October
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2013
Destination
India
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India offers quality treatment at affordable rates
“Life expectancy is increasing across the globe. People have not only became health conscious but also ready to spend money for healthcare and wellness. As people grow old, there medical need also enhances. Apart from regular body check-ups, some or other problems related to heart, knees, urological, neurological, dentistry, ophthalmology etc need to address at right time. Especially in Europe and America, numbers of elders are increasing and their medical requirements are also augmenting.
Though, health services in UK, Europe and other developed countries are qualitative, but cost too is very high. In the case of UK, National Health Service (NHS) is considered one of the best in the world. At the same time some people need to wait in the queue. This waiting period can be bypassed, if one is ready to spend little more in developing countries like India, where Medical Tourism is flourishing. By doing so, burden on NHS would also reduce.
For UK based NRIs Medical Tourism would come as natural as that of in UK. They generally travel frequently for some or other reasons to their ancestor’s land. Gujarat origin NRIs would have greater advantage as Gujarat is emerging as Medical Tourism hub of the country. Cities like Ahmedabad, Rajkot, Vadoara, Surat and Anand are not only offering prompt and advanced medical facilities but healthcare services are available at competitive prices.
Right from general diagnostic, body check-ups, wellness treatment that include skincare, knee replacement surgery, bypass surgery and many other medical problems can be addressed clubbing site seeing in Gujarat and other exotic places of India. Large numbers of Gujaratis residing abroad are increasingly spending their holidays for dual purpose – Medical treatment without waiting period and spending quality time with relatives coupled with visit to exotic tourist destinations.
Medical tourism activities have created win-win situations for all the stakeholders. NRI Patients have qualitative treatment at par with Europe and America at affordable rates. They would get prompt treatment, which they may not get in the countries of their residence for some treatments. Health care providers including hospitals, doctors and supporting staff would get highend client. Unlike local patient, the NRI and foreign patient would love to visit places that would stimulate local economy.
The purpose of this special issue on Medical Tourism is to encompass as many aspects of medical treatment as possible in a humble way. At the same time we have tried to ensure that the booklet would not only become promotional material, but it should be helpful for our readers. Our humble efforts are to create a platform where every one gets benefited. Keeping the fact in mind, we have carefully selected content in this booklet.
We also believe that there may be few cowboys in medical professions, but a great majority of the medical service providers are adhering to the highest professional standards and committed to medical ethics. They are intelligent enough functioning uprightly for their long, sustainable and successful professional life and reputation.
Timing of the booklet is important. We know it very well that every year between October and February plethora of NRIs visit their ancestral home. I wish this booklet would come handy for many of them, who are looking for quality healthcare faculties at much cheaper rate than their own countries.
I thank all those who supported our initiative of publishing this booklet. I would also like to acknowledge the work done by our Gujarat bureau team under Bureau Chief Nilesh Parmar.
Dear readers, I am extremely privileged to place this informative booklet in your hands. I not only wish for your long life but also pray for healthy, happy and most active life ahead. Respect your body and enjoy life with passion
Yours sincerely,
CB Patel Publisher/Editor www.abplgroup.com
Gujarat Samachar & Asian Voice | 3
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Message
Government of Gujarat
No.:Finance/H.F.W./Trans/57/652/13 Minister Finance, Health, Medical Education, Family Welfare, Transport, Government of Gujarat, Swarnim Sanku-1, 2nd Floor, Sachivalaya, Gandhinagar-382 010 Date :- 20.09.2013
Nitin Patel
It’s good to hear that ABPL group is publishing two newsweeklies, Gujarat Samachar and Asian Voice since 41 years from London. I am delighted to know that UK based ABPL Group is going to publish Medical Tourism magazine in October2013.
This special issue will provide the necessary information and details to Britain based Indian Diaspora for various health ailments and highlight the real image of today’s developed and modernized Medical Tourism in Gujarat. This special venture will also help to promote the State & National tourist spots, historical monuments & cultural heritage of our country. In this context, the special issue on Medical Tourism by ABPL group bears significance. I welcome this initiative and wish it a great success. With best wishes,
(Nitin Patel)
4 | Gujarat Samachar & Asian Voice
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Gujarat is emerging as Medical Tourism hub of India
Medical tourism is focused as potential growth sector in Gujarat. With world class health facilities, zero waiting time and affordable cost, NRIs are thronging to cities like Ahmedabad, Vadodara, Surat and Rajkot. Ahmedabad is becoming one of the most sought after medical tourism destination in India •
By Mayuri Dave
T
he Indian Medical Tourism industry in India is pegged at US $ 1 billion annually. It is growing at whooping 18 per cent every year and expected to touch US $ 2 billion by the end of 2015. It is a well known fact that hospitals having state-of-the-art facilities are easily getting 20 to 25 per cent more income from overseas patients compared to that of local ones. Conducive atmosphere for Medical Tourism coupled with right kind of manpower, Gujarat is set to get bigger slice of the pie. Gujarat is among the few states in India to have excellent healthcare infrastructure. The state is fast emerging as medical tourism destination in the country. Gujarati Diaspora in various countries are the largest clients and contributing immensely in the development of medical tourism in the state. Apart from NonResident Indians (NRIs), large number of foreign tourists 6 | Gujarat Samachar & Asian Voice
from Africa, Commonwealth of Independent States (CIS) and Gulf countries are coming to Gujarat. People from UK, USA and other developed countries generally come for organ transplant, treatment of orthopedic, cardiac and oncology problems during winter season. Over the past seven years, Ahmedabad has not only emerged as healthcare hub of Gujarat but it is being considered as second most preferred Medical Tourism destination in Western India after Mumbai. In fact, more and more patients are choosing Ahmedabad over Mumbai because of competitive packages being offered by the hospitals and clinics here. With world class health facilities, zero waiting time and affordable cost, Ahmedabad is becoming one of the most sought after medical tourism destinations in India. Apart from the world class amenities, hospitals offer pick up and drop service and ambulance services also. Three years ago, nearly 10 corporate hospitals in Ahmedabad had capacity of 1,300 beds which has www.abplgroup.com
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almost doubled due to addition of another five such world class hospitals. Not only NRIs and foreigners, people from neighboring states like Rajasthan, Madhya Pradesh and even from Maharashtra are also coming in large number for quality treatment at comparatively lower cost. Recently pharma major, Zydus Cadila, started a multi specially hospital. Banglore based Narayan Hrudayalaya Group has also started a state-of-the-art hospital on the eastern side of Ahmedabad. Vasan Eyecare and Indus Hospital of Lincoln Pharma Company have also started their operation in Ahmedabad. Columbia Asia Hospital is
also in the process to start a hospital here. Already 10 corporate hospitals, including Krishna Heart Institute, Apollo Hospital, Sterling, SAL, HCG, Life Care, Sanjivani, Shelby and CIMS are offering Medical Tourism facilities to overseas patients. GujaratÊs biggest pharma group in terms of market capitalization has formed a separate entity Zydus Hospital and Healthcare Research Ltd (ZHHR) to look after healthcare business. Besides Ahmedabad, Zydus group has also started a hospital at Anand in Kheda district. The infrastructure development in healthcare sector of Gujarat is applauded across India. From dominance of small nursing homes 25 years ago to state-of-the-art tertiary care corporate hospitals, today Gujarat has made a rapid progression. It is slowly but steadily transforming into a hot spot for investment in terms of the healthcare sector. Currently, the state's healthcare sector is witnessing an exponential growth, as evidenced by the growing number of hospitals and healthcare institutes, improving emergency medical services with the help of 108 ambulance services, increasing medical tourism, successful public private partnership (PPP) models and better medical education. This progress is a result of a concerted effort by the state government and the private sector such as corporate hospital groups, research organizations, educational institutes, pharmacies, medical device manufacturing companies
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and other healthcare delivery systems which promote alternative medicines. Experts attribute this success to three important components - technology advancement, quality oriented healthcare service and government initiatives taken to increase accessibility. The state has 13 medical colleges, nearly, 1,100 primary healthcare centers, over 7,200 sub centres, 273 community health centres (CHC) and 85 mobile healthcare units. Apart from Ahmedabad other major cities including Baroda, Rajkot, Surat and Bhuj are leading the progress path for the healthcare sector in the state. The State has also effectively controlled communicable diseases like HIV/ AIDS, TB, leprosy and malaria with meticulous implementation of national health programmes. Success in controlling sickle cell anemia has been acknowledged with the prestigious Prime MinisterĂŠs Excellence Award for administration in public health programme. Gujarat is associated with many high-end super-specialty institutes for heart, kidney and cancer treatment. Under its 'Vibrant Gujarat' banner, Gujarat has achieved overall development in health infrastructure within the state, which in turn has facilitated the growth of medical tourism. The state is an ideal location for promoting health tourism in a big way because of its unique position of having Gujarati population settled outside Gujarat and India. Gujarat has service providers with state-of-the-art treatment facilities, robust planning for integrated healthcare and companion care facilities as well as world-class support services and connectivity. According to an estimate medical tourism contributes to total of 25-30 per cent of the total healthcare market in Gujarat. Government of India (GOI) estimates the global population of Non-Resident Indians (NRIs) at around 2010 | Gujarat Samachar & Asian Voice
25 million, out of which there is a section of population who regularly visit India. A major chunk of these NRIs are from the Gujarati community and they are popularly known as Non- Resident Gujaratis (NRGs). During the year 2012, nearly 500,000 tourists visited the state for obtaining medical care. Ahmedabad is becoming one of the most sought after medical tourism destination in India. Apart from the world class amenities for critical surgeries, it has been observed that patients visiting hospitals for critical surgeries often opt for packages offered for cosmetic surgeries which are at very reasonable rates as compared to packages around the globe. The medical tourism industry in Gujarat has also proliferated and boosted the IVF and market. Tier I cites such Ahmedabad, Surat, Rajkot have been attracting a lot of investment in this regard. Gujarat has already gained recognition as a joint replacement hub as many international patients have been undergoing total knee replacement surgeries (TKR) in Gujarat since last one and half decade. Even Government of Gujarat has announced an integrated Medical Tourism policy to encourage healthcare tourism in the state. The policy is intended to create conducive atmosphere for medical tourism in the state. It promotes private players to create international standard medical facilities to attract high end tourists seeking quality healthcare services. The policy also envisages world-class medical facilities with public participation. It will also set up standards of hospital accreditation and entrepreneurs in the field of medical tourism. The government is promoting most sought after super specialties that include Cardiology, NeuroSurgery, Infertility treatment, orthopedics, Eye-surgery, Dental treatment and cosmetic surgery. www.abplgroup.com
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Combination of
Tourism & Skincare •
By Dr Suresh Joshipura & Dr Deep Joshipura
A
ccording to New Oxford dictionary of English, Dermatology is defined as Ă‚The branch of medicine concerned with the diagnosis and treatment of skin disorder.ĂŠ However, this definition has significantly changed in recent years when dermatology is just not confined to skin but has included many sub sets. Today development in the field of cosmetology, skin surgery and hair surgeries. LASERS has opened various new specialties in Dermatology. When we look into the mirror, what do we see? Naturally skin. Skin is the outward appearance of who or what we are, or would like to be. Skin is not merely a simple cover, it constitutes the largest organ of the body. It has a great deal of effects on internal systems and health. Starting from a baby to elderly grandparents, skin shows a great deal of variations. Age, nutrition, environment, chemicals, pollutants, stress, etc all these entities make a significant impact on skin. Today in the cosmetic era, skin care is of paramount importance. Apart from skin, its appendage like hair and nail has also gained unmatched significance. Today, hair care and trichology is one of the developing sectors in aesthetic medicine. Today, dermatology has expanded its wings in all the directions. From skin surgery to liposuction, hair transplant to fillers, dermatologists are the key players in cosmetic space. Anti-ageing treatment, 12 | Gujarat Samachar & Asian Voice
including botox (Botulinum toxin), fillers, non-surgical face lift, LASER skin tightening, microdermabrasion, mesotherapy and many others have started becoming a recognized hallmark. Patients are concerned about their aesthetic appeal and appearances and opt for these anti-ageing modalities. Skin diseases are often linked to external factors. Cold weather or winter is one of them. The major mechanism by which the dermatoses are affected during winter is through loss of lipid barrier in superficial layer of skin (epidermis) and increased transepidermal water loss (TEWL) thereby causing dryness. This dryness or xerosis, what we call in medical terms, predisposes to or aggravates various dermatological diseases. Psoriasis, a very common skin disease gets aggravated in winter. Cold weather
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predisposing to dryness and increased epidermal turnover causes increase in lesion. Apart from that dry skin causes pruritus and increases predisposition to eczema. Rosacea is another skin condition which is aggravated by cold climate. Rosacea is fairly common
14 | Gujarat Samachar & Asian Voice
in Type 1 and 2 skin individuals more commonly in western countries like Europe and America. Continents where a cold climate is often prevailing like Europe, Australia and North America have an increased predisposition to winter related dermatoses. Adequate care is required to prevent them. Proper use of moisturizers is the prime important step. Moisturizers reseal the lipid barrier of stratum corneum and replenish the outer lipid layer of the skin. This prevents the transepidermal water loss, assuring proper hydration of skin, thus preventing dryness. A moisturizer can be either an occlusive, humectant or emollient. Careful use of moisturizer, immediately after bath and subsequently, two or three times a day, prevents dryness. Individuals having skin diseases which aggravates in winter, need to pay special attention and must consult their dermatologist. Medical tourism is a developing and popular option for tourists across the globe. It basically clubs the medical procedures along with tourism and travel. Medical tourism is encouraged a lot in developing countries like India, Malaysia and Thailand. One of the key factors, favoring India in general and Gujarat in particular as a destination of choice for medical tourism include its high standard of medical care, low and affordable costs and variety of tourist attractions across the country. Medical tourism is encouraged in areas like
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cardiovascular thoracic surgeries, dental procedures and cosmetic procedures. Dermatology is a booming branch in Gujarat. The choice and standard of cosmetic and aesthetic surgeries being done here makes it a perfect choice. As far as cosmetic surgeries are concerned, medical tourism is strengthening itself in areas like aesthetic or plastic surgeries, breast enhancements, liposuction,
18 | Gujarat Samachar & Asian Voice
follicular hair transplantation, Botox, fillers and others. This is attributed to the low cost of these procedures. On comparing the basic rates of these cosmetic procedures in Gujarat and abroad, there is a whopping 20-30% decrease in rates in India. This attracts the tourists to get the procedures done here. Moreover, the high standard of care and expertise provided by Indian doctors is an added advantage. In Gujarat, Ahmedabad, Surat, Vadodara and Rajkot have stateof-the-art cosmetic centers.Three levels of service providers exist in India which encourages medical tourism in dermatology. One is government sector, second is private and third is corporate. Interestingly, all the three sectors take the opportunity to encourage medical tourism. In Gujarat, the centers of excellences are of international standards and utilize the best possible and advanced equipment to perform the cosmetic surgeries. For example, most of the leading cosmetic surgeons use the LASER machine which is globally renowned and FDA (US Food and Drug Administration) approved. Medical tourism is an ever increasing area which exposes a tourist to the great heights of expertise and medical care in India. (Dr. Suresh Joshipura is past president of Indian Association of Dermatologists, Venereologists and Leprologists. He is also board member of Asian Dermatological Association)
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•
By Sapana Vyas Patel
B
eing fit is easier than you think, especially if you make small changes in your daily routine. Small changes can make a big difference. You just need to concentrate on boosting your metabolism. ThatÊs it. Metabolism is the process by which food is broken down to release energy. Your metabolic rate reflects how much energy your body requires to carry out its basic functions like breathing, eating, sleep ing, digesting food and more. If your basal metabolic rate (BMR) is high, you burn more calories, even while resting. Your metabolism is determined by multiple factors, including genetics, age, gender, lack of exercise, low muscle mass, irregular eating habits, crash dieting, protein deficiency, thyroid problems and hormone levels. ÂIncreasing the metabolismÊ is the holy grail of fitness. It is a quick, safe, healthy and effective way to stay fit permanently. How to increase your metabolism? 1. Spend at least 45 minutes for exercising daily: Start doing some easy exercises that you can enjoy 20 | Gujarat Samachar & Asian Voice
doing each day like jumping rope, running, brisk walking, dancing, swimming, cycling or aerobics. You can also play sports like tennis, football, squash, volleyball, basket ball or cricket. 2. Lift weights: BMR is much higher in people with more muscle. The more muscle you have, the more calories you burn even when you are at rest. Every pound of muscle uses about 6 calories a day, just to sustain itself, while each pound of fat burns only 2 calories. So start lifting weights and build muscles in order to improve your metabolism. 3 . Eat every 2-3 hours: Each time you eat, you stimulate your metabolism for a short period of time, which means that the more often you eat, the more you will increase your metabolism. Eating small meals every 2 to 3 hours feeds muscle and burns fat. Frequent eating doesnÊt mean eating junk food. Make each mini-meal complete with a serving of vegetables and a healthy source of protein. www.abplgroup.com
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4. Eat more protein: Include healthy sources of protein in your meals such as lentils (Indian dal), whey protein, spinach (palak), chickpeas (channa), kidney beans (rajma), broccoli, cheese, paneer, soybeans, yogurt and milk. It helps you build muscles. 5. Eat metabolism boosters: Eat a tablespoon of chili and pepper in your food to increase your metabolism. Add ginger in food to speed up the bodyÊs digestion process. Have a green tea 3-5 times a day. It can burn up to 80 extra calories without any effort. What is the best time to exercise? You can exercise anytime in a day. The most important thing is to choose a time of day you can stick with, so that exercise becomes a habit. What you should avoid? 1. Crash Dieting: The worst thing you can do to your metabolism is Âstarve yourselfÊ. Although crash diets may help you lose weight, but you will lose muscles mass as well. The lower your muscle mass, the slower your metabolism. 2. Late Night Eating: When you sleep, your metabolism slows down because your body doesnÊt need energy. It turns any unneeded food into fat. 3. Too much cardio: It will actually burn your muscle tissues. A better way to boost metabolism through exercise is to start a strength-training routine along with cardio. MAKE SMART CHOICES WHEN YOU EAT OUT Even after five days of ÂgoodÊ eating, two days of ÂbadÊ eating will make you gain weight. You should learn how to choose healthy food from the restaurant menu. Tips: u Choose appetizers that contain vegetables and fruits. u Ask for whole-wheat options wherever possible. Avoid 'Maida'. u Request oil-free or butter-free options. u Ask them not to add any extra butter, cream, cheese or oil. u Have buttermilk, coconut water or lime water as a beverage, avoid soft drinks. u Order low calorie foods like dosa, idli, upma, curd rice, fruit yogurt or Mexican wraps. u Order veg. sandwich, veg. salads, veg. soups, veg. Frankie, grilled vegetables or veg. sabji. www.abplgroup.com
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EAT ÂMAGICÊ FOODS Increase your body's fat-burning potential, naturally. Make these foods a normal part of your diet regimen, you will see a remarkable difference in your body. They are beneficial to our overall health in multiple ways. 1. Green Tea: Make green tea your drink of choice. Having a green tea 3-5 times a day can burn up to 80 extra calories without any effort. 2. Coconut: Coconut is rich with medium chain triglycerides (MCFAs) which increases the metabolism up to 30 per cent. 3. Garlic: Alicin, a component of garlic, does a great job helping to flush fat from the body. 4. Chili Peppers: They increase your body temperature and speed up your metabolism. 5. Ginger: Ginger is used for centuries to help relieve digestive upset. It improves digestion and helps you lose belly fat. 6. Onions: Flavorful, aromatic and low in calories, onions deserve a regular place in your diet. They control cholesterol, thin the blood, protect against cholesterol. 7. Lemons: Lemons are excellent liver detoxifiers. Maintaining the health of the liver is also imperative to the bodyÊs ability to digest and burn fat. 8. Coffee: The caffeine kicks your metabolism into high gear. Caffeine also jump-starts lipolysis, the breakdown of fat. One to two cups a day is ideal. 9. Brown rice: Brown rice is a smart fat-loss food. It is packed with fiber, starchy carbohydrate and essential nutrients.
serving contains 23 grams of protein with just 120 calories. It is a low-calorie high in protein food. 14. Spinach: Spinach has the ability to lower cholesterol, rev up the metabolism and burn away fat. 15. Isabgol: One to 3 teaspoons of Isabgol with a glass of water before dinner helps in smooth functioning of the digestive system. It relieves constipation, thus making you less bloated. 16. Apples: Apples are a great fat-burning fruit because they are packed with fiber. The pectin in apples keeps cells from absorbing fat and also encourages water absorption, which helps remove fat deposits from the body. 17. Walnuts: The real fat hero in most nuts is monounsaturated fats. Walnuts are actually a rich source of omega-3s. One ounce (7 walnuts) provides almost 3 gm of alpha-linolenic acid. 18. Carrot: A medium-sized carrot carries about 55 calories and is a nutritional powerhouse. 19. Oatmeal: Oatmeal is an easy-to-cook fat burner. It works well as a fat-burning food because it contains insoluble and soluble fiber. Any food that is rich in soluble fiber will typically improve fat reduction. CONTROL FOOD PORTION Calorie counting is often complicated, tedious and inaccurate. So I have come up with an easier way to control calories. No weighing-scales or measuring cups. Just the ability to count in few seconds, using your hands. It is a great personalized food measurement tool because your hand size is relative to your body size. Benefits:
u If you cut down your portions, you can easily save
10. Cabbage: There are only 33 calories in a cup of cooked shredded cabbage, and it retains all its nutritional goodness even after cooking.
500 calories a day and you can expect to lose ½ kg per week. u If you have a fairly good idea of Âhow much you should eatÊ, you can enjoy the meals at restaurants and parties and still control your weight
11. Flax seed: These shiny, nutty-tasting seeds have a secret weight loss weapon compound called lignans. Try grinding and adding a tablespoon of flax seed each day to cereals, yogurt or salad dressing.
u Eat in smaller plates and bowls. u Stay flexible and adjust your food portion
12. Indian Dal (Lentils): Protein helps you build muscles and boost your metabolism. Protein rich foods have a high 'Thermogenic' effect. Hundred grams of lentils contain 26 grams of protein. A bowl of Indian dal is an excellent source of protein.
Tips:
based on your hunger and fullness. Know when your stomach is full and stop eating. u In many cases you have a choice between small, medium, or large sizes. Order small size whenever possible. u Chew 32 times and eat slowly. u Avoid distraction while eating, like watching TV or checking emails.
13. Whey protein: Thirty grams of whey protein 22 | Gujarat Samachar & Asian Voice
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HereÊs an easy-to-understand, simple-to-follow guidelines to help you avoid some common pitfalls. Hand Symbol Visual Aid
Fist
Cupped Hand
Serving Size
Foods
1 Cup
Sabji (Cooked Vegetables) Rice, Dal Soups, Pasta Beverages, Curd, Yogurt
1/2 Cup
Palm 3 Ounces (Thickness and Size)
Thumb
Pudding, ice cream, Almonds, Nuts, Chana, Soyabean, Dry fruits
Many people hunch over when they stand or sit. This creates compression, by stretching certain ligaments too much and others not enough. When you improve your posture and relieve this compression, the internal organs function properly, respiration deepens, the joints are lubricated and blood flows properly. Here is a quick test to check your posture: 1. Stand with the back on your head against the wall. 2. Place heels 2 inches from the wall. 3. Your buttocks and shoulder blades should touch the wall. There should be less than 2 inches between: l Your neck and the wall l Your back and the wall
Low fat paneer, Baked potato
1Tablespoon Salad dressing, Cheese, Chatni, Ketchup, Indian pickle, Cream
Thumb Tip 1 Teaspoon Butter, Margarine, Mayonnaise Oil, Ghee Hand 6 inches (Thickness and Size)
Roti Naan Paratha Bread Idlis
Two Cupped Hands
Vegetables Fruits, Popcorn, Boiled corn, Sprouts
8 Ounces
MAINTAIN GOOD POSTURE WhatÊs the first thing that we do when meeting a new person? We judge! First impressions take only seconds to form, but sometimes they last a lifetime. In this fast-paced world, you probably wonÊt get a second chance. You have to make it happen the first time. Moving your body with poor posture is taxing on your muscles and joints. When you slouch or slump, so does your spine and it lead to bad blood circulation. 24 | Gujarat Samachar & Asian Voice
START WITH 15-DAY TOTAL BODY WORKOUT WouldnÊt it be terrific to shape your body at home? Feel slimmer, stronger and more confident than ever? And do it while saving time? You need a good circuittraining workout! In the next few minutes I am going to share with you what has been called..."The Total Body Fat-Burning Workout" ItÊs so effective that you will see a desirable difference in two weeks! Yes, thatÊs just 15 days from right now. Soun ds Impossible? This is the secret that Celebrities and Models use to keep their bodies in such „photo ready‰ condition with their tied-up schedule. What is Circuit-Training? Circuit training is a form of body conditioning using high-intensity aerobics. It targets strength building and www.abplgroup.com
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muscular endurance. An exercise "circuit" is one completion of all prescribed exercises in the program. When one circuit is complete, one begins the first exercise again for the next circuit.
D. Lunges: 15-20 reps
15-Day Training Program: 1-5 Days - Complete the circuit (A to F) once 6-10 Days - Complete the circuit (A to F) twice 11-15 Days - Complete the circuit (A to F) thrice Exercises: A. Start with spot jogging to warm up: 5 min B. Push ups on the knees: 12-20 reps
E. Quadruped bent-knee hip extensions: 10-15 reps
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