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    Welcome to:
    Centre for Bariatric (Obesity) And Metabolic (Diabetes) Surgery
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    Dr Abhishek Katakwar MBBS, MS, FIAGES, DMAS (Germany), FMBS (Taiwan), FACS (US) Fellow Bariatric & Metabolic surgery (Taiwan) Fellow American College of Surgeons (US) Fellow Robotic surgery (Korea) Best Bariatric ( obesity ) and Metabolic ( Diabetes ) Surgeon
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    Honestly running was never in my genes, I don't remember any stories even of my forefathers about running. I am an amateur runner and my journey of being runner is inspired by many like Mr Rajendra jaiswal from Nagpur, who proudly explain about knee ailments he had to an extent that one of the leading orthopedic surgeon advised knee replacement to him, then he started running at the age of 40’s. Gradual, graded and proper training has made him a full marathon runner. Let me make running more interesting, like any other love story my love for running is two years old which had many breakups. And finally in 2018 beginning i decided to be committed and dedicated when I joined “Couch to 5K” organized by Hyderabad runners club (an non-profit organization with credit of organizing Hyderabad marathon). Truly speaking for last few years I had all possible excuses to join this excellent protocol based training program like professional and lack of time, but this time I made up my mind, reason being reaching 40’s can motivate you a lot. As mentioned love story are usually not easy going, so obviously my running love too had lot of ups and down during my training but consistency and motivation from fellow runners kept me on toes. Are you new to marathon running !!! My Advice 1. First few weeks are going to be difficult (Like any new relationship), when your body tries to deny and resist any change in habit. So listen to your brain and try to convince your body. 2. Obviously there will be few mornings when you don't want to get up because you slept late or yesterday was tiring, It is just a matter of first few minutes after getting out of bed. Also remember first few kilometers would be difficult during beginning but eventually you get accustomed. 3. “Solo running doesn't last more than few days, i have done it several times” at least for me. So go out join some running group and breath fresh air instead of running on treadmill. 4. “Compete with yourself”, as marathons are about running and completing it and not about securing first or second position as every finisher is a winner. 5. “Don’t be paranoid”, first you need to understand your limitations, endurance or fitness level so never compare your performance with any other, instead set goal for yourself about pace and distance. 6. “Breathing is the key” during initial days you may easily get breathless or fatigue. It’s all because of wrong breathing technique. Now the next question would be “how to breath during running” my experience says • Breath from nose (you may even try inhaling from nose and excelling from mouth). • Don't hold your breath while running but have a control on the rate of breathing, because its normal physiological defense mechanism of human body to hold breath during stress conditions. So let be voluntary breathing for initial days until your body adopts to breathing. • Look forward at horizon and keep your arms at side making your chest come forward (that will increase your lung capacity) Happy running, Author (Dr Abhishek katakwar) is an bariatric & metabolic surgeon based at Asian institute of gastroenterology, Hyderabad. abhishekkatakwar@gmail.com +91-8087358725
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    Why you don't lose weight despite best diet and exercise efforts For years you have tried various very low calorie diets and restriction to achieve weight loss, and to no avail.  It seems despite the decrease in intake and several hours in gym, your weight still was not dropping as you would have anticipated. With these severe habits, it's likely that it never really resulted in great weight loss and when it did, you may have found that you gained it back in no time at all. What actually is happening is related to your metabolism regulating hormones.  As you take in less and less, your body's hormones, such as thyroid and leptin, begin to drop in an effort to create homeostasis in the body.  At the same time the muscle tissue begins to break down and be used for energy (which will lead to an even slower, more depressed metabolism).   this slowing of your metabolism can turn into a vicious cycle.   So is it possible to fix this broken metabolism: Let’s start with exercise, taper it to about 3-5 days a week, maximum, with an hour at a time - as a maximum. Really,  30-45 minute workouts are more than enough. Keep in mind that resistance and weight training is the best way to enhance metabolism, while cardio workouts should be considered secondary and can be added in as part of the 3-4 day regimen, but a combination is best.  The next step is to look at your caloric intake, and be prepared to increase this slowly.  It is important to take this slow as to not gain weight back too rapidly, which will discourage you and may lead to another cycle of restricting your intake.  Try to calculate how many calories you are taking in and add about 50-100 calories a week. The goal will be to have added about 500 calories after the course of a few weeks. Author (Dr Abhishek katakwar) is a bariatric & metabolic surgeon based at Asian institute of gastroenterology, Hyderabad. abhishekkatakwar@gmail.com +91-8087358725
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    BMR vs RMR Basal Metabolic Rate (BMR) and Resting Metabolic Rate (RMR) are rates used to estimate the amount of calories a person will burn if he is at rest for 24 hours. Â It is used to determine the minimum amount of energy a person requires to keep his body functioning, his heart beating, his lungs breathing and to keep his body temperature normal. They are conducted the same way but there are very many differences between the two; one is that BMR is measured under more restrictive conditions, while RMR is measured under less restrictive conditions. There are many requirements before a person’s Basal Metabolic Rate can be taken, while taking a person’s Resting Metabolic Rate has no requirements at all. Here are some of the features of the two metabolic rates: *Basal Metabolic Rate* Basal Metabolic Rate is the rate that an organism gives off heat while at complete rest. Â It is measured while the person is awake but at complete rest. Â It is often conducted in a darkened room upon a person’s waking up after at least 8 hours of sleep. To get the correct BMR of a person, it is important that he does not exert any extra energy while doing the test. Â This is why a person who is being subjected to a BMR test is required to stay at the testing facility the night prior to the test. He is made to lie in a reclining position, resting completely. Â He is required to fast for 12 hours before testing to ensure that his digestive system is not working during the procedure. Â During this time the energy released by his body should only be sufficient to let his vital body organs to function. *Resting Metabolic Rate* Also known as Resting Energy Expenditure (REE), Resting Metabolic Rate is measured under less restrictive conditions than Basal Metabolic Rate. Â It does not require the person to spend the night in the testing facility to ensure at least 8 hours of sleep and rest before testing. He is still required to rest in a reclining position while the test is being taken but he does not need to get 8 hours of sleep. Calorie counters and calculators usually use Resting Metabolic Rate rather than Basal Metabolic Rate because the conditions upon which the RMR rates are taken reflect the normal situation in a person’s day to day activities. Â So the results are more realistic. Summary 1. Basal Metabolic Rate is taken under very restrictive conditions, while Resting Metabolic Rate is taken under less restrictive conditions. 2. Before the Basal Metabolic Rate is taken, the person is required to stay at the testing facility, while in taking the Resting Metabolic Rate; the person can stay wherever he wants. 3. Basal Metabolic Rate requires the person to have at least 8 hours of sleep, while Resting Metabolic Rate does not. 4. Twelve hours of fasting is required before the Basal Metabolic Rate can be taken, while no fasting is required before taking the Resting Metabolic Rate.
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