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Iqra Mazhar

Understand the connection between back pain and sleep problems with Meri Sehat. Explore solutions for improved spinal health and sleep.

Back Pain And Sleep Problems - What’s The Connection?

Madeeha Syed

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Is Acupuncture the Right Choice For You?

Overview

Acupuncture is an ancient, traditional Chinese practice. Chinese people would use this method to relieve pain and other unpleasant symptoms.

An acupuncturist inserts tiny needles on specific points on your body. These points are called &ldquo;acupoints&rdquo; where the flow of energy is redistributed and helps in healing. Acupoints help in releasing the chemicals to fight off the symptoms of illness.&nbsp;

According to research, this method has proven to be an effective way of relieving symptoms. 
&nbsp;

Acupuncture Treatment

The idea of having not one but numerous needles in your body sounds scary. But, if truth be told, most people don&rsquo;t feel a thing! Some only experience a minor discomfort while the needle is inserted. This is because the needles used in acupuncture are as thin as human hair and a pressure or aching sensation is felt only after the needle has been correctly placed.&nbsp;

During the procedure, needles could either be exposed to a gentle electric current or they could be heated.&nbsp;

Reportedly, people feel calmer and more relaxed, even energetic, after a session. 
&nbsp;

The energy that runs through the body is referred to as Qi in Chinese medicine. Practitioners of Chinese medicine hold that interruptions of Qi result in energy imbalances in the body, which causes disease.

Some acupuncture techniques use needles to prick acupuncture points (also referred to as acupoints) on various body parts in an effort to restore Qi equilibrium. The body has hundreds of acupoints located along 14 major meridians, also known as energy pathways. 
&nbsp;

The body&rsquo;s natural mechanisms are stimulated by the needles to:

<ul>
	<li>Respond to a disease or symptom</li>
	<li>Reset the body&#39;s balance</li>
	<li>Release organic substances, including the body&#39;s <a href="https://merisehat.pk/article/the-right-approach-to-painkillers">natural painkillers</a> endorphins and neurotransmitters, which regulate nerve impulses 
	&nbsp;</li>
</ul>

Acupuncture can relieve a variety of health issues, but majority of the people use it to treat long lasting pain, including:&nbsp;

<ul>
	<li>Back pain&nbsp;</li>
	<li>Muscle pain</li>
	<li>Neck pain</li>
	<li>Joint pain</li>
	<li>Migraines</li>
	<li>Menstrual pain</li>
	<li>Sports Injury 
	&nbsp;</li>
</ul>

Acupuncture is also used to treat conditions like:

<ul>
	<li>Nerve pain</li>
	<li>Side effects of cancer treatment</li>
	<li>IBS (irritable bowel syndrome)</li>
	<li>Pregnancy issues</li>
	<li>Hot flashes and menopause symptoms 
	&nbsp;</li>
</ul>

Acupuncture may have side effects in some people, just like any other form of medical care. They are:

<ul>
	<li>Pain and bleeding at the insertion site</li>
	<li>Nausea</li>
	<li>Infections</li>
	<li>Allergic response&nbsp;</li>
	<li>Skin rash</li>
	<li>An area of bruising around the needle puncture site&nbsp;</li>
	<li>Dizziness 
	&nbsp;</li>
</ul>

Serious side effects include:

<ul>
	<li>Blood vessel and nerve damage&nbsp;</li>
	<li>Issues from the needle breaking during therapy&nbsp;</li>
	<li>Organ injuries</li>
	<li>Brain and spinal cord injuries 
	&nbsp;</li>
</ul>

Rarely, acupuncture complications could prove fatal.&nbsp;

Remember, you should always consult a doctor before getting acupuncture. Also, make sure that a skilled healthcare professional is performing the procedure using sterile, disposable needles to decrease the chances of negative effects. 
&nbsp;

Bottom Line

Although acupuncture&rsquo;s exact mechanism of action is unknown, research suggests that it might alter the autonomic nervous system and release endorphins. It could be helpful in treating various health concerns, including mental health illnesses, pain, inflammatory diseases, stress, and skin appearance. But you need to exercise caution because for some people, acupuncture could result in minor or major side effects.

If you have difficulty in managing pain and other health conditions, you could consider getting an acupuncture done. It&rsquo;s always a good idea to check with your healthcare provider to find out what&rsquo;s the right choice for you!

Namwer Rao

Are You Sleeping On Your Sleep Cycle?

The circadian rhythm is the internal biological clock that regulates the sleeping-and-waking time of every person. This rhythm is controlled based on the sleep-wake cycle, which is also called the light-dark cycle, and it&rsquo;s present in almost all life forms.&nbsp;

Additionally, the circadian rhythm is related to many physiological processes like mood, metabolism, body temperature, hormone secretion and more. Therefore, having a good sleep and waking up at the right time has many health benefits for all people.

The circadian rhythm refers to the physical and mental changes that occur within an organism throughout an approximately 24-hour cycle. This cycle is controlled by signals sent from various parts of the brain to control functions like body temperature, hormone secretion and more. 
&nbsp;

Circadian Rhythm

When you don&rsquo;t sleep enough or at appropriate times during the day (for example: staying up late on weekdays), this can throw off your circadian rhythm&nbsp; and affect your energy levels during waking hours too!

You may be asking yourself, why is sleeping on time so important? Well, there are many reasons for this. First of all, sleeping has a lot of benefits for the body and mind.

<ul>
	<li>Sleep As A&nbsp;Time For The Body To Rejuvenate: When you sleep your brain stops sending signals to your muscles and organs telling them what to do. This allows them to rest and recover from the day&rsquo;s activities. 
	&nbsp;</li>
	<li>Sleep As A&nbsp;Time For The Mind To Relax: While you&rsquo;re asleep, you don&rsquo;t think about anything or anyone else but yourself and your own needs. This can help reduce stress levels when done consistently with other relaxation methods (such as meditation). 
	&nbsp;</li>
	<li>Importance Of Sleep In Children: Children need at least 10 hours of sleep each night because they still have developing brains which require proper rest in order to grow properly into young adults who will eventually be able to function independently without assistance from parents or guardians. 
	&nbsp;</li>
</ul>

The first sleep is probably the most important part of the entire sleep cycle because it helps people fall asleep faster and have a longer rest throughout the night.&nbsp;

If a person doesn&rsquo;t get enough sleep during the first part of the night, that can have consequences during daytime as well. Some people may be more prone to falling asleep faster with two separate sleeps instead of one long one. This phenomenon is called &ldquo;first sleep&rdquo; or &ldquo;second wind&rdquo; and it occurs in humans as well as other organisms including fruit flies, rats and mice. 
&nbsp;

Lack of sleep can lead to a variety of health problems. The following are some common ailments that have been linked to a lack of sleep:

<ul>
	<li>Headaches</li>
	<li><a href="https://merisehat.pk/disease/depression">Depression</a> and <a href="https://merisehat.pk/disease/anxiety">anxiety</a></li>
	<li>Weight gain and obesity (insulin resistance)</li>
	<li>Memory loss and cognitive impairment</li>
	<li><a href="https://merisehat.pk/disease/diabetes-type-1-and-2">Diabetes type II (pre-diabetes</a>)</li>
	<li>Heart disease 
	&nbsp;</li>
</ul>

The Circadian Rhythm is an internal clock that tells your body when to sleep and when to wake up. Disrupting this clock may not seem to cause a lot of damage right now but overtime, the damage accumulates and starts showing up when it is too late.&nbsp;

The concept of beauty sleep is somewhat related to maintaining a good circadian rhythm. While you are sleep, your body takes this time to undo the daily damage done to your cells. In this case, the blood flow supplies the key nutrient to your exhausted cells. The same is the case with your other organs, they take the time to reset and repair.&nbsp; 
&nbsp;

Our body gets used to when we sleep so much that we immediately start feeling tired regardless of our hectic or slow day. Ignoring this signal causes your brain and body to work overtime during their off hours. Think of your own productivity levels when you have to work overtime in your office, you are just pushing yourself without energy to somehow get the work done and go back home as early as possible. Our bodies are no less than a machine that needs their time off in a timely manner.&nbsp;

Circadian rhythm is an important part of our life as it regulates our sleeping and waking time. If you want better health and well-being, make sure you have enough sleep at night and wake up on time in the morning. This will help your body recover from stress caused by work or school during daytime so that you can function better throughout the day.

Umna Salah

Can't Go To Sleep? Here’s Why And How To Fix It

You&rsquo;re lying in bed, trying to fall asleep. You&rsquo;ve tried everything: reading a book, taking a bath, meditating, nothing seems to work. If this sounds like you, don&rsquo;t worry, I&rsquo;m here to help. In this article, we&rsquo;ll explore some of the most common reasons why people can&rsquo;t fall asleep and what you can do about them. 
&nbsp;

trick your body into sleeping

It&rsquo;s hard to shut down the mind, but if you can allow yourself to be free of all thoughts, worries and overthinking, it&rsquo;s easier to get a good night&rsquo;s sleep. This is why meditation has become so popular as a way to relax and clear your mind.

If you are having trouble going to sleep at night because you have too much on your mind, try focusing on relaxing exercises, such as taking deep breaths for 10 minutes or listening to calming music before bedtime.

If you feel like there is simply too much for your mind to process before bedtime, try not to think about anything at all until after midnight (or whenever you plan on falling asleep). That means no worrying about things that happened earlier in the day or what needs doing tomorrow morning&mdash;just let everything go until it&#39;s time for bed!

&nbsp;

Your environment can also influence the quality of your sleep. If you are sharing a bed with a partner who snores, or have pets that are noisy at night, this can affect your ability to get into REM and deep sleep stages of sleep. If you suffer from these problems, try to keep your pets out during night time.

&nbsp;

If you nap during the day, this can make it harder to fall asleep at night. This is because napping reduces your total sleep time and delays your internal circadian rhythm. In other words, it makes for a long period of time with reduced sleep quality and quantity, which makes falling asleep at night even more difficult.

Napping during the day also makes you feel groggy when it&rsquo;s time to go to bed. It&rsquo;s like drinking coffee in the morning. Once the caffeine has worn off, you may find yourself struggling to stay awake until lunchtime, instead of the usual 3pm!

If you want an afternoon nap but don&rsquo;t want these side effects on your nighttime slumber, consider power naps (naps lasting between 15 minutes and 1 hour), instead of full-on snoozing sessions (which can last longer than 90 minutes). Naps are great if they help improve alertness or performance, however, they shouldn&#39;t be used as a substitute for nighttime sleep if that&rsquo;s what you need most!

&nbsp;

You may have heard that it&#39;s important to go to bed at the same time every night and wake up at the same time every morning. This is true, but even more important is your schedule on weekends and weekdays. If you get enough sleep every night, then it doesn&rsquo;t matter if you sleep in on Saturdays or stay up late on Sundays, your body will adjust to these changes when they happen.&nbsp;

However, if you&rsquo;re not getting enough sleep overall, especially if it&rsquo;s because of inconsistent nighttime habits, then your body might have trouble adjusting to irregular schedules.

&nbsp;

Imagine this scenario: you go to bed at 10pm as usual, but you&rsquo;re not tired. You try and get comfortable, but you can&rsquo;t stop thinking about all of the things that happened during the day &mdash; the conversations you had with colleagues, how much work is left to do tomorrow, or what your friends are doing right now. You start worrying about them and then feel guilty because they don&rsquo;t have time for a phone call when they could be sleeping.&nbsp;

Then another thought pops into your head: did I switch off my iron? Should I check? Now we all know that checking whether an appliance is turned off isn&rsquo;t going to help us sleep any better than worrying if our friends are safe (unless there&rsquo;s a fire nearby somewhere), but this process repeats itself over and over again until suddenly, it&rsquo;s 2am, and there&rsquo;s no hope for rest tonight either!

So how can we avoid these situations? The key is finding something else, anything else, to occupy our minds instead of keeping track of every single little thing that crosses our minds throughout the day.

&nbsp;

Pillow size is another important consideration. Your pillow should be firm enough to support your head and neck, but soft enough to mold around your head and neck as you sleep. A proper pillow will also allow you to keep your spine in alignment while sleeping on either side or on your back, which helps with good posture.

If you have been using the same old pillows for years, it may be time for an upgrade. If a new pillow doesn&rsquo;t work right away, try adjusting its height (keep adding or removing stuffing) until you find one that works for you 
&nbsp;

Don&rsquo;t forget about the other side of the bed - do not share a bed with someone if that person snores heavily. Snoring can really affect quality of life. If a partner snores loudly enough at night that it keeps other people awake or keeps them from getting enough sleep themselves, then this could lead to fights between couples over who gets up earlier so they don&rsquo;t disturb their spouse&#39;s slumber. This problem can be resolved by setting up separate bedrooms for each person or getting rid of noisy beds altogether by buying two twin mattresses instead!

&nbsp;

If you can&rsquo;t get to sleep, it could be for any number of reasons. There are a lot of things that can keep you from drifting off into blissful slumber.

<ul>
	<li>You have too much going on. If there&rsquo;s something weighing on your mind, or if you&rsquo;re in an environment that&rsquo;s too stimulating (like a loud restaurant or party), try taking a moment to reflect on everything that&rsquo;s stressing you out and how it might affect your sleep quality. Try jotting down some notes and setting aside time tomorrow to talk over those issues with someone else so they&rsquo;re not still bothering you when it&rsquo;s bedtime.</li>
	<li>You napped during the day or had too much caffeine/food/alcohol before bedtime. When we nap during the day, we tend to wake up feeling more alert than usual, and while this can be helpful if we have somewhere important to go after work and need the extra boost, it can also hinder our ability to fall asleep at night when all we want is rest.</li>
	<li>Your sleep schedule is off-kilter or irregularly shifted throughout the week due to travel changes etcetera. This will make it harder for us humans whose bodies are programmed over thousands of years by evolution just like all animals&rsquo; bodies, except ours has evolved way faster so now sometimes ours needs work done on them sometimes too. Thus, needing proper rest does matter, so here are some tips. 
	&nbsp;</li>
</ul>

If you are listening to music, watching TV, or playing video games, shut it off! Your brain may be losing focus and this makes it hard for you to sleep.

If you can&rsquo;t sleep, get up and do something else before going back to bed. The more time spent lying awake in bed the more difficult it becomes to fall asleep again.

&nbsp;

On a personal note, I have always <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle" target="_blank">struggled with sleeping</a>. When I was younger, I had to have my mom read me bedtime stories to help me fall asleep and would still be up way past midnight reading under my covers. These days, it&rsquo;s not as bad but there are still nights where my mind won&rsquo;t shut off and I find myself lying awake for hours. Sometimes it&rsquo;s because of something that happened earlier in the day or week; other times it&#39;s just a matter of getting enough rest.

As you can imagine, this can be frustrating when you want nothing more than to turn off your brain and go to sleep! But there are ways you can get better at falling asleep faster, and even staying asleep all night long if you want.

&nbsp;

If you have tried all of these tricks and still can&rsquo;t sleep, there&rsquo;s nothing left to do but wait it out! Just remember, sometimes things happen in life that are out of our control. If you are lying there tossing and turning, just try to breathe deeply and stay calm. It may take some time for us humans to get back into a <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">regular sleeping cycle</a> again, so don&rsquo;t be discouraged if you&rsquo;re stuck in bed all day without any hope of going anywhere else anytime soon!

The Right Approach To Painkillers

Pain is a complex physical sensation that has both biological and psychological components. Painkillers help manage pain by reducing its intensity or duration. The way in which painkillers work may vary from person to person, but they&#39;re typically used as short-term treatments. 
&nbsp;

Approach to Painkillers

Painkillers are drugs that relieve pain. They can be taken as a pill or injected directly into the body, and they&rsquo;re usually <a href="https://merisehat.pk/doctor-now">prescribed by a doctor</a>.

Painkillers are not addictive when used in moderation, but they should be used carefully because they can cause serious side effects (like nausea or constipation) if misused. Painkillers don&rsquo;t actually cure the underlying cause of your pain; instead, they temporarily mask it until your body heals itself naturally.

Painkillers are dangerous when taken incorrectly: either too little to relieve pain or too much to become an overdose risk. 
&nbsp;

<h5>Acetaminophen</h5>

Acetaminophen (also known as paracetamol) is an over the counter (OTC) pain reliever that&rsquo;s generally considered safe to use when taken at recommended doses. This drug is often used in conjunction with other medications, including opioid painkillers like codeine or morphine. According to the National Institutes of Health (NIH), acetaminophen can be used safely in children older than two months of age, but it isn&rsquo;t recommended for use by children under the age of 12 months due to increased risk of potentially serious liver damage.

Acetaminophen overdose has become increasingly common in recent years; according to the NIH, nearly 200 Americans die every year from unintentional overdoses on this drug alone. However, a large number of these fatalities involve alcohol consumption; if you have consumed alcohol before taking acetaminophen &mdash; even just one drink &mdash; do not exceed more than four grams per day (4000 mg). This limit includes both over the counter and prescription products containing this ingredient. 
&nbsp;

<h5>Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)</h5>

NSAIDs are used to treat pain and inflammation. They&rsquo;re often used to ease the discomfort of arthritis or other inflammatory conditions but can also be taken for headaches and other types of muscle pain. They are available over the counter and don&#39;t require a prescription.

NSAIDs are non-narcotic, which means they won&rsquo;t make you feel like you&rsquo;re &ldquo;high.&rdquo; However, this doesn&rsquo;t mean they don&rsquo;t have side effects; they do have some risks associated with them, such as stomach ulcers or gastrointestinal bleeding if taken on an empty stomach (which is why it&rsquo;s important to wait at least two hours after eating before taking NSAIDs). These risks can be alleviated somewhat by taking them with food, although this only reduces the severity of these risks &mdash; it doesn&rsquo;t eliminate them altogether. 
&nbsp;

<h5>Opioids</h5>

Opioids are a class of drugs that relieve pain. They include heroin, fentanyl, morphine and codeine. Opioids can be addictive and dangerous; they are not recommended for long-term pain relief because they are associated with addiction and overdose deaths. However, opioids (particularly tramadol) may be used to treat chronic pain when other medications have failed or caused too many side effects for the patient to tolerate them.

Opioids are not the same as heroin or other illegal street drugs &mdash; but they do share some of the same effects on users&rsquo; bodies and minds as heroin does: They slow breathing down until it stops completely (which can lead to death) and cause intense euphoria while they&rsquo;re being taken that makes users want more each time, they use them. 
&nbsp;

Acetaminophen is a painkiller, but it&rsquo;s not an NSAID. Acetaminophen is not an opioid, nor does it have the potential for abuse or addiction like opioids do. In fact, you can buy it at almost any grocery store in your area without a prescription from a doctor!

But because acetaminophen is a non-controlled substance (a Schedule 1 drug), you may end up taking too much of it if you don&rsquo;t know how to use it properly. This can cause damage to your liver and kidneys over time. Aspirin also has many side effects when taken incorrectly &mdash; it can lead to ulcers or stomach bleeding if taken along with other medications that thin the blood (like warfarin). 
&nbsp;

For those suffering from pain, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is common. You might have taken NSAIDs for a headache or back pain, or to calm inflammation after exercising. These include ibuprofen and naproxen, which are most commonly used for headaches and menstrual cramps respectively. Aspirin is an NSAID as well, but its use in children has been linked to an increased risk of Reye syndrome &mdash; a rare condition where damage occurs to the liver and brain. 
&nbsp;

Painkillers can also be used as an immediate solution when dealing with more acute injuries or illnesses. For example: if you&rsquo;re sick from the flu and start vomiting every five minutes because your stomach hurts so much from dehydration &mdash; then getting some medicine into your system will help relieve those symptoms immediately. 
&nbsp;

Painkillers are a good way to treat the causes of pain, but they can have dangerous side effects. If you take too many painkillers on a regular basis, they can cause liver damage, stomach ulcers and constipation. These drugs also make it harder for your body to absorb vitamins A and K1 and 2 (which are important for healthy skin).

If you&rsquo;re taking prescription painkillers because of an injury or surgery, then it&rsquo;s important to keep taking them as directed by your doctor. However, if you&rsquo;re experiencing chronic pain that isn&rsquo;t caused by an injury or surgery (for example: arthritis), then there are safer ways than using over-the-counter or prescription drugs like ibuprofen or acetaminophen.

If someone tells me that their back hurts so bad when I ask about their symptoms; I would recommend seeing a physiotherapist instead of popping pills every day in order avoid further complications down the road. 
&nbsp;

Every medicine comes with its own set of side effects and while they are a convenient way of fixing the problem, painkillers are not your permanent solution. While the administration of OTC painkillers sometimes is fine, making a habit out of it can cause many long-term issues. The best way to deal with any sort of painful condition is to go to your physician and get it checked. Always target the root cause of the problem and practice safe medication. 
&nbsp;

Painkillers are a necessary part of our lives. They can help ease the pain of an injury, get rid of a headache or menstrual cramps, and even make it possible to sleep at night. But all drugs have side effects, and painkillers are no exception. So, when it comes time for you to take them, be sure you know exactly what kind of medication you&rsquo;re taking &mdash; not just so that you can avoid negative reactions with other medications or medical conditions but also because some types might be more effective than others depending on what kind of pain they&rsquo;re treating! Always consult your healthcare practitioner before subjecting your body to any medicine.&nbsp;

Medilink Consultant clinic

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

This article or video has been viewed by many visitors, and is popular.

What’s Triggering My Migraine?

Introduction

A migraine refers to a severe headache in a focused region of the cerebrum that is frequently accompanied by queasiness, spells of vomiting, and an incontinent aversion to light. It can last hours to days. Not all <a href="https://www.merisehat.pk/disease/migraines-73">migraines</a> are linked to a trigger. 
&nbsp;

If you are one of those people who are affected by what they eat, then one of the most reliable methods to not aggravate the already painful headache is to identify your triggers and avoid these as much as you can. For some individuals, that implies avoiding specific food sources.

&nbsp;

Scientists and doctors alike have been unable to trace the specific reason for migraines. Specialists concur that short, immediate, and abrupt changes in your cerebrum movement and activity are likely to blame. These also have an unpleasant influence on your veins and nerve signals. The outcome: a pounding headache that can persist for an unpredictable period, ranging from a few hours to days. 
&nbsp;

Numerous things can cause migraines, like the medication you take, an unprecedented imbalance of hormones, and an absence of rest. Your eating regimen can also have an impact. In around 10% of individuals with migraines, food is a major trigger.

&nbsp;

Understanding migraine, its common triggers and treatment

As indicated by the Migraine Research Foundation, food sources may trigger migraines. However, any trigger overall is profoundly individualized, making conclusive findings more obscure and difficult to reach. To date, there has not been any such thing as a widespread migraine trigger. Yet, there are a few normal triggers that can cause or add to migraine episodes in certain individuals.

&nbsp;

<h5>1. Caffeine</h5>

We realize that some of you are most likely disappointed when you see caffeine leading this list, yet research demonstrates that unnecessary caffeine consumption can set off headache assaults. Moreover, recent studies propose reducing those daily espresso shots to decrease migraine recurrence<a href="#accordion">[1]</a>. 
&nbsp;

If you heavily rely on caffeine for that morning boost and cannot imagine beginning your day without an espresso, certain studies suggest that a moderate dosage may help hinder migraines<a href="#accordion">[2]</a>. Therefore, it is important to note that excessively devouring coffee will not do you much good.&nbsp; We realize that the caffeine boost can feel like a lifeline at times, so we will not ask for a total ban. However, try to restrict yourself to under two cups each day<a href="#accordion">[3]</a>. 
&nbsp;

<h5>2. Chocolate</h5>

This list may contain some of your favorite foods and snacks, which is why it should not come as a shock that chocolate ranks so high within our list of food triggers. According to recent research, 22% of migraine patients held chocolate as the responsible culprit for worsening symptoms<a href="#accordion">[2]</a>. Another study claimed that 42% of their subjects blamed chocolate for triggering their migraine attacks<a href="#accordion">[4]</a>. 
&nbsp;

This is understandable as chocolate contains beta-phenylethylamine, a compound that is also found in caffeine and has been associated with triggering headaches in non-migraine patients. And to perfectly mirror the dialogue of a typical brown mom, there are fruits that you could consume in place of chocolates.&nbsp; 
&nbsp;

<h5>3. Additives&nbsp;</h5>

It is perhaps a no-brainer that any chemical enhancements or excessively processed items will have negative impacts on your health. Some of the most common additives you should avoid in the supermarket are: 
&nbsp;

<ul>
	<li>Monosodium Glutamate (MSG): MSG is a popular flavour enhancement found in canned and frozen foods, such as soups, snacks, seasonings, etc. It is the primary heading within the ingredients label in soy sauce and meat tenderizers. The chemical is occasionally labelled on preserved food sources as a natural preservative or a hydrolyzed protein. Reports demonstrate it can set off a migraine within 20 minutes of consumption. An estimated 10-15% of people suffering from migraines are affected by MSG<a href="#accordion">[5]</a>. 
	&nbsp;</li>
	<li>Nitrates And Nitrites: These synthetic substances are present in many restored and handled meats, like sausages. They release a compound called nitric oxide which, when gets into your system, expands your veins, and then triggers the nervous system to cause a migraine 
	&nbsp;</li>
	<li>Aspartame: Research suggests that artificial sweeteners play a crucial part in triggering migraines. These sugar alternatives are found in processed soft drinks, desserts, and many more. 
	&nbsp;</li>
</ul>

While studies have found a correlation between such processed foods and preservatives, there is not much difference in the pool of subjects and the placebo when introduced to these additives. But just to be safe, stick to natural alternates. 
&nbsp;

<h5>4. Aged Cheese</h5>

Cheese naturally contains a substance known as tyramine. It is formed once the cheese starts ageing and breaking down proteins. The age of cheese and concentration of tyramine are proportionally related. The more time it takes for the cheese to age, the greater the concentration of tyramine within the aged cheese. Since tyramine is linked to triggering headaches, people with migraines should look out for tyramine levels in cheese. Common types of cheeses with a high tyramine content include feta, parmesan, brie, gorgonzola, and blue cheese. Moreover, it&#39;s better to avoid cheeseburgers and pizzas when experiencing migraine symptoms. 
&nbsp;

<h5>5. Nuts And Seeds</h5>

Did you just find a recipe for peanut butter noodles? Are you fond of spreading almond butter over toast? Or do you like having nut butter straight from the jar? Well, unfortunately, these eating habits are likely contributing to the pounding sensation in your head. New information suggests that certain nuts are rich sources of tyramine, the same substance found in aged cheese. Avoid binge eating or snacking on nuts and seeds such as peanuts and pumpkin seeds<a href="#accordion">[7]</a>. 
&nbsp;

There may be a possibility that your food trigger has not been listed, or you may have more than just one. It is a frustrating and laborious task to find your food trigger. For sorting out your pain and migraine triggers, follow the basic idea of tracking and noting the food and beverages you devour in a day-to-day food migraine journal. Strictly monitor the progress and maintain entries in the journal. 
&nbsp;

You may assume a food to be delicate if you respond to it differently. If a specific food or beverage initiates a migraine consistently, 20 minutes to 2 hours after consumption, that should be marked as a trigger. 
&nbsp;

In any case, remember that even though it sounds easy to follow, figuring out potential food triggers may be exhausting and painful. As anything you consume would possess a risk of setting off your migraine. Although you will be in contact with and consume certain food triggers, you should not dismiss other factors that could be contributing to your perpetual headache. To analyze these risk factors, ask yourself the following questions: 
&nbsp;

<ul>
	<li>Are you sleep-deprived?</li>
	<li>Have you skipped a meal?</li>
	<li>When was your last menstrual cycle?</li>
	<li>Have you been hydrating yourself sufficiently?</li>
	<li>Has the weather changed since the start of your headache? Did it become sunnier?</li>
	<li>Is there a family history of headaches?&nbsp;</li>
</ul>

&nbsp;

Conclusion

While a search is still ongoing to assess the link between food triggers and migraines, it is safe to assume that no harm would come from avoiding certain foods. But it is also important to consider different aspects which may be hindering ease and causing more discomfort. Consult a doctor to find methods that work for you in a convenient and effective environment.&nbsp;

Key Points

The article was written for informational purposes rather than providing options for treatment. To summarize:<ul><li>The cause of migraines has yet not been found, but certain food triggers have been linked to aggravating them.</li><li>Foods and beverages such as caffeine, cheese, nuts, processed meats, preservatives, and citrus foods should be avoided.</li><li>Other factors also influence migraines, such as family history, menstrual cycle, sun exposure, and dehydration.</li></ul>

[1].University of Cincinnati Academic Health Center. (2022, June 21). Diet can impact migraines.

[2].Shapiro, R. E., & Cowan, R. (2017, January 10). Caffeine and Migraines. Retrieved from American Migraine Foundation:

[3].Mostofsky, E., Mittleman, M. A., Buettner, C., Li, W., & Bertisch, S. M. (2019). Prospective Cohort Study of Caffeinated Beverage Intake as a Potential Trigger of Headaches among Migraineurs. The American Journal of Medicine, Retrieved from Science Daily

[4].Gibb, C., Davies, P., Glover, V., Steiner, T., Rose, F. C., & Sandler, M. (1991). Chocolate is a Migraine-Provoking Agent. Cephalalgia, 11(2), 93–95.

[5].Diamond, M. L., & Marcus, D. A. (2016, August 13). Diet and Headache Control. Retrieved from American Migraine Foundation:

[6].Gruber, H. J., Bernecker, C., Lechner, A., Weiss, S., Wallner-Blazek, M., Meinitzer, A., . . . Truschnig-Wilders, M. (2010). Increased nitric oxide stress is associated with migraine. Cephalalgia, 30(4), 486-92.

[7].Bauer, J. (2022). Nuts and Seeds: How Food Affects Health. Retrieved from Joy Bauer:

Zarlish Kazmi

A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

A Guide to Essential Vitamins and Micronutrients and Should you be Taking Them?

Types

The booming health and fitness industry, diets (fad or otherwise), and holistic living practices have introduced plenty of terms in our daily life that may sound like gibberish to the common man. What is nutrition? What is a nutrient?&nbsp; Nutrition is anything you put in your body allowing it to repurpose it for survival, development and help it function normally. This is delivered via nutrients which are of two kinds:&nbsp;<span style="font-size: 12pt; font-family: &quot;Times New Roman&quot;; color: rgb(0, 0, 0); background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;">

Macronutrients

<h5 style="line-height:1.295;margin-top:0pt;margin-bottom:0pt;">Macronutrients:</h5>Proteins, fats and carbohydrates. As can be understood by the name, they are needed in bulk and are necessary for the growth and functions of a human body.

Micronutrients

<h5>Micronutrients:</h5>

Vitamins and minerals. Only needed in trace quantities, these play a crucial role in many essential bodily functions.

&nbsp;

Micronutrients and what they do

Vitamins

<h5 style="margin-top: 0pt; margin-bottom: 0pt; line-height: 1.295;">Vitamins:</h5>Vitamins are organic compounds our bodies can’t produce on their own. Your body needs 13 of these in total. These can be either fat soluble (A, D, E and K) or water soluble (All eight types of vitamin B and C). Let’s quickly dive into what these vitamins do for us:

Vitamin A

<h5 style="line-height:1.295;margin-top:0pt;margin-bottom:0pt;">Vitamin A:</h5>Widely known for its major role in fortifying our vision, this is also necessary for immune function, bone health, fetal development and fighting certain cancers. Found in fish meat liver, eggs, milk, vegetables such as squash, carrots and spinach. Vitamin A rarely runs out since most foods contain this compound, but if it does ever happen such as in low-income countries like Nigeria, it will lead to night blindness.

Vitamin D

&nbsp;

<h5><a href="https://merisehat.pk/disease/vitamin-d">Vitamin D</a>:&nbsp;</h5>

This &lsquo;sunshine vitamin&rsquo; is absorbed through the skin. It&rsquo;s necessary for bone strength and deficiency at any stage of life can have detrimental effects. Rickets in the young and osteomalacia in the elderly, both of which lead to a loss of structural integrity of bones. Salmon, butter and milk are great resources to get this from and so is regular exposure to sunlight.&nbsp;

&nbsp;

Vitamin E

<h5 style="line-height:1.295;margin-top:0pt;margin-bottom:0pt;">Vitamin E:</h5>An antioxidant that functions mainly to protect other vitamins and certain molecules from being damaged. It has been known to help in Alzheimer’s disease. You can get this from vegetable oils, leafy greens, whole grains and nuts.&nbsp;

Vitamin K

<h5 style="line-height:1.295;margin-top:0pt;margin-bottom:0pt;">Vitamin K:</h5>This plays a major role in blood clotting. Cabbage, liver, broccoli and kale are rich in this, and bleeding occurs if there’s a deficiency.

Vitamin Bs

<h5 style="line-height:1.295;margin-top:0pt;margin-bottom:0pt;">Vitamin B1, B2, B3, B5, B6, B7, B9, B12:</h5>Essential for energy, red blood cell production, healthy skin, nervous system function and hormone production. These can be obtained from salmon, soy products, whole grains, leafy greens, poultry, mushrooms, potatoes, peanut butter, broccoli avocadoes, tomatoes, fish chicken eggs legumes bananas. A lack of B6 and B12 can lead to anemia whereas if you’re low on B1 and B3 you might experience mental confusion.

Vitamin C

<h5>Vitamin C:</h5>We all remember how this one found its popularity at the beginning of the Covid19 pandemic. This was owing to the fact that it fights infections. Apart from this, it helps grow and repair tissues, protects against certain cancers and cataracts and has antioxidant properties. Get it from peppers, broccoli, guavas, papaya, kiwi, oranges and strawberries. Deficiency may lead to a disease called Scurvy. You can get bleeding gums, loss of teeth, brown spots on your skin and even death may occur if it’s severe enough.

Minerals

Minerals are chemical elements, hence less likely to be degraded by cooking, boiling etc. We have two types of these on the basis of how much our body needs these. Some of the major mineral are calcium, magnesium, phosphorus, sodium, potassium, chloride. Trace minerals are iron, zinc, iodine, selenium, copper, manganese, fluoride etc. They take part in all kinds of bodily functions such as:&nbsp;<ul></ul><ul><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Water balance</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Blood cell production</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Cognitive benefits</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Blood sugar regulation</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Immune function</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Bone health</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Nerve conduction</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Hormone production</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Enzyme activation and so much more.</li></ul>Some of the natural resources of these minerals are dairy products, tofu, kale, fish meat eggs poultry nuts cheese, salt, nuts beans, whole grains and legumes.&nbsp;&nbsp;

The growing conscientiousness about health in the general public has led to almost everyone consuming some kind of a multivitamin supplement. It’s mostly bought for all the claims we see on the packaging. These claims range from “fights oxidative stress” to “improves immune system” and “supports cardiovascular health”. There are several reasons why that might not be the case however:&nbsp; <ul></ul><ul><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Gives you a false sense of security where you might feel like now that you have everything in this little pill, you don’t ever need to buy another vegetable ever again.&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">They might interfere with the effectiveness of some drugs such as insulin, Xanax etc.&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Fat soluble vitamins may build up in local fat stores and lead to trouble down the road.</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">They are not FDA approved! Yes. These supplements are not highly regulated and any one can manufacture and market them as they please with all kinds of lofty claims.</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">There has been research that suggests linkage between cancer and high dosages of certain vitamins.&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Some of these vitamins and minerals, when taken together can be counterproductive to each other.&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Research has shown that rates of cancer, heart attack and mental decline were found to be similar in people who take vitamins and those who don’t.&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">The very real risk of toxicity. It might seem far-fetched but such cases are well documented in medical literature. This is especially true for vitamin E and beta carotene (A) supplements.&nbsp;</li></ul>

Now there are certain situations in which it makes sense to consume these supplements such as:&nbsp;<ul></ul><ul><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">Your doctor found out you have a deficiency for a certain vitamin, such as a Vitamin D deficiency is quite common.</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">You have a condition that doesn’t allow your body to absorb vitamins and minerals from your food (malabsorption syndrome).&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">You’re pregnant. Pregnancy increases the nutritional demands of the body. Pre-natal supplements and folic acid helps replenish the resources that are essential for the healthy development of the baby.&nbsp;</li><li style="line-height: 1.295; margin-top: 0pt; margin-bottom: 0pt;">You’re vegan. Chances are you might be running low on your vitamin B12 stores and it’s wise to obtain it from an alternate source.</li></ul>

Bottom line

So, bottom line, if you do want to start living a healthier lifestyle it would be smart to start with consuming a healthy diet overall. Naturally replenishing your vitamin and mineral stores eliminates much of the trouble that comes with these synthetic cocktails. If you still think you’re lacking something then it would be wise to consult your doctor before buying the first multivitamin that your guy at the pharmacy raves about.

In the end, it’s always better to be safe and careful with what you put inside your body.

Dr. Safia Mehmood

Menopause And Breast Cancer

According to research, in all of Asia, Pakistan has the highest rate of <a href="https://merisehat.pk/disease/side-effects-of-breast-cancer-treatment">breast cancer</a>, with 1 in 9 women at risk of getting diagnosed with breast cancer<a href="#accordion">[7]</a>&nbsp;<a href="#accordion">[6]</a>. This is usually because of the myths associated with the condition. Delayed screening means the cancer is diagnosed when it has advanced and there is little chance of survival.

Understanding the link between Menopause and Breast cancer

Age is one of the major risk factors for developing breast cancer. The likelihood of being diagnosed with a malignant tumor in the breast is greatest between the ages of 45 and 55. Unless an individual has previously undergone chemotherapy, surgeries such as hysterectomy or oophorectomy, or possesses a genetic predisposition to experience early menopause, this is when a natural decline in hormone levels occurs.

The decreased production of estrogen and progesterone leads to irregular menstrual periods before they eventually cease. During this phase, one may experience hot flashes, sexual difficulties, insomnia, memory problems, osteoporosis, and anxiety.

However, menopause itself is not our concern here. Menopause itself is not related to a higher risk of getting cancer. It&rsquo;s the fact that 1 out of 8 cases of breast cancer occur during their lifetime, mostly in women over 50, that&rsquo;s worrisome<a href="#accordion">[8]</a>. This is why the age factor is important &ndash; a girl who starts menstruating before 12 and/or experiences menopause after 55 will have an increased number of ovulations and, thereby, increased exposure to hormones like estrogen.

And then there&rsquo;s the issue of medications or treatments like hormone replacement therapy one may be taking to manage the menopausal symptoms, which increases the risk of breast cancer. 
&nbsp;

While menopause is a risk factor for breast cancer, interestingly, breast cancer can also induce menopause. Treatments like chemotherapy, ovarian suppression (through surgery, hormone therapy, or radiotherapy), and hormone therapy (e.g., anastrozole, exemestane, letrozole, and tamoxifen) cause menopausal symptoms<a href="#accordion">[9]</a>.&nbsp; While each woman reacts differently to therapy, premature menopause due to breast cancer may be permanent (rather than temporary) if they&rsquo;re closer to the natural age of experiencing it. 
&nbsp;

Menopausal signs that are frequently experienced include:

<ul>
	<li>Joint pain</li>
	<li>Night sweats</li>
	<li>Anxiety and irritation</li>
	<li>Mood change</li>
	<li>Heart palpitations</li>
	<li>Change in libido</li>
	<li>Hot flushes</li>
	<li>Changes to hair and skin</li>
	<li>Weight gain, especially around our waist</li>
	<li>Difficulty sleeping</li>
	<li>Memory issues</li>
	<li>Vaginal dryness 
	&nbsp;</li>
</ul>

The onset of these symptoms can be gradual or sudden. It is worth mentioning that not all individuals experience all the listed symptoms, and the severity of symptoms can vary among individuals. 
&nbsp;

The estrogen-driven breast cancers, also known as estrogen-receptor-positive cancers, are a more common occurrence than aggressive cancers. They tend to develop gradually and have a lower mortality rate. In other words, they require less aggressive therapy and have a better outlook and reduced chance of recurrence.

According to studies, if you&rsquo;re overweight or obese post-menopause, you have a 20-60% greater risk of developing breast cancer than those who are lean<a href="#accordion">[10]</a>. This extra fat is the main source of estrogen at that time. It also produces proteins that increase inflammation throughout the body, which causes breast cancer to recur. 
&nbsp;

<h5 style="text-align:justify">Medications</h5>

There are two distinct kinds of drugs, and they both function differently. Aromatase inhibitors (AIs) reduce or halt the body&#39;s production of estrogen, which causes the tumors to die. Tamoxifen prevents estrogen from acting on breast cancer cells.

Both tamoxifen and an aromatase inhibitor can be used to treat postmenopausal individuals with estrogen-positive breast cancer. However, aromatase inhibitors are generally more effective and do not increase the risk of blood clots or uterine cancer<a href="#accordion">[10]</a>. 
&nbsp;

Exercising, a balanced diet, quitting smoking (including avoiding passive smoking) and drinking alcohol, and relieving stress can help breast cancer patients deal with the symptoms. 
&nbsp;

Menopause can be a risk factor for breast cancer and vice versa. However, you can overcome both issues with a balanced diet, a healthy lifestyle, proper checkups, and the right therapy.

[1]Sohail S, Alam SN. Breast cancer in Pakistan-awareness and early detection.

[2] Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International journal of cancer. 2010 Dec 15;127(12):2893-917

[3] Clemons M, Simmons C. Identifying menopause in breast cancer patients: considerations and implications. Breast cancer research and treatment. 2007 Aug;104:115-20.

[4] Biglia N, Bounous VE, Sgro LG, D'Alonzo M, Pecchio S, Nappi RE. Genitourinary syndrome of menopause in breast cancer survivors: are we facing new and safe hopes?. Clinical Breast Cancer. 2015 Dec 1;15(6):413-20.

[5] De Villiers TJ, Pines A, Panay N, Gambacciani M, Archer DF, Baber RJ, Davis SR, Gompel AA, Henderson VW, Langer R, Lobo RA. Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Climacteric. 2013 Jun 1;16(3):316-37.

[6] Academic.oup.com.

[7] Khan NH, Duan SF, Wu DD, Ji XY. Better Reporting and Awareness Campaigns Needed for Breast Cancer in Pakistani Women. Cancer Manag Res. 2021;13:2125-2129. Published 2021 Mar 2. doi:10.2147/CMAR.S270671

[8] NHS choices.

[9] Menopausal symptoms and breast cancer. Breast Cancer Now.

[10] Stepko B, En español , español E, 03 O. Dealing with breast cancer after menopause. AARP

Syeda Qurat-ul-Ain

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Doctor, Am I Having An Angina Attack?

Chest pain is one of the most common presentations in emergency departments (EDs) across the world. In the United States, more than 8 million ED visits each year are due to chest pain<a href="#accordion">[1]</a>.As per an analysis of ED surveillance data in Pakistan, more than 7% of all admitted patients complain of chest pain<a href="#accordion">[2]</a>. However, only a small proportion of these patients have a life-threatening condition. The cause of chest pain can vary ranging from minor indigestion to medical emergencies such as myocardial infarction (MI).&nbsp; 
&nbsp;

Approximately half of all chest pain cases have a cardiac cause while the other half are caused by gastrointestinal, pulmonary, psychological and musculoskeletal diseases. Gastroesophageal reflux disease (<a href="https://www.merisehat.pk/disease/gerd-56">GERD</a>) is the most prevalent cause of non-cardiac chest pain<a href="#accordion">[3]</a>. 
&nbsp;

The most common causes of chest pain are: 
&nbsp;

<ul>
	<li>Cardiovascular - angina, heart attack, aortic dissection, pericarditis</li>
	<li>Gastrointestinal - GERD, oesophagal rupture, peptic ulcers, gallstones, pancreatitis</li>
	<li>Pulmonary - pleuritis, pneumonia, pulmonary embolism, pneumothorax</li>
	<li>Musculoskeletal - Muscle injury, broken ribs, shingles</li>
	<li>Other - anxiety, panic attack 
	&nbsp;</li>
</ul>

Cardiac chest pain also called angina, is the most common symptom of cardiovascular disease (CVD). Chest pain is often described as discomfort, tightness, heaviness, or pressure in the chest. This pain can also occur in the jaw, neck, arms, shoulder, and back. Moreover, you may also experience nausea, vomiting, fatigue, and shortness of breath. Angina is mostly triggered by exercise, cold, or emotional stress. 
&nbsp;

Although angina signs and symptoms can vary. If your chest pain occurs on physical exertion, is relieved by rest or prescribed angina medication, and lasts 1-5 minutes, then it is likely angina. If your chest pain continues to worsen or lasts longer than 10 minutes then a diagnosis of MI, aortic dissection, or pulmonary embolism should be considered. Since angina symptoms often overlap with several other diseases, it is best to book an appointment with a doctor immediately. Remember, no type of chest pain is good.&nbsp;

&nbsp;

Angina is not a disease, but a symptom of an underlying heart condition such as coronary artery disease (CAD). The American Heart Association (AHA) defines angina as chest pain or discomfort caused by the heart muscle receiving an inadequate supply of oxygenated blood<a href="#accordion">[4].</a>&nbsp; 
&nbsp;

Atherosclerosis results in narrowing and hardening of the coronary arteries. As a result, the cardiac muscles are unable to receive sufficient oxygen-rich blood. The reduced blood supply and increased oxygen demand of the muscles then result in ischemia. During periods of increased activity or emotional stress, the heart needs to pump harder as the muscles require more blood and oxygen. However, the narrowed vessels restrict the blood flow. Thus, resulting in chest pain, or angina.&nbsp;

Understanding different types of chest pain

There are several types of angina depending on the cause or severity of the symptoms. These include stable, unstable, microvascular, and variant angina. Stable angina is the most common and typically results from physical exertion. It lasts 1-5 minutes and is relieved by rest or nitroglycerin pills. On the other hand, unstable angina is a medical emergency and is often the first sign of a heart attack. The chest pain can occur at rest, lasts longer than 10 minutes, and is not relieved by medications.&nbsp; 
&nbsp;

Microvascular angina results from coronary microvascular disease (MVD) that affects small coronary vessels. Along with chest pain, patients complain of sleep disturbances and shortness of breath. Compared to other types of angina, microvascular angina is more painful and lasts longer. 
&nbsp;

Variant angina is the rarest type and mostly occurs between midnight and early morning. Spasm of the coronary arteries leads to a painful condition.&nbsp;

&nbsp;

Doctors mostly prescribe nitrates such as nitroglycerin for treating acute episodes of angina. These medications widen and relax the blood vessels. Thus, improving blood flow to the muscles and providing immediate pain relief.&nbsp; 
&nbsp;

During an episode, it is important to stop what you are doing and rest. A half-sitting position, on the floor or chair, is preferred. If your doctor has prescribed you a sublingual nitroglycerin pill or spray, you may take it. If the chest pain does not get better, you can repeat a dose after 5 minutes. Moreover, it is important to stay calm as stress and anxiety can worsen chest pain.&nbsp;

&nbsp;

If you start having an angina attack, stop what you are doing and rest. Sit in a semi-seated position and stay calm. If the pain does not get better with rest within 5 minutes, call for an ambulance. Do not drive yourself to the hospital when experiencing any kind of chest pain.&nbsp;

&nbsp;

Angina is not a life-threatening condition. However, unstable angina can increase a person&rsquo;s risk of myocardial infarction. It is associated with a 7-8% mortality in medically treated patients<a href="#accordion">[5]</a>. Whereas chronic stable angina has a mortality rate of 4%<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Once your chest pain is relieved, it is best to book an appointment with a doctor. Moreover, a doctor&rsquo;s consultation should be sought if your angina becomes frequent, worsens in severity, or changes pattern. A doctor will be able to find out the cause of your angina and prescribe medications and lifestyle changes for your condition.

&nbsp;

To prevent a recurrence of angina, the doctor often prescribes various medications such as aspirin, beta-blockers, statins, and calcium channel blockers. However, some patients fail to respond to these medications and continue to experience chest pains. Therefore, in 2006, the FDA approved ranolazine for use in chronic angina patients. According to research, the drug not only reduces angina episodes but also improves exercise-induced angina<a href="#accordion">[6]</a>.

Remember to always consult a doctor before starting any new drug.&nbsp;

&nbsp;

In some patients, despite medications and lifestyle modifications, the chest pain continues to persist and recur. As a result, doctors may recommend procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).&nbsp;

<h4>"Consistently high blood pressure can damage vital organs. Check yours today with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!" </h4>

During a heart attack, or myocardial infarction (MI), a person experiences persistent chest pain that feels like a squeezing or pressure in the centre of the chest. The pain can radiate to the jaw, neck, back, shoulder, arm, and upper abdomen. Moreover, unlike an angina attack, the chest pain in an MI lasts longer than 15 minutes and is accompanied by sweating, lightheadedness, nausea, shortness of breath, and a rapid or irregular heartbeat.&nbsp; 
&nbsp;

Heart attacks are often fatal. Hence, if discomfort persists or worsens, it is best to consult a doctor immediately.&nbsp;

&nbsp;

In women, angina often presents at an older age and with atypical symptoms. These include abdominal pain, stabbing chest pain, nausea, fatigue, and discomfort in the jaw or teeth. Moreover, some women might not even experience any chest pain and instead, just have fatigue.&nbsp;

According to the American Heart Association, women (54.4%) have a higher prevalence of angina than men (45.6%). In women, angina is more often the presenting symptom of coronary artery disease<a href="#accordion">[7]</a>. And, women also frequently experience coronary microvascular disease.&nbsp;

&nbsp;

Home remedies can be effective for non-cardiac chest pains from minor causes such as heartburn, or other gastrointestinal issues. However, angina can increase one’s risk of heart attack and can be a medical emergency. Therefore, it is best to consult a healthcare professional and follow their guidance.

Approximately 10-30% of patients with angina-like chest pain will have no underlying heart disease<a href="#accordion">[8]</a>. Since their pain is poorly understood, it&#39;s hard to manage their condition. In such cases, hypnotherapy has proven effective in reducing pain intensity, but not the frequency of episodes<a href="#accordion">[8]</a>.&nbsp;

&nbsp;

A part of traditional Chinese medicine, acupuncture involves the insertion of thin needles at specific points throughout the body. These acupuncture points are meant to stimulate the central nervous system and cause the release of chemicals. As a result, the body&rsquo;s natural healing mechanism is activated. Therefore, the technique has been used to treat chronic pain, migraines, fibromyalgia, and even asthma. 
&nbsp;

Since certain acupuncture points can have an effect on cardiac health, researchers have explored its use in treating angina. The therapeutic method has an effectiveness of 80-96%<a href="#accordion">[9]</a>.&nbsp;Moreover, when compared to conventional medical treatments, acupuncture causes a quicker relief of angina and lacks adverse side effects. Therefore, making it an efficient option for regular angina treatment.

&nbsp;

Although exercise can trigger angina, it can also reduce the risk of angina. Patients are typically recommended daily, regular exercise. This helps improve the heart muscles’ circulation.&nbsp;

It is always recommended to consult your doctor before resuming any kind of activity. Any activity that puts unnecessary stress on the heart such as physical exertion should be avoided.&nbsp;

The sooner you make lifestyle changes and stick to them, the quicker you can return to your normal routine. Taking medications and avoiding risk factors can reduce one&rsquo;s symptoms.

&nbsp;

The most common risk factors of angina include diabetes, obesity, smoking, alcohol and hypertension. Regular exercise, a healthy diet, quitting smoking, losing weight, and learning to manage stress can all decrease your risk of angina.&nbsp; 
&nbsp;

[1].American Heart Association. (2020, January 29). Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association. Circulation, 141(9), 139-596.

[2].American Heart Association. (2021, November 8). Angina (Chest Pain). American Heart Association. Retrieved July 13, 2022, from https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain

[3].Amsterdam, E. A. (2010, July 26). Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association. Circulation, 122(17), 1756-76. 10.1161/CIR.0b013e3181ec61df

[4].Chaitman, B. R. (2006, May 23). Ranolazine for the Treatment of Chronic Angina and Potential Use in Other Cardiovascular Conditions. Circulation, 113, 2462-2472.

[5].Hilton, T. C., & Chaitman, B. R. (1991). The prognosis in stable and unstable angina. Cardiology clinics, 9(1), 27-38.

[6].Jones, H., & Cooper, P. (2006). Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy. Gut, 55(10).

[7].Paichadze, N., Afzal, B., Zia, N., & Mujeeb, R. (2015). Characteristics of chest pain and its acute management in a low-middle income country: analysis of emergency department surveillance data from Pakistan. BMC Emergency Medicine, 15(13). 10.1186/1471-227X-15-S2-S13

[8].Thompson, S. E., Liu, J. J., & Saltzman, J. R. (2007, September). Prevalence of Gastroesophageal Reflux Disease in Patients with Non-Cardiac Chest Pain Presenting to the Emergency Department. The American Journal of Gastroenterology, 102.

[9].Xu, L., Xu, H., Gao, W., & Wang, W. (2013). Treating angina pectoris by acupuncture therapy. Acupuncture & electro-therapeutics research, 38(1-2), 17-35. 10.3727/036012913x13831831849457

Nimrah H. Sattar

Insulin And Postpartum

The postpartum period refers to the time after you give birth. Your hormonal levels will be fluctuating as your body recovers from the physical and emotional toll of the pregnancy. You&rsquo;ll probably be overwhelmed by all sorts of emotions during this period.

Besides mood, these changes can affect your blood sugar regulation, particularly if you had <a href="https://merisehat.pk/disease/diabetes-gestational">gestational diabetes</a>. However, you can have postpartum diabetes even if you did not have gestational diabetes. 
&nbsp;

Around 2-10% of all pregnant women in the US have gestational diabetes<a href="#accordion">[1]</a>. The condition often shows up during the middle of pregnancy when the placenta produces hormones that prevent the body from efficiently using insulin. Consequently, glucose concentrates in the blood rather than being absorbed by the cells.

The best thing to do after the diagnosis of gestational diabetes is to look after yourself as much as possible. It&rsquo;s crucial to monitor blood glucose during labor and birth. While eating healthy and staying active during pregnancy can help control blood sugar levels, you may need to take insulin as well to control your blood sugar levels and avoid complications, like preeclampsia and birth defects, for you and your baby. 
&nbsp;

Insulin can be injected via pen or syringe and it&rsquo;s generally safe to use as prescribed by your doctor. Using too much insulin or skipping a meal, however, may cause hypoglycemia which can be dangerous for both you and your baby.

Note: If you have type 1 or type 2 diabetes, refer to a professional doctor before getting pregnant as uncontrolled gestational diabetes is not safe for your baby. Moreover, several diabetes tablets are not safe to be taken during pregnancy so your doctor can guide you regarding insulin injections<a href="#accordion">[2]</a>. 
&nbsp;

Understanding the importance of insulin in pregnancy

If you were diagnosed with gestational diabetes, it&rsquo;s important that you get tested for diabetes after delivery. Your doctor will order regular glucose checking for a few days after delivery, usually before breakfast and two hours after meals, to ensure your glucose levels are within the normal range. An oral glucose tolerance test is recommended 6-12 weeks after birth<a href="#accordion">[2]</a>. 
&nbsp;

If your blood glucose level is:

<ul>
	<li>Normal &ndash; Get checked every three years</li>
	<li>Pre-Diabetes &ndash; Get checked every year; talk to your doctor about minimizing your risk of diabetes</li>
	<li>Diabetes &ndash; Consult your doctor and set up a treatment plan 
	&nbsp;</li>
</ul>

The symptoms of gestational diabetes usually disappear in the postpartum period as blood sugar levels return to normal after labor and any medications, including insulin, will be stopped after your baby is born. But it&rsquo;s also possible that it progresses to type 2 diabetes. Around 50% of women with gestational diabetes develop type 2 diabetes<a href="#accordion">[1]</a>. 
&nbsp;

Getting checked helps because type 2 diabetes presents few symptoms during the early stages of the disease. With a timely diagnosis, you can prevent or delay the development of type 2 diabetes by continuing with your treatment, eating healthily, and avoiding a sedentary lifestyle.

Note: For future pregnancies, make sure to inform your healthcare team about your history of gestational diabetes. 
&nbsp;

According to the American Diabetes Association, breastfeeding can help you manage your diabetes<a href="#accordion">[3]</a>.

For the baby, breastfeeding for the first six months at least means a reduced risk of developing type 1 diabetes, obesity leading to type 2 diabetes, and other health issues like eczema and respiratory disease. For the mother, benefits include a lower risk of developing health conditions like breast and ovarian cancers and type 2 diabetes in addition to a quicker recovery after birth. 
&nbsp;

That said, is it safe to take insulin while breastfeeding your newborn? Yes, it is<a href="#accordion">[3]</a>. This is because insulin molecules are large enough to not pass through the breast milk to the baby.

However, the dose needs to be adjusted accordingly after the pregnancy and, again, during breastfeeding. Ideally, the blood sugar level while breastfeeding should be between 90 and 180 mg/dL.

These levels may drop during breastfeeding, a condition known as hypoglycemia, so you should eat before each session to keep the glucose levels stable. And check your blood glucose levels every time before and after nursing. 
&nbsp;

<ul>
	<li>Gestational diabetes goes away soon after birth in the majority of cases. This is because of a drop in pregnancy hormones and the insulin resistance associated with them.</li>
	<li>If you have had gestational diabetes or are at risk of postpartum diabetes, you should monitor your blood sugar regularly during the postpartum period.</li>
	<li>Breastfeeding may help reduce insulin and blood sugar levels after birth.</li>
	<li>If you started taking insulin during pregnancy, it may be stopped after childbirth. But, depending on your blood glucose levels, you may have to restart insulin again.</li>
	<li>If you were taking insulin before pregnancy, you will most probably continue to do so. However, the dosage and the type of insulin may be reviewed by your doctor.</li>
	<li>Lifestyle recommendations may further help prevent developing type 2 diabetes. 
	&nbsp;</li>
</ul>

[1] Gestational diabetes. Centers for Disease Control and Prevention.

[2] Department of Health &amp; Human Services. Diabetes - gestational. Better Health Channel.

[3] Diabetes and breastfeeding. Diabetes and Breastfeeding | ADA

Shermeen Zuberi

The Impact Of Stress On Weight Gain/Loss And Mental Health

In today&#39;s fast-paced and demanding world, <a href="https://merisehat.pk/disease/stress">stress </a>has become an inevitable part of our lives. Whether it&#39;s due to work pressure, relationship issues, financial concerns, or any other life challenge, stress affects us all at some point. Not only does stress take a toll on our mental well-being, but it can also have a profound impact on our physical health, particularly when it comes to weight gain or loss. 
&nbsp;

&quot;I always tell my clients to have fun when working out with me,&quot; says 33-year-old Ahsan Shah, a fitness trainer and consultant based out of Karachi with over 15 years of experience in managing fitness and weight loss with clients in both Karachi and Dubai. &quot;If they&#39;re not having fun and are stressed out, it will impact not only their motivation but also their cortisol levels,&quot; he says. &quot;This affects everything: whether they will be consistent in pursuing a healthy exercise and diet regimen and most importantly, how their body will respond to it.&quot;&nbsp;

&nbsp;

Weight gain and Stress

<h5>Weight Gain And Stress</h5>

Stress can significantly contribute to weight gain for various reasons. One of the main factors is the hormonal response triggered by stress. When we are under stress, our body releases cortisol, often referred to as the &quot;stress hormone.&quot; Cortisol plays a crucial role in regulating metabolism, blood sugar levels, and energy balance. However, prolonged or chronic stress can lead to consistently elevated cortisol levels, which can disrupt these processes.

Increased cortisol levels can cause an increase in appetite, particularly for foods that are high in sugar, fat, and calories. This can lead to overeating and indulging in unhealthy food choices as a way to cope with stress. Additionally, cortisol can promote the accumulation of fat, especially around the abdominal area, which is associated with an increased risk of various health problems, including cardiovascular diseases and<a href="https://merisehat.pk/disease/diabetes-type-1-and-2"> type 2 diabetes</a>.

Furthermore, stress can disrupt sleep patterns. Lack of sleep or poor-quality sleep is linked to weight gain as it affects hunger-regulating hormones, such as leptin and ghrelin. When we don&#39;t get enough sleep, ghrelin levels increase, stimulating hunger, while leptin levels decrease, reducing feelings of fullness. This imbalance can lead to excessive calorie intake and weight gain over time. 
&nbsp;

<h5>Weight Loss And Stress</h5>

On the other hand, stress can also lead to weight loss in some individuals. During stressful periods, some people may experience a loss of appetite or have difficulty eating due to digestive disturbances. This can result in inadequate nutrition and unintentional weight loss. Moreover, stress can increase metabolic rate and energy expenditure, causing some individuals to burn more calories than they consume, leading to weight loss. 
&nbsp;

<h5>Mental Health And Stress</h5>

The impact of stress on mental health is widely recognized. Chronic stress can contribute to the development or exacerbation of mental health conditions such as anxiety and depression. These conditions can have a profound effect on a person&#39;s overall well-being and can further contribute to weight gain or loss.

Stress and mental health are closely intertwined. For some individuals, stress can trigger emotional eating or binge eating episodes as a coping mechanism to alleviate negative emotions. This can create a vicious cycle where stress leads to unhealthy eating habits, resulting in weight gain, and in turn, worsening mental health symptoms.

Conversely, stress can also lead to loss of appetite, decreased interest in food, or even disordered eating patterns. In severe cases, chronic stress can contribute to the development of eating disorders like anorexia nervosa or bulimia nervosa, which can have serious consequences on both physical and mental health. 
&nbsp;

<h5>Managing Stress And Promoting Well-being</h5>

To mitigate the negative effects of stress on weight and mental health, it is crucial to implement effective stress management strategies. Here are some recommendations: 
&nbsp;

<ul>
	<li>Regular Exercise: Engaging in physical activity can help reduce stress levels, promote weight management, and enhance overall well-being. Exercise releases endorphins, the body&#39;s natural mood elevators, which can counteract the negative impact of stress hormones. 
	&nbsp;</li>
	<li>Balanced Diet: Adopting a balanced diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats can support both physical and mental health. Avoid using food as a coping mechanism for stress and opt for healthier stress-relief strategies. 
	&nbsp;</li>
	<li>Adequate Sleep: Prioritize good sleep hygiene and aim for seven to eight hours of quality sleep each night. Establishing a consistent sleep routine can improve stress resilience, aid in weight management, and enhance mental clarity. 
	&nbsp;</li>
	<li>Stress Reduction Techniques: Explore stress reduction techniques such as meditation, deep breathing exercises, yoga, or mindfulness practices. These techniques can help calm the mind, reduce cortisol levels, and promote relaxation. 
	&nbsp;</li>
	<li>Seek Support: Don&#39;t hesitate to reach out for support from friends, family, or mental health professionals. Talking about your stressors and emotions can provide relief and help you develop healthier coping mechanisms. 
	&nbsp;</li>
</ul>

bottom Line

Stress can have a significant impact on both weight management and mental health. It is important to recognize the interplay between stress, weight gain/loss, and mental well-being. By implementing effective stress management strategies and seeking support when needed, individuals can better navigate the challenges of stress and promote their overall health and well-being.

Back pain and <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">sleep</a> problems can be a vicious cycle. However, there are ways to alleviate both issues and promote better overall health.

&nbsp;

Understanding the link between Back Pain and Sleep Issues

Back pain and sleep problems are two of the most common health issues that affect millions of people worldwide.

In particular, low back pain, which is considered a primary cause of disability worldwide, is a widespread condition and it affects individuals of all ages<a href="#accordion">[3]</a>. Based on the 2015 Global Burden of Disease Study, the global prevalence of activity-limiting low back pain was 7.3%, which means approximately 540 million individuals were affected at any given time<a href="#accordion">[3]</a>.

Low back pain is more likely to occur in individuals who have certain lifestyle habits, such as engaging in physically demanding occupations, smoking, and having low levels of physical activity.

Back pain and sleep issues are often interconnected, with one affecting the other. When a person suffers from back pain, it can be challenging to get a good night&#39;s sleep. The lack of sleep can then exacerbate the pain, leading to a vicious cycle of pain and sleeplessness. Lack of sleep can also affect mood and energy levels, making it harder to cope with pain. 
&nbsp;

<h5>Understanding Back Pain</h5>

Back pain is a common problem that can be caused by a variety of factors, including injury, poor posture, and aging. The pain can range from mild discomfort to severe. Moreover, it can be localized or radiating to other areas of the body.

Some common symptoms of back pain include stiffness, muscle spasms, and difficulty moving or standing.

A study conducted on 9,611 participants using cross-sectional methodology has shown that inadequate sleep duration and poor sleep quality are linked to low back pain<a href="#accordion">[1]</a>. 
&nbsp;

<h5>Understanding Sleep Problems</h5>

Sleep problems can be caused by a variety of factors, including stress, anxiety, depression, and physical pain.

When a person experiences back pain, falling asleep and staying asleep can be difficult. Certain sleep disorders like sleep apnea can also cause back pain due to abnormal sleeping positions. 
&nbsp;

Fortunately, several strategies can improve both back pain and sleep problems. Here are some tips: 
&nbsp;

<ol>
	<li>
	<h5>Exercise</h5>
	</li>
</ol>

Regular exercise, especially low-impact activities, like walking, swimming, or yoga, can help strengthen the muscles supporting the spine and improve overall fitness. This can help reduce back pain and improve sleep quality. 
&nbsp;

<ol start="2">
	<li>
	<h5>Improve The Sleep Environment</h5>
	</li>
</ol>

Make sure the mattress, pillows, and bedding are comfortable and supportive. Keep the bedroom dark, quiet, and cool, and limit screen exposure before bedtime. Here are some additional tips for better sleep patterns with back aches. 
&nbsp;

Choosing The Right Mattress And Pillow

<ul>
	<li>Use a supportive mattress</li>
	<li>Use a cervical or ergonomic pillow to support and align the neck and spine 
	&nbsp;</li>
</ul>

Sleep Position

<ul>
	<li>Avoid sleeping on the stomach</li>
	<li>Place a pillow between the knees when sleeping on the side</li>
	<li>Use a pillow to support the spine when sleeping on the back 
	&nbsp;</li>
</ul>

Practice Good Sleep Hygiene

<ul>
	<li>Develop a consistent sleep routine, i.e., going to bed and waking up at approximately the same time every day.</li>
	<li>Avoid caffeine and nicotine in the hours leading up to bedtime</li>
	<li>Avoid large meals close to bedtime 
	&nbsp;</li>
</ul>

<ol start="3">
	<li>
	<h5>Try Relaxation Techniques</h5>
	</li>
</ol>

Meditation, deep breathing, or progressive muscle relaxation can help reduce stress and promote relaxation, which can help improve sleep quality and reduce back pain. 
&nbsp;

<ol start="4">
	<li>
	<h5>Consider Physical Therapy</h5>
	</li>
</ol>

A physical therapist can help develop an exercise program tailored to the individual needs of the person to help reduce pain and improve flexibility. 
&nbsp;

<ol start="5">
	<li>
	<h5>Consider Alternative Therapies</h5>
	</li>
</ol>

Acupuncture, chiropractic care, or massage therapy may also help reduce back pain and improve sleep quality. However, it&rsquo;s important to consult a healthcare professional before trying any alternative therapies. 
&nbsp;

<ol start="6">
	<li>
	<h5>Manage Stress</h5>
	</li>
</ol>

Stress can exacerbate back pain and disrupt sleep, so find ways to manage stress. This includes scheduling a specific time of the day to worry about everything going on in life.

Another technique is to form a habit of journaling. Writing down worries, especially anything that triggers anxiety before sleep, helps them get out in the open so that it can be addressed.

Moreover, a to-do list for the following day can help instill a sense of achievement as well as deal with all the worries before bedtime. 
&nbsp;

Back pain and sleep problems are two of the most common health issues that affect people worldwide. These issues are often interconnected, with one affecting the other. Practicing good sleep hygiene, using proper sleeping positions, engaging in regular exercise, stretching before bed, and seeking professional help can improve both back pain and sleep problems. Remember, caring for the body is essential for a healthy and fulfilling life. 
&nbsp;

Key Takeaways

<ul>
	<li>Back pain can make it difficult to get comfortable in bed, leading to sleep problems.</li>
	<li>Poor sleep can worsen back pain by causing muscle tension and reducing the body&#39;s ability to heal and repair itself.</li>
	<li>Common causes of back pain and sleep problems include poor sleeping posture, an uncomfortable mattress, a sedentary lifestyle, stress, and medical conditions.</li>
	<li>To improve sleep and reduce back pain, it&#39;s important to prioritize healthy sleep habits and address any underlying issues.</li>
</ul>

[1] Murase K, Tabara Y, Ito H, et al. Knee Pain and Low Back Pain Additively Disturb Sleep in the General Population: A Cross-Sectional Analysis of the Nagahama Study. PLoS One. 2015;10(10):e0140058. Published 2015 Oct 7. doi:10.1371/journal.pone.0140058.

[2] Vos T, Allen C, Arora M, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: A systematic analysis for the global burden of disease study 2015. The Lancet. 2016;388(10053):1545-1602. doi:10.1016/s0140-6736(16)31678-6.

[3] Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356-2367. doi:10.1016/s0140-6736(18)30480-x.