of their weight is body fat!
In an attempt to resolve some of the misinterpretation of the traditional height-weight charts, the Department of Agriculture and the Department of Health and Human Services devised one weight table for both men and women that allows for variations in body structure, the distribution of weight, and weight gains in middle age. Weights at the lower end of the range are recommended for individuals with a low ratio of muscle and bone to fat; those at the upper end are advised for people with more muscular builds.
*2/277/5*

Acne vulgaris is most commonly caused by the hormonal changes of adolescence. Adolescent girls produce more of the hormone oestrogen and boys, androgen. These hormones lead to an increase in the activity of the sebaceous glands of the skin on the face, neck and back. Sebum, the sticky substance produced by these glands, can fill the skin pores resulting in blackheads and whiteheads. If these become blocked and infected the skin becomes inflamed and covered with red and purplish pimples which may disappear, or in more extreme cases, cause scarring. For the adolescent who has a new and sudden interest in body image, acne is very distressing.
Diet is important and sweets and oily foods must be avoided. It is important to stay away from junk food, takeaways and dairy products; nuts and chocolate can also cause problems. Drink soy milk as a milk substitute and get plenty of fresh air and exercise to help keep the skin healthy. Foods containing high levels of vitamin A have shown good results with acne sufferers as have foods with high zinc content. As teenagers’ diets are usually not as good as they should be, supplementation of these nutrients is advised.
Skin care needs special attention. It is best to avoid removing blackheads as this may result in scarring. It can be done if the area has been softened with a special lotion containing the herb thyme. Only soaps designed for skin health should be used and a good skin scrub will help remove the dead top layer of skin and help open the pores. This will allow the sebum to escape without clogging. To treat the pimples use a tea tree gel daily. Tea tree is an anti-bacterial oil which will not harm healthy skin but will effectively destroy acne bacteria. Also, wash and condition the hair regularly and keep it off the skin as this will aggravate the oiliness.

Topical treatment
Wash face with an anti-bacterial face wash daily. Apply a tea tree gel to the pimples once daily.

Supplements
Children over 12
Bio Zinc            1 tablet daily with food
Cod liver oil             1 teaspoon daily before food
Vitamin E             250 IU daily with food
Sodium sulphate        200 mg. twice daily
In severe cases add echinacea 175 mg twice daily in combination with red clover, sarsaparilla, burdock and yellow dock.
*1/199/5*

There are three main types of substances acting as nervous transmitters: acetylcholine, catecholamines, and peptides.
Acetylcholine is the prime transmitter for the parasympathetic nervous system, which with the sympathetic system makes up the autonomic nervous system. Its effects are to some extent opposite to those of the sympathetic nerves: the heart is slowed, the gut becomes sluggish, the pupils become constricted. Physical exercise can make the effects of the parasympathetic more marked; this is the reason why an athlete often has a slow pulse rate, slow pumping of the heart being more efficient than rapid beating. Acetycholine also controls the muscles of the body, being released at nerve endings in muscle cells (the South American arrow poison, curare, works by blocking the effects of acetylcholine to produce paralysis).
Catecholamines: the sympathetic nervous system uses nor-adrenalin as a transmitter; this substance can be measured in the blood and its level is raised in situations such as stress or exercise when too much is released to be destroyed or taken up again. Tyramine, mentioned previously as a cause of migraine, has effects similar to those of noradrenalin. Another catecholamine, serotonin (5-hydroxytryptamine) has marked effects on the brain and is also present in the small blood cells (platelets) concerned in the first stages of blood clotting. Its relevance in the study of migraine is that it has a marked constrictive effect on blood vessels and its release from platelets can cause spasm in the related area.
Apart from their effects on blood vessels as nervous transmitters, amines also have local effects when coming into direct contact with the vessel wall. Cheese and red wine contain tyramine whereas chocolate contains phenylethylamine; once consumed these substances enter the blood stream and exert their effects on blood vessels. In those taking certain drugs for depression they may cause catastrophic rises in blood pressure. The chain reaction in patients on these drugs in no way resembles a migraine attack, however, and is more in keeping with the severe headache found with high blood pressure (hypertensive encephalopathy).
The finding that certain amines can cause vasomotor changes, raising the blood pressure and producing severe headaches, is of interest in the study of the causation of vascular headaches.
When small, measured quantities of the catecholamine transmitter tyramine are given, small, reproduceable rises in blood pressure are produced. Migraine patients need less tyramine than other people to achieve the same rise in blood pressure (there is a similar increased sensitivity to tyramine in depressed patients). The explanation may be that there is an increased sensitivity to tyramine in migraine subjects’, but it is uncertain whether this is secondary to the headaches or a sensitivity which is always present in migraine patients.
Tyramine raises blood pressure partly by stimulating the release of noradrenalin from nerve endings. These effects could spark off the changes discussed but the most obvious interpretation may not be the actual explanation. When migraine sufferers are given a tablet of tyramine, its metabolism and excretion resembles the results in similar experiments with depressed patients. It would be easy to deduce that migraine is linked to depression biochemically; but all that can be said at present is that certain people who have migraine and others who are depressed are similar in one particular biochemical measurement.

*31/152/5*

The research that culminated in the publishing of Human Sexual Response was creative and thorough and was conducted with meticulous care. For almost the first two years, Masters and Johnson worked with a group of prostitutes, gathering interview data from individuals who had been in a unique position to observe many sexual response cycles in a large number of different individuals. Of the original 145 prostitutes, a small number (8 women and 3 men) were chosen for further anatomic and physiologic study. These individuals proved invaluable as subjects during the months of trial and error when the techniques and instruments to study the sexual response were being devised and refined. However, the results that came out of their work with these prostitutes were not included in the final report. Masters and Johnson have described this group as having “migratory tendencies,” that is, they frequently moved from place to place, which made it difficult if not impossible to obtain detailed response patterns over a long period of time. More importantly, this group had a high incidence of pathology of the sexual and pelvic organs, making the group unsuitable for research into normal sexual functioning.
The final subjects studied by Masters and Johnson were all volunteers, many from the university community. Subjects were expertly screened to weed out those who were only “thrill seekers” or who had volunteered for other inappropriate reasons. The remaining volunteers were all paid for their time spent in the laboratory. A total of 382 women, ranging in age from 18 to 78 years, and 312 men, aged 21 to 89 years, actively participated to some extent in the project. Included were both married couples and unmarried singles.
*91\265\8*

Mention the “natural environment” and most people think of the plants and animals that exist in places not yet overrun with humans. Our minds perceive the natural environment and the human environment as very distinct—an old-growth redwood forest is put neatly in one category and a New York City subway in the other. The natural environment in which we evolved consisted of savannas, meadows, and forests. Now we live in enclosures of steel, glass, plastic, and plaster. Most of the animals that share these unnatural environments with us—our dogs and cats—are domesticated; that is, they are different from their wild ancestors, genetically altered through human influences on their breeding. In this sense they are all unnatural. So too are virtually all the plants and animals we eat, whether or not their packaging dubs them “natural.” Many of us spend most of our waking hours looking through glass plates at the changing patterns of light generated by electrical current. It is easy to come to the conclusion that we have left virtually all of the natural world behind in our movement toward an ever more technologically sophisticated civilization.
That conclusion is wrong. We accept it because our perceptions of nature are profoundly biased by our size. Being large animals, we easily recognize all the organisms at the large end of the spectrum of life. We are hopelessly inept at recognizing in our daily experience the far greater number of organisms so small they cannot be seen with the naked eye. These microscopic organisms are parts of nature too. And when we moved from caves made of rock to caves made of wood, metal, plaster, and glass, we did not exclude them from our daily existence in the way that we excluded lions, wolves, eagles, and frogs. Some microbes have been added to our immediate environment as a result of our closer association with domestic animals over the past ten thousand years. Only a tiny minority have been excluded—those that were sufficiently harmful to us to make us care about them, and were sufficiently vulnerable to be knocked out by antibiotics or vaccines. The rest have come along for the ride, often changing, to be sure, but changing in ways that are not fundamentally different from the ways they have been changing throughout our quarter-million-year tenure as a species on earth.
Our intimate natural environment has always included an abundance of invisible organisms. Now we are familiar with the tiny minority that cause us obvious problems, and we are slowly but increasingly becoming aware of the rest—as microscopes make visible the invisible, and molecular techniques reveal their chemical footprints. Still, we continue to ignore microbial wildlife because most of it does not cause obvious problems for most of us.
This comfortable state of affairs is made possible by henchmen that mercilessly identify, tag, poison, blast, and eat the microbes that trespass on our biological turf. The number of these henchmen within each of us is greater than the number of people on earth, and they are organized into one of the most remarkable inventions that has graced the globe: the immune system. After studying the immune system for about a century, we still do not understand just how remarkable it is. Our minds, at least at present, have proved too feeble. Like the brain, the immune system stores information, communicates, and makes decisions. It also patrols, enforces, and attacks with an efficiency and ruthlessness that make the Gestapo look quaint.
The discovery of antibiotics is one of the great achievements of medicine. But these medications are like children’s toys compared with the extraordinary complexity of the immune system’s miniature enemy-detection sensors, communication systems, and teams of specialists. These specialists are more diverse and more flexible than the members of any police force. The best specialists are selected for the job. The numbers of these specialists are increased as necessary according to communiques from other specialists. New kinds of specialists are created when the old specialists do not quite have the right abilities. When the mission is accomplished, the force of unnecessary specialists is reduced to just a few of the best, who are poised to go through the whole process again more quickly if the same kind of adversary shows up.
These teams of specialists include individuals that make specific tags (antibodies) that are put on microbes so other members of the army (macrophages and other phagocytic cells) can recognize, surround, and capture each invader. The invaders are then disposed of with chemical weapons such as peroxide. Some specialists, such as the macrophages, take body parts of the engulfed pathogens and mount them on stalklike structures on their surface much like the victors in human conflicts mounted the heads of their victims on pikes. This “antigen presentation” sends a powerful message. Other cells, called helper T cells, contact the presented body part to see whether it fits their own recognition machinery. If the fit is tight, the helper T cell then reproduces itself prolifically; the progeny scout out other cells that can also recognize the specific enemy but have different talents at their disposal. When the helper T cell finds the same microbial body part on another type of immune cell, the helper cell says in chemical language, “Yes, you have found the enemy. Now use your particular expertise in the control effort.” Some of these other cells are demolition experts, called cytotoxic T cells, which then reproduce and move through the body to find infected cells. Infected cells will mount body parts of the pathogens on their surfaces, much as the macrophages do, but this mounting indicates their infected state—they are marking themselves for destruction. When a cytotoxic T cell with the right fit binds to the mounted body part, it blows up the infected cell.
One of the other major targets of the helper T cells are the B cells, which transform themselves into antibody-producing machines after contact with a T cell that carries news of a pathogen. The news is conveyed by an actual part of the destroyed pathogen that locks onto an antibody anchored on the B cell surface. The antibodies produced by these transformed B cells are the same molecule the B cells used to receive the news, but now they are released from the cell into the blood, lymph, and sometimes into the tears and saliva. When the antibodies encounter the pathogen part, they attach to it. When the pathogen part is still attached to an intact pathogen, the pathogen becomes coated with antibodies; it thus becomes recognizable by phagocytic cells like macrophages, which engulf and digest the mess.
Even with all the complex communication, mobilization, and destructive power, pathogens would still often overwhelm the immune system if the B cells of our fish ancestors had not evolved a clever trick hundreds of millions of years ago. The pathogens’ inherent advantage derives from their short generation time. The mutations and genetic rearrangements of infectious agents, coupled with their short generation time, provide them with a tremendous potential for staying well ahead of humans in the race between offenses and defenses and counterdefenses and so on. To deal with this disadvantage, the cells that generate antibodies play the pathogens’ game. They reproduce quickly, let loose with a high rate of mutations, and recombine the subunits of the instructions for specific antibodies, almost like replacing a few cards of a hand in a life-and-death game of poker. The newly invented antibodies are tested in the centers of lymph nodes to see if they work well. Almost none of them do. To nip the proliferation of bad ideas in the bud, the cells that came up with them are killed. But a few of the antibodies are better. The cells that produced them are allowed to live and encouraged to grow. The defense against the invaders improves. When the population of invaders is destroyed, most of the specialists that were marshaled are no longer needed and commit suicide; a few are left as memory cells to respond quickly should the same invader return.
This description, which only hints at the underlying complexity of immunological defenses, makes it sound as though these cells of the immune system have brains. Indeed, they act as if they had brains, but they do not. All the interactions are orchestrated by chemical signals and chemical responses. Chemical messages are released from one cell to another, across membranes, and to different parts within the cell to control the cell’s mechanical responses and its reading of genetic instructions. Individually, these defense cells do not have brains, but taken collectively, their ability to process and communicate information bears a surprising resemblance to the brain.
This magnificent immune system fails us sometimes because all this identification, communication, mobilization, reproduction, and fine-tuning takes time. While the immune system is performing these activities, the pathogens are busy reproducing and invading. Once the invasion is identified and the immune system mobilized, the outcome depends on how quickly the immune system can make up for lost time. When a novel pathogen is encountered, the time from the initial invasion to immunological control typically takes about a week. If the same invader is encountered by the person a month or a year later, the response time is much
shorter—typically a couple of days, thanks to the quick responses of the memory cells. It is so fast and effective that the person may not even be aware of the invasion. With the pathogen-host evolutionary arms race running neck and neck, the shorter time makes all the difference—the difference between illness and health, and sometimes between survival and death.
*23\225\2*

Chhindwara District is situated on Satpura plateau at 1550-3820 feet above the Sea level. The District lies between 18 8′ – 20 9′ E. The arrangements of the plateau varies in altitude from 760-1030 mts. the plains in the south have a general elevation of 400 mts. The valley – Patalkot is situated 82 km away in the north-west of Chhindwara. Patalkot (Patal -subterrene, kot = fort) is a horse-shoe shaped valley in which there are 12-small villages. Tamiya (1000 m in height) and Patalkot valley (400 m) are the parts of Satpura plateau and are located in south-east direction of Pachmarhi. Both the spots are botanists paradise as far as the grandeur of natural vegetation is concerned.
The area came under the british rule in 1853. The forests were thrown open to the contractors on royalty system who removed the best teak trees for supply to the railways. The forests were declared reserved in 1879. Due to population explosion and civilization deforestation has been done in the nineteenth century onward with a rapid rate.-The two places, Patalkot and Tamiya because of the rich flora have attracted tourists, botanists and other nature lovers.

THE LAND

The main Chhindwara plateau is characterised by scattered flat topped trap hillocks with step-like terrace. The Chhindwara plateau slopes steepyly and abruptly eastwards to a general elevation of about 450 mts in plains. Archaens type of rock occurs in Chhindwara. It consists of intensely metamorphosed highly folded magniferou metasediments. Gondwana formation is the main-type geoliogical formation of the area. Patalkot is filled with sedin.entary rocks, uncovered gravel pebbles, needlestones, and sandstone observed at various level. The rocks of the area are grey, red or purple and quite hard. The rocks also contain felspar and mica as common ingredients. The climate of Chhindwara in general, and Tamiya and Patalkot in particular is neither hot nor too cold. The characteristic feature of Satpura range is that as compared to Himalayas and south India mountains inspite of low altitude the rainfall is high, i.e., average about 200 cm per year.

THE PEOPLE

Gond and Bharia are the main tribes of Chhindwara District. Earlier, their primary occupation was hunting and fishing. But now they have adapted the practice of cultivation of maize, Soyabean, Millet, Kodo, and Kutki, etc. However, a large number of Gonds work as farm and forest laboures. Among the Gonds proper, there are two sub-divisions, Raj Gond and Dhur Gond. Gond which formerly was the name of the region spread over western Bihar and eastern Bengal. There are several groups or sub-tribes of Gond. The Gonds have exogamous totemic clans. A man must not marry within his clan nor he should marry in a clan which worships the same number of Gods. Each clan worships a specific number of Gods and has somewhat linkage with Dravidian language. Besides, this, now they have learnt Hindi language to some extent. Their economy is based on agriculture and forest produce. Economically they are very poor people. Their children suffer from malnutrition. In Patalkot, Bharia people are dominating/About 98 per cent Bharia and 2 per cent Gonds reside in the valley.

MEDICINAL PLANTS

Saxena and Shukla reported 275-medicinal plants from Patalkot valley. The important medicinal plants and their uses are given in Table 1.

Maheshwari and Dwivedi studied the ethnome-dicinal plants of Bharia tr’be of Patalkot valley and reported that Bharia utilizes a large number of plant species occurring wild in the district as herbal remedies in various diseases. They gathered first-hand information of about 61-medicinal plants and mode of therapeutic uses of these plants. A list of rare medicinal plants is given in Table 2.
Ramprasad et al. reported 55-medicinal plants from Patalkot valley. They studied the important Value Index of 27-medicinal herbs which are given in Table 3.
Ram Prasad et al.  reported that roots are abun dantly used by Bharias followed by leaf, whole plant, flower, fruits, and bark.

Rai and Nonhare (1992, 1994) carried-out the eth-nomedicinal studies of Bicchua block of Chhindwara and reported 100-medicinal olants which are given in Table 4.

CONSERVATION STRATEGIES

Conservation can be defined as – “the management for the benefit of all life including humankind of the biosphere so that it may yield sustainable benefit to the present generation while maintaining its potential to meet the needs and aspirations of the future generation.”

Owing to rapid rate of destruction of forests precious herbal medicines are becoming rare day-by-day. Some of these medicinal plants are much threatened and others are vanishing rapidly. So, it is indispensable to take necessary steps to protect the plants from degeneration. There are two important methods, viz., in situ and ex situ conservation. In Ayurveda, it is mentioned that the medicinal plants are highly active, if they are grown in their natural habitat. In Chhindwara District Patalkot, specially Chhindi area should be selected for in situ conservation of medicinal plants. Other places where efforts for in situ conservation can be made include: Tamiya, Harrai, Bicchua, and Devgarh, etc. Gond and Bharia people can be involved for the propagation of drug-plants.
Ex situ conservation also plays a significant role in minimising degeneration of medicinal plants. For this purpose, nurse y of medicinal plants can be prepared and plants can be multfplied by applying modern techniques, such as, tissue culture, biological control of insect-pests, etc. In Patalkot, a nursery of medicinal plants has been developed by the Government. Endeavours have also been made by Danielson College Environmental Conservation Programme to conserve medicinal plants in the college garden. However, these conserved plants/nurseries need proper care, protection and multiplication, and above all is financial assistance.

Not only conservation strategies, but awareness among the/common people is also required for the conservation of nfiexlicinal plants. This aim can be achieved by distribution of rhedicinal plants of daily use like Emblica officinalis. Plumbago zeylanica, Sapindus laurifolius, Swertia chirata, Tinospora cordifolia, Ocimum basilicum. It can be undertaken in social and Agro-forestry programmes.

Paramedical staff must be trained for the collection of medicinal plants time to time as the different parts of the plants are to be collected as per their availability and maturity. The reasonable price should be paid to the people for this collection.

Major set-backs

The medicinal plants are required in a great number as compared to their production, and therefore, the vendors adulterate them with similar plants. Ichnocarpus frutescertse is
used in place of Hemidesmus indicus. Saraka bark is adulterated with Polyanthia. In lieu of Piper longam, Balanophora dioca is used. Chirayta (Swertia chirata) is often compared with Andrographis panicuiata, and hence instead of the former latter is used frequently. Convolvulus pluricaulis which is locally known as Shankhpuspi is often replaced by Evolvulus alsinoides.    ’

There are many such plants which are used instead of other similar plants. Sometimes, it is due to the ignorance of the sellers, but generally they adulterate the herbal drugs due to their less or non-availability in their niche.
*26\218\2*

When there is irritation of the lower gastrointestinal tract, the fibre component of fruits and vegetables may need to be softened by cooking. In acute conditions, fibre may be removed by straining the vegetables and fruits. Milk often proves difficult causing diarrhea.
Infrequent and difficult passage of small amount of stools is termed constipation. The amount and frequency of stools varies with individual dietary pattern, lower in urban population on refined foods and higher in rural population on whole grains; although exercise, stress and hormones have some role to play in this. There are many other causes of constipation other than simply inadequate fibre intake. Some of the other causes are:
1. Irritable bowel syndrome
2. Multiple sclerosis and Parkinson’s disease
3. Colorectal cancers
4. Hypothyroidism and diabetes
5. Lack of physical activity
6. Drugs.
High-fibre foods along with higher fluid intake helps.
1. Eat whole grains, legumes and grams.
2. Eat lots of whole fruits and vegetables.
3. Eat whole wheat cereals and whole wheat bread.
4. Bulk laxatives like isabgol helps.

Irritable bowel syndrome (IBS)
It is a disorder of the motor activity of the whole bowel although symptoms involving colon are more common. It generally has abdominal pain and altered bowel habit. Subjects could have diarrhea, constipation or both accompanied with abdominal distention, gas, bloating and feeling of incomplete evacuation. Mental stress is a major associated factor.
No specific diet is recommended unless subjects have specific allergies to a particular food, however, a bland diet rich in soft fibre is recommended to avoid distention and constipation.
*2/356/5*

Sometimes these breathholding spells can be aborted or prevented by diverting the child’s attention. Also, since the crying and frustration that cause these spells are reinforced by parental overprotection in fear that a spell will reoccur, behavioral modification should be taught to the family by the physician or by a behavioral psychologist. Parents should learn to ignore the crying and reward the child’s good behavior, and not reward the tantrum and breathholding with attention and concern. The spells will probably then decrease in frequency and the child will outgrow them without long-term consequences as the central nervous system matures.
There is a second form of these spells that is misnamed “pallid breathholding spells,” usually occurring after trauma such as a bump on the head. The child suddenly stops what he has been doing, turns pale, and may fall down. Occasionally the child will then arch his back and rarely experience jerking movements. Such spells are not preceded by crying, breathholding, or turning blue. They are caused by “vasovagal syncope,” that is, fainting because of overactivity of the normal reflex that slows the heart rate. If the heart beat slows sufficiently, not enough blood is pumped to the brain and the child loses consciousness and stiffens. These “pallid breathholding spells” are the infancy and childhood counterpart of fainting when blood is drawn. The slowing of the heart rate can often be reproduced in the physician’s office by pressing on the child’s closed eye. If a child has an overactive vagal nerve reflex, the physician will hear a dramatic slowing of the heart rate, at times even a brief pause between heart beats. If an EKG (electrocardiogram) is running at the time, the increasingly longer interval between heart beats can be documented.
Although they are frightening, pallid spells are usually benign and will be outgrown. Only rarely, when the spells are quite frequent, is it necessary to consider treatment, but not with anticonvulsants since these spells are not seizures. The appropriate medications are those that block the action of the vagus nerve and prevent the slowing of the heart.
*24\208\8*

Essentials of treatment
The goals of treatment are (1) to relieve symptoms; (2) to enable the patient to lead a normal life; and (3) to prevent or delay the onset of complications. The following are crucial requirements if these goals are to be met: (1) maintenance of normal weight; (2) regular spacing of meals; (3) normal nutritional requirements with normal proportions of carbohydrate, fat, and protein; (4) usually restriction of cholesterol and modification of the type of fat; (5) use of oral compounds or insulin, if not controlled by diet alone; (6) regulation of physical activity; and (7) attention to body hygiene. For children two additional requirements are maintenance of normal rate of growth and emotional well-being.

Diet prescription
Energy. Weight control is the single most important objective of dietary management. An overweight patient is initially placed on a diet that permits a loss of 3/4 to 1 kg (1 1/2 to 2 lb) each week. From 1000 to 1200 kcal is suitable for obese women and 1200 to 1500 kcal for obese men. The diets described on p. 345 are suitable without further calculations of the diet for protein, fat, and carbohydrate.
Individuals of normal weight are given sufficient calories to maintain weight:
In bed            25 kcal per kg (11 kcal per lb)
Sedentary        30 kcal per kg (14 kcal per lb)
Moderately active    35 kcal per kg (16 kcal per lb)
Protein. About 15 to 20 per cent of total calories are provided by protein. This corresponds to about 1 to 1.5 gm per kg body weight, an allowance that is typical of American diets.
Carbohydrate. Approximately 50 to 55 per cent of calories are furnished by carbohydrate. Severe restriction of carbohydrate is no longer recommended. Diets that provide more liberal intake of carbohydrate do not proportionately increase the hyperglycemia or the need for insulin or oral compounds.
Fat. The remaining calories (30 to 35 per cent) are furnished by fat-Most physicians recommend that saturated fats should be kept at a minimum (about 10 per cent of total calories) and that polyunsaturated fats should be increased to at least 10 per cent of total calories. Cholesterol is preferably restricted to 300 mg daily. These limitations on the kinds and amounts of fat are intended to maintain blood cholesterol levels at a lower level and thus to prevent or delay the onset of cardiovascular complications.
Let us suppose that a diet is being planned for a sedentary individual weighing 60 kg who needs 1800 kcal.
0.20 X 1800 kcal = 360 kcal from protein
360: 4 = 90 gm protein
0.50 X 1800 kcal = 900 kcal from carbohydrate
900 kcal: 4 = 225 gm carbohydrate
0.30 X 1800 kcal = 540 kcal from fat
540:9 = 60 gm fat
*3/234/5*