Explore how laughter might impact blood pressure. Learn the science behind the benefits and how a good laugh can improve your health on Meri Sehat.

Can Laughter Really Lower Blood Pressure?

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Ismail Munir

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Laughter Is Indeed The Best Medicine – Here's How

Introduction

You probably would have laughed it off when someone mentioned laughter as the best therapy because it&#39;s too hard to believe, right?&nbsp; But, guess what? There is now a plethora of evidence and research to back the claim that a good laugh can do wonders.&nbsp;

&nbsp;

As we go along this article, you will learn more about the power of humor and what staying happy does to a person, especially if they&rsquo;ve been sick for a long time. The theory suggests humor promotes healing through staying happy. Let&rsquo;s see how it achieves that. 
&nbsp;

Understanding the Benefits of Humor Therapy

Humor therapy, also known as therapeutic humor or laughter therapy, refers to the art of using humor to relieve stress and pain, and to improve your overall sense of well-being<a href="#accordion">[1]</a>. Humor therapy uses the power of giggles and smiles to help you heal and escape the worries of life<a href="#accordion">[2]</a>.&nbsp;

&nbsp;

Scientists have proven that laughter can alter the brain chemistry, by reducing<a href="merisehat.pk/disease/stress"> stress</a> and promoting the release of happiness hormones, namely serotonin and dopamine. Humor therapy would help you to feel confident and in control of your life. Additionally, it would liberate you from the negative emotions that are pooling inside, helping you to let go of added stress and worries concerning your health condition or about life events in general<a href="#accordion">[3]</a>.

&nbsp;

Research has proven that patients who received humor therapy showed a significant improvement in their health. Among the health benefits observed in these patients was reduction in blood pressure, a boost in the activity of the immune system, reduction in stress hormone levels, and a rise in the levels of endorphins (a chemical produced in the body that brings about feelings of euphoria)<a href="#accordion">[3]</a>.

&nbsp;

In fact, upon realizing the importance of humor therapy, many hospitals have now either installed humor carts or have set up rooms where comic material is provided to people of all ages<a href="#accordion">[2]</a>. The funny material consists of comic recordings, audios, humorous films, books, or games. In certain hospitals, there are volunteers whose sole job is to make the patients laugh. Humor therapy has also become a part of the standard treatment plan for cancer patients at some hospitals<a href="#accordion">[3]</a>. 
&nbsp;

<h5>How Did Humor Therapy Come to Light?&nbsp;</h5>

It was in 1930 when humor therapy was used for the first time at a children&#39;s hospital by bringing in clowns to cheer up the children affected with polio. Later in 1979, Norman Cousins, a physician, in his book Anatomy of an Illness mentioned the benefits of humor therapy to educate the masses. He mentioned how humor therapy had a pivotal role in managing his pain while he was getting treated for rheumatoid arthritis of the spine, which is a very painful condition affecting the joints. According to Cousins, laughter eased the pain for him, as is proven by multiple researchers how having a good laugh can decrease stress and alleviate pain<a href="#accordion">[4]</a>.

&nbsp;

It was not until 1998, however, when the movie Patch Adams starring Robin Williams was released that people started appreciating the importance of laughter in treating individuals who are sick. According to the movie, &#39;Being happy is the most revolutionary act one can commit&#39;, and rightly so since happiness is associated with a myriad of health benefits<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

Laughter is a great medicine &ndash; one that has insurmountable benefits &ndash; and it&rsquo;s free! It&#39;s surprising, isn&rsquo;t it, how you laugh all day long as kids at one silly thing or the other but as you grow older, the natural tendency to enjoy life and laugh at petty moments drifts somewhere in the background. Responsibilities take over. However, if you try seeking humor, you can still fill your life with so much positivity that you&rsquo;ll be surprised.&nbsp;

&nbsp;

Humor and a good laugh can improve your emotional, physical, and psychological health. Moreover, humor is said to strengthen relationships, keep you happy, and also results in longevity<a href="#accordion">[5]</a>. 
&nbsp;

Here&#39;s a list of health benefits of a good laugh<a href="#accordion">[5]</a>:

<ul>
	<li>Helps the body to relax and dissipates the tension building in muscles. Your muscles stay relaxed for about 45 minutes after you have laughed.</li>
	<li>Promotes the release of endorphins, which is a substance that promotes feeling of wellbeing and relieves pain for some time.&nbsp;</li>
	<li>Improves heart health by increasing the blood flow within the heart. Staying happy can even reduce your risk of heart attack and other cardiovascular diseases. Now, isn&#39;t that huge?&nbsp;</li>
	<li>Helps burn calories if you&rsquo;re laughing for a good 10-15 minutes every day. While it is no substitute for gym, it can help you lose 3-4 pounds in a year.&nbsp;</li>
	<li>Lifts off the load of anger. You start looking at the funny side of the problem and this helps to resolve conflict and prevents negative feelings from developing in relationships.&nbsp;</li>
	<li>Add years to your life. A study in Norway conducted on people battling with cancer revealed that those who had a good sense of humor lived longer than their counterparts who didn&#39;t laugh often.&nbsp;</li>
	<li>Brings people together and strengthens relationships. Laughing together creates a strong, positive, and emotional bond between people.&nbsp;</li>
	<li>Relieves stress and improves mood. It helps you look at things from a different perspective so that you don&#39;t feel overwhelmed. 
	&nbsp;</li>
</ul>

Laughter or humor therapy is a non-traditional and non-pharmacological treatment approach that is mainly considered for old individuals in nursing homes, people with chronic diseases, and for patients battling with cancer. Humor therapy is offered alongside conservative treatment and has a tremendous effect on their mental health and immune function<a href="#accordion">[6]</a>.

&nbsp;

Additionally, laughter therapy does not require extra facilities or any specialized preparation, hence, it is easily available for all. Therapeutic humor is merely the use of the innate ability of humans to laugh at gleeful circumstances. But, to be able to laugh heartily after an extremely exhausting day can be extremely rewarding, too. Similarly, for patients dealing with chronic pain, a good laugh can momentarily take away their pain and it provides them an opportunity to enjoy life. Humor therapy is not just an inexpensive treatment option, it is also devoid of any adverse effects<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

The elderly people in our society are already prone to mental health problems due to the natural process of aging; loneliness, pain, and discomfort in daily activities means they&rsquo;re likely to suffer from depression. A study found that older individuals endure pain considering it a normal part of the process of aging and are hesitant to request for pain relief because they don&#39;t wish to be labeled as &#39;complainers&#39;<a href="#accordion">[7]</a>. As heart wrenching as it sounds, it is true that most elderly individuals are not heard and this adds to their psychological and physical stresses<a href="#accordion">[6]</a>. Humor therapy can be a breath of fresh air in their lives, a chance to live life and laugh out loud.

&nbsp;

A study was conducted to evaluate the effectiveness of laughter therapy in relieving chronic pain, alleviating loneliness, promoting life satisfaction, and enhancing happiness in older patients who were living with chronic pain. Chronic pain is defined as pain ongoing for more than 3 months. In this study, 36 old people from a nursing home were invited for an 8-week long humor therapy program while 34 old people were taken as a control who did receive humor therapy. Upon completion of the program, the individuals who were introduced to humor therapy reported remarkable reduction in their perception of loneliness, decreased pain, and a profound feeling of happiness accompanied with life satisfaction. However, the control group reported no significant changes. Consequently, this study proves that therapeutic humor is an effective intervention in the elderly population<a href="#accordion">[7]</a>.

&nbsp;

Chronic disease patients usually have a negative attitude towards life and it worsens their physical and mental health. Incorporating humor therapy in their treatment plan will significantly improve their outlook on life.&nbsp; 
&nbsp;

There is no denying that caregiving is no easy job and it can take a significant toll on the healthcare providers. Long working hours and little rest adds on to the stress and it is believed that sharing a good laugh can benefit the doctors as it does the patients. Roughly 40-70% healthcare providers show signs of clinical depression, which is a worrying figure<a href="#accordion">[8]</a>. Humor therapy can be provided to tackle the situation because cracking jokes and sharing hearty laughs over funny movies might be all that they need to instill positive feelings<a href="#accordion">[8]</a>. Saving people is a tough job already; laughing often would renew the stamina of the caregivers and build positive energy!&nbsp; 
&nbsp;

Conclusion

Whether young or old, sick or healthy, everyone needs a bit of humor to feel alive. Whether they realize this or not is a different debate, but finding reasons to laugh and giggle at even the silliest of things helps to have a positive outlook on life. People who are battling with chronic diseases or older individuals fighting loneliness have all greatly benefited from humor therapy. So, grab a comic book, watch a sitcom or do anything that makes for a good laughter experience!&nbsp;

Key Points

<ul><li>Humor therapy is the art of using humor to heal, to relieve pain, and to reduce stress.&nbsp;</li><li>Humor therapy creates a healthy brain environment and releases happy hormones.&nbsp;</li><li>Laughter therapy improves the physical, psychological, and emotional health of an individual.&nbsp;</li><li>Humor therapy greatly benefits individuals who are old, dealing with chronic diseases, or those battling with cancer.&nbsp;</li><li>Caregivers can also benefit from humor therapy.&nbsp;</li></ul>

[1] NCI Dictionary of Cancer Terms. National Cancer Institute.

[2] Humor Therapy – Health Information Library | PeaceHealth. Peacehealth.org.

[3] Therapeutic Humor - Therapedia. Theravive.com.

[4] Encyclopedia. Humor Therapy.

[5] Laughter is the Best Medicine - HelpGuide.org.

[6] Yim J. Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review. Tohoku J Exp Med. 2016;239(3):243-249. doi:10.1620/tjem.239.243

[7] Tse M, Lo A, Cheng T, Chan E, Chan A, Chung H. Humor Therapy: Relieving Chronic Pain and Enhancing Happiness for Older Adults. J Aging Res. 2010;2010:1-9. doi:10.4061/2010/343574

[8] How Humor Can Improve your Health | Silver Creek Retirement. Silver Creek.

Nawal Adnan

Know Your Blood Pressure Numbers

Blood pressure refers to the force applied by the flowing blood against the walls of the body&#39;s arteries<a href="#accordion">[1]</a>.&nbsp;Not only does this force help supply organs with oxygen and nutrients but also white blood cells and antibodies for immunity, and hormones like insulin<a href="#accordion">[2]</a>. Moreover, along with transporting oxygen and nutrients, blood pressure also plays a role in removing harmful metabolic end products, including carbon dioxide and other toxins cleared from the liver and kidneys.&nbsp; 
&nbsp;

Understanding blood pressure readings

When blood pressure exceeds the normal range, it is called <a href="https://www.merisehat.pk/disease/hypertension-57">hypertension</a>. Blood pressure is composed of a pair of numbers. The first (systolic) number represents the blood vessels&#39; pressure when the heart contracts. The second (diastolic) number is associated with the pressure in the vessels when the heart rests in between the beats<a href="#accordion">[1]</a>.&nbsp;The combination of the two allows doctors and health professionals to gauge the overall well-being of an individual. 
&nbsp;

Mild and temporary fluctuations in blood pressure are normal and can be triggered due to a myriad of reasons. However, if an individual deviates from the normal range for a chronic period, then that may indicate a deeper and more complex medical condition, and should be further explored by a licensed practitioner. To analyze quantitively, blood pressure has been categorized into five categories<a href="#accordion">[3]</a>. 
&nbsp;

<h5>Normal Range</h5>

The first range of blood pressure is defined as the normal range and is expected from every healthy individual. Numbers under 120/80mmHg are viewed as normal<a href="#accordion">[4].</a>&nbsp;Activities that encourage and support the heart&rsquo;s rhythmic motions, such as a well-balanced healthy diet and physical activity can help maintain the blood pressure in the normal range<a href="#accordion">[4]</a>. 
&nbsp;

At birth, the blood pressure stays at 64/40mmHg and then rises to 120/80mmHg as one reaches adulthood<a href="#accordion">[3]</a>. Several factors, both natural and human-induced, can then cause the blood pressure to fluctuate. For example, checking the blood pressure after delivering a fervent speech or running a marathon will likely give a high reading. This is perfectly normal as the increased adrenaline levels cause the body to increase the blood pressure, and supply the heart with more oxygen for fight or flight events<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

<h5>Elevated Levels</h5>

This is a warning stage to alarm patients and usher them into hypertension treatment before it is exacerbated. Elevated levels are denoted by persistent high blood pressure readings. A doctor is likely to investigate for differential diagnosis if the systolic blood pressure is in the range of 120-129mmHg and the diastolic is less than 80mmHg<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

Individuals who constantly have elevated levels of blood pressure are more vulnerable and at risk of developing various coronary diseases early in their life<a href="#accordion">[5]</a>. An aneurysm is an abnormal bulge in the blood vessel wall that can result from prolonged and unattended elevated levels of blood pressure. Elevated blood pressure levels also increase the risk of cardiovascular failure. Moreover, damage to the renal vessels can affect healthy kidney functioning. Since little veins in the eyes are particularly defenseless against harm, hypertension can also prompt vision issues and even visual impairment<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

<h5>Hypertension Stage I</h5>

If not addressed, then elevated levels can deteriorate to advanced stages of hypertension. Stage 1 is defined by consistently high blood pressure levels of systolic 130-139mmHg and diastolic 80-89mmHg<a href="#accordion">[3]</a>. At this phase of hypertension, specialists endorse and stress a reconsideration of routine activities and life changes. They may also prescribe blood pressure medications based on the individual&#39;s risk of developing an atherosclerotic cardiovascular disease (ASCVD), such as a heart attack or a stroke<a href="#accordion">[3]</a>.&nbsp;&nbsp; 
&nbsp;

<h5>Hypertension Stage II</h5>

If treatment for hypertension stage 1 does not prove to be successful, then the individual is likely to progress to hypertension stage 2. Hypertension stage 2 is defined as blood pressure readings of 140/90mmHg or higher<a href="#accordion">[3]</a>. At this stage, specialists will probably recommend lifestyle changes and alternatives to the previously prescribed blood pressure prescriptions While treating a patient with stage 2 hypertension, the clinician should decide on the proper blood pressure (BP) objective, select the underlying anti-hypertensive routine, and change that routine, as required, to accomplish the objective BP. Likewise, the clinician ought to think about the effect of the treatment routine on both the patient&#39;s consistency with treatment and long-term risk for cardiovascular disease (CVD)<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

If an individual has a history of high blood pressure, then they may be more likely to develop a hypertensive crisis. This phase of hypertension necessitates immediate and proper medical assistance. Therefore, it is important not to delay treatment. If during a routine blood pressure check, the readings out of nowhere surpass 180/120mmHg, try not to panic. Take a deep breath, wait for five minutes, and afterwards test the blood pressure once more. However, if the readings are bizarrely high twice in a row, immediately contact a hospital or a doctor<a href="#accordion">[3]</a>. Such high levels could indicate that the person is going through a hypertensive crisis.&nbsp; 
&nbsp;

Moreover, with the blood pressure reading being higher than 180/120mmHg the individual might witness other alarming and distressing symptoms. These suggest signs of conceivable organ harm<a href="#accordion">[7]</a>. They may range from chest pain to difficulty in breathing, body numbness and pain (especially in the back), visible change in vision, and communication problems. If these accompany the blood pressure readings, then an individual should not hesitate or wait for the shortness of breath to pass away, and immediately call for medical help<a href="#accordion">[7]</a>.

&nbsp;

<h4>"Stay on top of your blood pressure reading with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!"</h4>

To maintain the blood pressure (BP) goal according to the individual&rsquo;s age, health, and stage, the patient must regularly monitor their readings for comparison and to confirm if the advised treatment is leading to any progress or not. Realistically, it is neither economical nor feasible to expect an individual to travel great lengths, and pay hefty consultation fees for a quotidian blood pressure reading. Therefore, a doctor may suggest investing in a home blood pressure monitor. 
&nbsp;

A home blood pressure apparatus is a more accessible and economical alternative than rushing to the hospital each day. Moreover, a patient does not require a doctor&#39;s prescription to purchase one. Thus, increasing its prevalence in every home. However, it should be stated that home blood pressure observation is not a substitute for visits to the primary care physician for more serious concerns and complications that might arise due to hypertension. Additionally, home blood pressure apparatuses might have a few shortcomings of their own<a href="#accordion">[7].</a> However, these can be avoided if the individual makes an informed purchase.&nbsp; 
&nbsp;

Don&#39;t hesitate to venture onto the world wide web and gather all necessary specifications before buying a home blood pressure monitor. You can even bother a doctor for suggestions for a reliable and approved gadget. Make sure to be diligent with the yearly check-ups of the apparatus. For the inauguration, bring it to the doctor&#39;s office and request a doctor or nursing staff to teach you the proper method of checking blood pressure at home. This will help guarantee correct readings<a href="#accordion">[7]</a>.&nbsp;

&nbsp;

Hypertension is a gateway to permanent damage and life-long complications. Therefore, it is important to understand the different stages of high blood pressure and the method to monitor it. The predominance of hypertension with increasing age is a result of the gradual rise in systolic blood pressure. 
&nbsp;

Systolic hypertension is the most common type of hypertension in people older than 50 years and reflects the pathologic decline in the blood vessel and arterial compliance<a href="#accordion">[6]</a>. The increase in systolic blood pressure is a more significant risk factor for cardiovascular disease than diastolic blood pressure rise. However, both should be regulated through prescribed treatments and lifestyle changes.

&nbsp;

While hypertension covers a range of sub-topics, it is important to remember that: 
&nbsp;

<ul>
	<li>Hypertension results from the normal blood pressure rising consistently. Blood pressure is measured through a pair of readings: systolic and diastolic.</li>
	<li>Systolic blood pressure results from the heart contracting, while diastolic pressure develops when the heart relaxes.</li>
	<li>The normal range of blood pressure is less than 120mmHg for systolic, and less than 80mmHg for diastolic.</li>
	<li>Elevated levels are defined as a systolic reading of 120-129mmHg and diastolic pressures of less than 80mmHg.</li>
	<li>Hypertension Stage 1 has blood pressure readings of 130-139mmHg and 80-89mmHg for systolic and diastolic respectively.&nbsp;</li>
	<li>Hypertension Stage 2 has blood pressure readings of 140mmHg or higher for systolic and 90mmHg or higher for diastolic.&nbsp;</li>
	<li>During a hypertensive crisis, systolic readings soar above 180mmHg while diastolic readings are higher than 120mmHg. This requires immediate medical attention.</li>
</ul>

&nbsp;

[1].World Health Organization (WHO). (2021, August 25). Hypertension. Retrieved from World Health Organization (WHO)

[2].Weatherspoon, D. (2022, March 20). What is a normal blood pressure reading? Retrieved from Medical News Today:

[3].American Heart Association. (2022). Understanding Blood Pressure Readings. Retrieved from American Heart Association:

[4].Jaret, P. (2021, September 17). High Blood Pressure. Retrieved from WebMD:

[5].Chobani, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., IzzoJr, J. L., . . . Rocella, E. J. (2003). Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension, Vol. 42, No. 6, 1206-1252

[6].Giles, T. D., & Materson, B. J. (2005). Treating stage 2 hypertension. Journal of clinical hypertension (Greenwich, Conn.), 7(8), 464–470.

[7].Mayo Clinic. (2021, July 1). High blood pressure (hypertension). Retrieved from Mayo Clinic:

Zarlish Kazmi

Humza Khizer

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

The Nation’s Stance Against TB

Pakistan, with around 510,000 new <a href="https://www.merisehat.pk/disease/tuberculosis">Tuberculosis (TB)</a> cases reported every year and around 15,000 transitioning to drug-resistant TB cases consistently, is positioned 5th among high-burden nations overall. It represents 61% of the TB burden in the WHO Eastern Mediterranean Region. The nation is assessed to have the 4th most elevated predominance of multidrug-resistant TB (MDR-TB) worldwide.&nbsp; 
&nbsp;

Key explanations behind the development of the medication-resistant types of TB range from untimely and late diagnosis; unadministered, improper, and insufficient medication regimens; poor development and absence of a social help program for high-risk populaces<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

Understanding Pakistan's Fight Against TB

The Pakistan National Tuberculosis Program (NTP) has accomplished a momentous and consistent improvement in the staggering number of TB cases identified from 11,050 in 2000 to 248,115 in 2008. Likewise, treatment achievement rates recorded were an impressive 91% in 2007<a href="#accordion">[6]</a>.&nbsp; 
&nbsp;

This has been accomplished through robust responsibility and monetary contributions by the Government along with well-being advancement offered by supporters. 
&nbsp;

The World Health Organization (WHO) Directly Observed Treatment Short-course (DOTS) technique for TB was embraced and guided by Pakistan from 1995 onwards. However, significant advancement in TB control was accomplished after the recovery of the NTP in 2001 when TB had been proclaimed a public general health crisis through the Islamabad Declaration<a href="#accordion">[6]</a>.&nbsp; 
&nbsp;

The NTP operates under the Ministry of Health and is answerable for general coordination, strategy course, and specialized direction for TB control, while realistic execution is the obligation of the Provincial TB Programs (PTPs) and specialists within each region. The NTP focal unit connects elaborately with PTP chiefs and regional TB facilitators<a href="#accordion">[6]</a>. 
&nbsp;

The TB administrations are incorporated into the essential general medical care framework at the district level<a href="#accordion">[10]</a>.&nbsp; 
&nbsp;

A 2003 study led by the NTP and PTPs in Lahore and Rawalpindi locale saw that under 3% of general practitioners (GPs) were strictly abiding by the public rules for active contact tracing and the management of TB, while 90% of GPs were depending on chest radiography for confirmed diagnosis<a href="#accordion">[5]</a>.&nbsp; 
&nbsp;

Parastatal health administration&rsquo;s structure is one more place of entry outside the general medical care framework and NTP guidelines. In general, 32 government services and the federal bureau secretariat, with 208 independent (parastatal) bodies, give well-being administrations to 389,923 representatives and their dependents<a href="#accordion">[4]</a>. Excluding the Ministry of Defense, which has its own monetary cost for wellbeing administrations.&nbsp; 
&nbsp;

Lately, though, a high need has been given to creating practical organizations with medical care suppliers in the private domain, taking on a deliberate methodology following the WHO rules. Extra drives, like a better reconnaissance and research center organization, and improved follow-up and treatment modalities subsidized by international and public sources, have added to the huge improvement in recognition and treatment achievement rates framed previously.&nbsp; 
&nbsp;

The target of the survey was to feature the accomplishments of Pakistan&#39;s NTP throughout the last 10 years and to frame the exceptional needs and difficulties for what&#39;s to come. Moreover, the NTP has become more inclusive and has strived to work against discrimination of any sort while providing treatment and care for TB. This has been achieved by systematically drafting a communication manual through collaborative efforts to become more accessible to the people in Pakistan<a href="#accordion">[8]</a>.

&nbsp;

The PPM model was established to function through a typical and unanimous decision [memorandum of understanding, (MOU)] between the NTP (public arm) and the partaking wellbeing office proprietors (private arm) while adhering to the pertinent and important public TB rules<a href="#accordion">[13]</a>.&nbsp; 
&nbsp;

The NTP support component (material stockpile, monetary help, and specialized help) to the private supplier was, likewise, something very similar and uniformly disseminated in all TB offices working through the PPM model (PPM-1, 2, 3, and 4). It was provided by the Provincial TB control program (NTP provincial wing) via the area TB control program (NTP district wing) in all existing PPM approaches.&nbsp; 
&nbsp;

Nonetheless, the PPM enrolled cases were notified by private suppliers to the district TB control program (DTB), then to the Provincial TB control program (PTP), and lastly refreshed into the NTP data set. The four PPM approaches were following a specific arrangement of patient assessment, demonstrative diagnostics, and follow-up methods<a href="#accordion">[13]</a>. 
&nbsp;

First and foremost, the principal strength of the PPM mediation study (various methodologies of the customary PPM model) is that the data was gathered from regularly updated and revised program information, so the discoveries are theoretically going to mirror the program&#39;s real factors<a href="#accordion">[13]</a>. Second, the review and target population have an enormously appropriate sample size, which correspondingly allows the gauge to be a closer and more accurate representation of the truth. Third, the STROBE rules were adhered to for unparalleled concentration on the plan, procedure, and announcement of results which limits the gamble of systemic predispositions<a href="#accordion">[14]</a>. And fourth, the review gives proof and a graphic outline of all the TB case notifications (PPM and non-PPM) from all TB treatment offices accessible for 97% of Pakistani DOTS residents living in 4 regions in the review period<a href="#accordion">[13]</a>. 
&nbsp;

From the 4 PPM approaches (PPM-1, - 2, - 3, and&minus;4), increase in GP facilities ought to be centered more toward their PPM coverage result, as well as changing the PPM-1 procedure for consideration of GPs that are only practicing TB care in the private sector. On the other hand, NGO facilities should focus on an expansion in their PPM coverage, whereas private clinics should upgrade their PPM coverage proficiency, alongside broadening the treatment achievement rate up to 85%<a href="#accordion">[13]</a>.&nbsp; 
&nbsp;

However, changes in Parastatal offices cannot just be pointed toward redesigning the Parastatal commitment toward PPM TB case notification. They should also be working on their subsequent systems to prevent the default of Parastatal notified TB cases as well as holding the number of Parastatal offices offering TB administrations<a href="#accordion">[13]</a>. 
&nbsp;

The Integrated Health System Strengthening and Service Delivery (IHSS-SD) Activity is a United States Agency for International Development (USAID) subsidized drive in Pakistan. Integrated in 2018, it has been working intimately with the government and district well-being specialists to reform, change, and reinforce the well-being framework that has been implemented at the provincial level<a href="#accordion">[11]</a>. 
&nbsp;

The general objective of this specialized forum was to help the Provincial TB Control Programs in Sindh and Khyber Pakhtunkhwa in further developing the dynamic contact tracing of bacteriologic positive TB cases and decentralizing the administration of drug-resistant TB cases. 
&nbsp;

The definitive goals of this technical and international action were to accumulate sufficient proof for demonstrating the viability of active contact tracing and screening as a major strategy to work on the detection of bacteriologic positive instances of TB within the networks, and to improve the testing limit of the provincial TB programs. The program began on January 1, 2021, and finished on September 30, 2021<a href="#accordion">[11]</a>. 
&nbsp;

Diagnosing and proving the necessary care for TB cases in refugee camps and new settlements is a challenging task as many individuals are unregistered and undocumented. Besides, the societal stigma revolving around TB acts as a silent suppressor. Additionally, everyday environments, financial status, and restricted admittance to medical care are boundaries to TB services<a href="#accordion">[9]</a>.&nbsp; 
&nbsp;

There are a lot of instances where healthcare agents missed out TB among the refugees of Afghan populations in the three states covered by the Global Fund award.&nbsp; 
&nbsp;

Tracing TB cases and contact tracing is an effective way to stop the spread of the disease, including the epidemic of drug-resistant strains.&nbsp; 
&nbsp;

The Global Fund is a grant that functions under UNDP&#39;s attempts to reinforce joint effort and data sharing between Afghanistan, Iran, and Pakistan to guarantee quality care for patients who are relocating<a href="#accordion">[9]</a>. 
&nbsp;

UNDP introduced a cross-country computerized platform for recording and detailing TB cases among displaced people, returnees, and mobile communities. It was planned in association with public TB programs, the Global Fund, the United Nations High Commissioner for Refugees (UNHCR), International Organization for Migration (IOM), and others.&nbsp; 
&nbsp;

The online application was created by Dure Tech and uses the WHO Prevent TB Digital Platform. It depends on open-source technology and incorporates a patient-focused module, as well as interoperability with well-being data frameworks. Hence, empowering the screening of TB patients across the continuum of medical services, transcending borders and nationalities<a href="#accordion">[9]</a>. 
&nbsp;

The PMDT model of care in Pakistan comprises 3 connected systems of hierarchies<a href="#accordion">[7]</a>. At the highest point of the order is a full-scale framework that could be referred to as the macro system, which contains the majority of global wellbeing organizations. These include the WHO and the Global Fund, which give direction and monetary help to the PMDT model of care. 
&nbsp;

At the national level, the public and provincial TB programs work collaboratively with the non-legislative associations forming a mesosystem that gets the necessary assistance from global offices, and subsequently interprets and adjusts rules for nearby settings and districts. Together, the two frameworks build a microsystem &mdash; i.e., the PMDT facilities, which work as per universally accepted norms of care and are rooted in a former, more extensive wellbeing system<a href="#accordion">[7]</a>.&nbsp; 
&nbsp;

The PMDT model focuses on materials. For example, foundation, medications, and quantities of individuals tested and screened. Initially, there wasn&rsquo;t much emphasis on developing competencies of the PMDT staff; hence, they were incapable of giving responsive care. 
&nbsp;

Later the PMDT staff suggested prioritizing medical services connected to responsiveness which, when implemented, proved to be fruitful for patients<a href="#accordion">[1]</a>.

&nbsp;

Significant steps have been made to provide accessible and effective medical services and care for TB. However, more efforts are needed since ailing health, unfortunate lodging, and sterilization, for instance, intensified by other risk factors, like tobacco, liquor use and diabetes aggravate the condition which are still prevalent in the society.&nbsp; 
&nbsp;

The Minister pledged and vowed Pakistan&#39;s continuous and unwavering stance with the global community in the fight to eradicate TB and is undoubtedly dedicated to ending the TB pestilence by 2030 as visualized in the agenda 2030 for Sustainable Development and its Sustainable Development Goals, World Health Organization End TB Strategy, Stop TB Partnership Global Plan to End TB<a href="#accordion">[12]</a>. 
&nbsp;

<ul>
	<li>Pakistan has a high prevalence of TB cases; it stands 5th in the world.</li>
	<li>Pakistan has made significant contributions to reducing the global burden of TB.</li>
	<li>The National TB Control Program (NTB) works at the central level to draft and implement national policies for TB care.</li>
	<li>NTB caters to the growing TB population through models such as the Public-Private Mix (PPM) Model or the Programmatic Management of Drug-Resistant Tuberculosis (PMDT).</li>
	<li>Global organisations such as WHO and the Global Fund assist Pakistan in fighting against TB.</li>
	<li>The Integrated Health System Strengthening and Service Delivery (IHSS-SD) Activity by USAID has allowed smooth provincial administration for TB.</li>
	<li>Tuberculosis is a notification priority disease in Pakistan and any presenting cases should be notified to the concerned authorities immediately.</li>
	<li>In 2018, Federal Minister for National Health Services Saira Afzal Tarar said Pakistan&#39;s committed to eradicate TB by 2030 as visualised in the agenda 2030 for Sustainable Development and its Sustainable Development Goals, World Health Organization End TB Strategy, Stop TB Partnership Global Plan to End TB.</li>
</ul>

&nbsp;

[1] Abbas, S., Kermode, M., & Kane, S. (2020). Strengthening the response to drug-resistant TB in Pakistan: a practice theory-informed approach. Public health action, 10(4), 147–156.

[2] Federal Bureau of Statistics. (2009). National health accounts Pakistan 2005–06. Islamabad: Federal Bureau of Statistics, Statistics Division.

[3] Khan, J. A., Irfan, M., Zaki, A., Beg, M., Hussain, S. F., & Rizvi, N. (2006). Knowledge, attitude, and misconceptions regarding tuberculosis in Pakistani patients. Journal of Pakistan Medical Association, 56(5), 211–214.

[4] Metzger, P., Baloch, N., Kazi, G., & Bile, K. (2010). Tuberculosis control in Pakistan: reviewing a decade of success and challenges. Eastern Mediterranean Health Journal, Volume 16, 47-53.

[6] National TB Control Programme (NTP). (2014). National TB Control Programme Reach, treat, cure everyone: Annual report, 2014. Islamabad, Pakistan: Ministry of National Health Services Regulations & Coordination.

[6] National Tuberculosis Programme (NTP). (2008). Advocacy, communication and social mobilization: national strategy and operational guidelines. Islamabad: Ministry of Health.

[7] Ostby, K., & Burton, T. (2022, March 29). Tracking the 'missing cases' of TB as it moves across borders.

[8] Shah, S., Sadiq, H., Khalil, M., & Noor, A. (2003). Do private doctors follow national guidelines for managing pulmonary tuberculosis in Pakistan? Eastern Mediterranean Health Journal, 9(4), 776–788.

[9] Shaikh, B. T., Laghari, A. K., Durrani, S., Chaudhry, A., & Ali, N. (2022). Supporting tuberculosis program in active contact tracing: a case study from Pakistan. Infectious Diseases of Poverty volume 11, 42.

[10] The Frontier Post. (2018, March 27). All resources to be mobilized to fight against TB says Saira.

[11] Ullah, W., Ahmad, W., Haq, M. U., Yaqoob, A., Fatima, R., & Khan, G. M. (2021, August 10). Public–Private Mix Models of Tuberculosis Care in Pakistan: A High-Burden Country Perspective. Retrieved from Frontiers Public Health:

[12] Vandenbroucke, J. P., Elm, E. V., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., . . . Initiative., S. (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Annals of internal medicine, 147(8), W-163.

[13] World Health Organization (WHO). (2006). Engaging all health care providers in TB control: guidance on implementing public-private mix approaches. Retrieved from World Health Organization (WHO):

[14] World Health Organization (WHO). (2022). Tuberculosis.

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

What Does Your Blood Type Have To Do With Your Risk Of Stroke?

Did you know that your blood type has a significant say in your susceptibility to <a href="https://www.merisehat.pk/disease/stroke">stroke</a>? Well, yes that&#39;s true, and, as surprising as it may sound, recent research has proven that individuals with type A blood group have a 16% higher risk of early-onset stroke, whereas individuals with blood type O have a 12% reduced risk of early onset stroke<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

A study was conducted and data was collected from 48 genetic studies on the incidence of ischemic stroke in the adult population (aged 18-59 years). Ischemic stroke is caused by a clot in the blood vessel supplying the brain, thus, disrupting the blood flow to the brain tissue. The study revolved around 17,000 patients who have had a stroke in the past and 600,000 healthy individuals as controls who had no previous history of stroke 
.&nbsp;

The purpose of the study was to determine the genetic causes behind stroke since it was not known earlier and the results showed a significant correlation between an individual&#39;s blood type and the risk of early-onset stroke<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

Understanding the Association Between Blood Groups and Risk of a Stroke

It is imperative to know about the different blood groups before discussing their linkage with stroke. 4 blood groups are known to exist in humans &ndash; A, B, AB, and O. The blood group O is the commonest while the blood group AB is the rarest blood type. Individuals inherit their blood group from their parents<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

These blood groups are determined based on the presence of antigen (a protein) on the surface of our red blood cells.&nbsp; 
&nbsp;

<ul>
	<li>Type A: The A antigen is present on the surface of the red blood cell while the B antigen is present in the plasma.</li>
	<li>Type B: The B antigen is present on the surface of the red blood cell while the A antigen is present in the plasma.</li>
	<li>Type AB: Both A and B antigens are present on the surface of red blood cells and no antibody is present in the plasma.</li>
	<li>Type O: No antigen is present on the surface of the red blood cell; however, both A and B antigens are present in the plasma<a href="#accordion">[2]</a>. 
	&nbsp;</li>
</ul>

Individuals with blood type O are known as universal donors because they can donate blood to anyone, while individuals with blood type AB are known as universal recipients because they can receive any and all blood types<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

According to the study, early stroke is more common in individuals with type A blood and less common in individuals with type O blood as compared to individuals who have had late onset stroke and those who had no previous history of stroke. Moreover, individuals with type B blood group are more likely to have both early and late onset of strokes<a href="#accordion">[4]</a>. 
&nbsp;

Now, you might be wondering how serious a stroke is? So, let&#39;s take a look into what stroke is and how serious it can be.&nbsp; 
&nbsp;

Stroke is referred to as a medical emergency since it can result in lifelong disability if prompt medical actions aren&#39;t taken<a href="#accordion">[5]</a>. Strokes are mostly ischemic, but they can be hemorrhagic as well.&nbsp; 
&nbsp;

In an ischemic stroke, there is blockage in a blood vessel supplying the brain. This disruption in the blood flow starves the brain tissue of oxygen and consequently results in the death of brain cells.&nbsp; 
&nbsp;

Since the brain is the control center of the body, any damage to the brain results in long-term consequences. For instance, after a stroke, people may experience blindness and problems with speech and memory. Individuals may also develop paralysis on the side of the body that is contralateral (opposite) to the site of stroke. That is, if an individual had a stroke in the right side of their brain, then the left side of their body would be paralyzed<a href="#accordion">[2]</a>. 
&nbsp;

According to the Center of Disease Control and Prevention (CDC), every 40 seconds someone in the U.S. experiences a stroke and every 3.5 minutes someone dies because of it. It is regarded as one of the leading causes of mortality (death) in the U.S<a href="#accordion">[6]</a>.&nbsp; 
&nbsp;

Stroke may present as<a href="#accordion">[7]</a>:&nbsp; 
&nbsp;

<ul>
	<li>Sudden weakness in the face, arm, or leg&nbsp;</li>
	<li>Sudden numbness in face, arm, or leg&nbsp;</li>
	<li>Sudden blindness&nbsp;</li>
	<li>Sudden confusion&nbsp;</li>
	<li>Sudden difficulty with understanding speech</li>
	<li>Sudden trouble with speaking&nbsp;</li>
	<li>Sudden dizziness</li>
	<li>Sudden loss of balance&nbsp; 
	&nbsp;</li>
</ul>

<h5>What Is An Early And Late Onset Stroke?</h5>

Stroke that occurs in individuals younger than 60 years of age is known as early onset stroke, whereas stroke that happens after 60 years of age is late onset stroke.&nbsp; 
&nbsp;

<h5>How Does Type A Blood Increase The Risk Of Early Onset Stroke?</h5>

Type A blood group increases the risk of having early onset stroke by 16% while the risk of having a late onset stroke is estimated to be 5% in individuals with type A blood<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

Unfortunately, researchers don&#39;t have the answer as to why type A blood confers a higher risk of stroke in individuals less than 60 years of age, but it is believed that it has something to do with the clotting mechanism. There are studies that suggest that people with type A blood are slightly prone to developing blood clots in the leg &ndash; a condition known as deep vein thrombosis<a href="#accordion">[1]</a>. This signals towards the pro-clotting nature of type A blood group that paves way to the formation of other clotting-related diseases, including stroke<a href="#accordion">[1]</a>. 
&nbsp;

<h5>Should I worry If I Have Type A Blood?</h5>

Researchers emphasize that the risk associated with type A blood and early onset stroke is not that significant, hence, individuals with this blood type need not to worry about it nor do they need to engage in additional screening or medical testing. If you have Type A blood, you can simply take it as a reminder to be cautious and to take steps to manage any risk factors you might have. 
&nbsp;

Additionally, stroke risk doubles every decade after 55 years of age and CDC has warned about the risk of stroke increasing with age. Most strokes occur in individuals after 50 years of age, but it has been reported that early onset stroke incidences are increasing, too. Every 1 in 7 strokes happen in individuals aged between 15 and 49 years<a href="#accordion">[6]</a>. 
&nbsp;

Yes, strokes can be prevented. As a matter of fact, 80% of strokes are preventable<a href="#accordion">[6]</a>. 
&nbsp;

While you cannot alter your blood type or stop your age from progressing, there are certain risk factors of stroke that you can control through lifestyle modifications. To do so, you first need to know the modifiable risk factors for stroke. This include<a href="#accordion">[5]</a>:&nbsp; 
&nbsp;

<ul>
	<li><a href="https://www.merisehat.pk/disease/hypertension-57">Hypertension </a>(high blood pressure)&nbsp;</li>
	<li>High cholesterol levels</li>
	<li><a href="https://www.merisehat.pk/disease/diabetes-type-1-and-2">Diabetes mellitus</a>&nbsp;</li>
	<li>Smoking&nbsp;</li>
	<li><a href="https://www.merisehat.pk/disease/obesity">Obesity&nbsp;</a> 
	&nbsp;</li>
</ul>

Taking steps, such as quitting smoking and alcohol, incorporating exercise in your routine, managing your blood pressure and cholesterol levels, and eating a diet that is rich in fruits, vegetables and fibers can significantly reduce your stroke risk. 
&nbsp;

In a nutshell, even though blood type A is associated with increased risk of early onset stroke as proven by recent research, the risk for stroke is modest. Instead of worrying and finding ways to screen stroke, you should take it as a reason to be mindful about your health and work on other modifiable risk factors to reduce your chances of stroke.&nbsp; 
&nbsp;

<ul>
	<li>Stroke is a medical emergency that can result in life-long disability.&nbsp;</li>
	<li>Certain genetic factors, such as blood type, have been discovered through research to influence the risk of stroke.</li>
	<li>Blood type A is found to be associated with increased risk of early onset stroke, while individuals with blood type O are associated with decreased risk of early onset stroke.&nbsp;</li>
	<li>Early onset stroke occurs in individuals before the age of 60 years.&nbsp;</li>
	<li>The risk of stroke with blood type A is modest. Instead of getting involved in screening for stroke, individuals with blood type A should adopt healthier practices to manage the modifiable risk factors of stroke.&nbsp;</li>
</ul>

[1] Chang N.  Published 2022. Accessed September 23, 2022.

Norris J. Type A vs. O: Does blood type influence stroke risk?. Medicalnewstoday.com. Accessed September 23, 2022. https://www.medicalnewstoday.com/articles/is-there-a-link-between-your-blood-type-and-risk-of-stroke. Published 2022.

[2] Bailey E. Blood Type Linked to Risk of Stroke Before Age 60. Healthline.

[3] What Is A Universal Blood Type?. Redcrossblood.org.

[4] Conditions H, Risk S, Haase M. This Blood Type May Mean You’re at a Higher Risk of Early Stroke, New Study Finds. Prevention.

[5] Norris J. Type A vs. O: Does blood type influence stroke risk?. Medicalnewstoday.com.

[6] Solis-Moriera J. Your Blood Type May Influence Your Stroke Risk, Study Shows. Health.Published 2022.

[7] CDC.

A. JABBAR DENTAL CLINIC

Sadia Khan

Is Your Blood Glucose Normal?

Risk factors aside, diabetes really can affect anyone at any age. This is why there is an urgent need to understand normal blood sugar levels for individuals of all age groups, especially children, adults, and pregnant women. Only then will you be in a position to grasp why deviations of any sort can be problematic. 
&nbsp;

Understanding Normal Blood Sugar Level

Your blood sugar level is basically a measure of the glucose concentration in your body. But what is this elusive &ldquo;normal&rdquo; range?<a href="#accordion">[1]</a>

<ul>
	<li>The normal fasting blood glucose is between 70 mg/dL and 100 mg/dL.</li>
	<li>A normal postprandial (random) blood sugar level is less than 140 mg/dL. 
	&nbsp;</li>
</ul>

However, these values may vary slightly depending on the specific demographic group.<a href="#accordion">[6][7]</a>

<ul>
	<li>For children under 6 years old, this range is 100-180 mg/dL before meals.</li>
	<li>For children aged 6-12 years old, the range is 90-180 mg/dL.</li>
	<li>For children aged 13-19, the range is 90-130 mg/dL.</li>
	<li>According to research, it takes 15-20 minutes longer to reach peak postprandial blood glucose levels compared to non-pregnant women.</li>
</ul>

The American Diabetes Association recommendations during pregnancy are 95 mg/dL or less (fasting) and 120 mg/dL or less (random). 
&nbsp;

Monitoring blood sugar levels is crucial for several reasons.

<ul>
	<li>It allows for the early detection of abnormal glucose levels, enabling timely intervention to prevent complications, such as hypoglycemia and hyperglycemia, which can have serious health implications.</li>
	<li>It helps maintain these levels in children to support their growth and development.</li>
	<li>A significant percentage of adult patients with type 2 diabetes mellitus have poorly controlled blood glucose levels.<a href="#accordion">[4]</a>Therefore, monitoring helps make informed decisions about physical activity, food, and medications to meet glucose targets.</li>
	<li>For pregnant women, the prevalence of self-monitoring of blood glucose (SMBG) is reportedly 70.8%.<a href="#accordion">[5]</a></li>
</ul>

This is because gestational diabetes mellitus (GDM) poses specific challenges, including an increased likelihood of spontaneous abortions.<a href="#accordion">[3]</a> Furthermore, high uric acid levels are prevalent in pregnant women, particularly in the third trimester.<a href="#accordion">[2]</a> 
&nbsp;

Maintaining normal blood sugar levels is crucial for individuals across all demographics, especially children and pregnant women. 
&nbsp;

Key Takeaways

<ul>
	<li>Regular monitoring of blood sugar levels is essential for your overall health and well-being.</li>
	<li>The normal fasting blood glucose is between 70 mg/dL and 100 mg/dL.</li>
	<li>A normal postprandial (random) blood sugar level is less than 140 mg/dL. </li>
</ul>

[1] (2019). Relation between katsaridaphobia and blood glucose level. Journal of Clinical & Experimental Immunology, 4(1).

[2] Haribaik, A., Bekti, H., & Posmaningsih, D. (2022). Uric acid levels in pregnant women. Muhammadiyah Medical Journal, 3(2), 53.

[3] Kanwal, A., Salam, A., & Bashir, A. (2021). Spontaneous abortions and gestational diabetes mellitus- a study from pakistan. Journal of Shalamar Medical & Dental College - JSHMDC, 2(2), 58-63.

[4] Mamo, Y., Bekele, F., Nigussie, T., & Zewudie, A. (2019). Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in jimma university medical center, jimma zone, south west ethiopia: a case control study. BMC Endocrine Disorders, 19(1).

[5] Mansouri, D., Alawi, H., Barasyn, K., Bnnounh, M., Haddad, N., Al-Hafdey, D., … & Khayat, E. (2015). Self-monitoring of blood glucose among diabetic patients attending al-eskan primary health care center in makkah al-mukarramah city. International Journal of Medical Science and Public Health, 4(4), 527

[6] Nigam, A., Varun, N., Sharma, S., Munjal, Y., & Prakash, A. (2019). Glycaemic profile in the second and third trimesters of normal pregnancy compared to non-pregnant adult females. Obstetric Medicine, 13(1), 30-36.

[7] Managing your blood sugar: Medlineplus medical encyclopedia. MedlinePlus.

Staff Writer

Iqra Mazhar

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

A Short, Bloody Story About Long COVID

The first case of <a href="https://www.merisehat.pk/disease/covid-19">COVID-19</a> came forward in November of 2019. However, it wasn&rsquo;t until March 2020 that the World Health Organization (WHO) declared the outbreak a pandemic.

&nbsp;

Over the past year, several people have begun travelling to countries across Europe. Considering the recent ease in lockdown measures and international travel restrictions, this may not come as a surprise to many people. But what&rsquo;s surprising is the fact that thousands of them are spending all their life savings on these European destinations. Do they need a vacation that badly? Or are they in search of something bigger?&nbsp;

According to a BMJ study, thousands of patients with long COVID are traveling to Switzerland, Cyprus, and Germany for &lsquo;blood washing&rsquo;<a href="#accordion">[1]</a>. While this may sound like a satanic ritual, it&rsquo;s an experimental treatment being offered across private clinics in these countries. Patients report spending &euro;15,000 to &euro;40,000 on the treatment, just for a slight relief of their debilitating symptoms<a href="#accordion">[1]</a>. Although there is a lack of research on blood washing for treating <a href="https://www.merisehat.pk/disease/covid-19">COVID-19</a>, long COVID sufferers are desperate. After having their symptoms dismissed by several healthcare professionals, and trying every treatment in the book, they are willing to try anything.&nbsp;

This makes us wonder: how bad could long COVID possibly be that people are willing to travel to far-off locations for an unproven &lsquo;blood washing&rsquo; treatment?

Throughout the pandemic, researchers have discovered significant information on the virulence, transmission, and mechanism of the novel coronavirus (SARS-CoV-2). Thus, with time, COVID-19 has evolved from a respiratory illness to one with multi-system effects. While many of our questions regarding the novel coronavirus and COVID-19 have been answered, several things remain a mystery. One such mystery is long COVID.&nbsp;

&nbsp;

Understanding Long COVID

The first case of COVID-19 came forward in November of 2019. However, it wasn&rsquo;t until March 2020 that the World Health Organization (WHO) declared the outbreak a pandemic<a href="#accordion">[2]</a>. As of 29th July &lsquo;22, the world has recorded more than 57 million COVID-19 infections and 6.3 million deaths<a href="#accordion">[3]</a>.

Typically, a mild or moderate coronavirus infection lasts two weeks. However, in some individuals, the symptoms can persist for months after, or return after recovery. This is called long COVID.&nbsp;

Over the years, researchers have referred to the condition by several names: long-haul COVID, chronic COVID, post-acute COVID-19, long-term effects of COVID-19, and post-acute sequelae of SARS CoV-2 infection (PASC). According to WHO, long COVID develops in people with a history of probable or confirmed coronavirus infection, typically 3 months from the onset of COVID-19<a href="#accordion">[4]</a>. The symptoms last for at least 2 months and cannot be explained by some other illness.&nbsp;

Approximately 10-20% of COVID-19 patients go on to develop long COVID<a href="#accordion">[4]</a>. As per a Lancet study, 1.5% of the UK&rsquo;s population had self-reported long COVID in July 2021<a href="#accordion">[5]</a>. Moreover, the greatest prevalence was reported among people aged 35-69 years. In contrast, the prevalence of long COVID in South-East Asia largely remains unknown; likely due to a limited number of studies. One study in India reported long COVID in 29.2% of patients; another from Pakistan found residual symptoms in 83.7% of patients, even a month after COVID<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

These symptoms are often debilitating and affect one&rsquo;s overall quality of life. The WHO has issued a list of 33 symptoms of long COVID<a href="#accordion">[4]</a>. The most common symptoms are:

<ul>
	<li>Fatigue</li>
	<li>Shortness of breath</li>
	<li>Brain fog&nbsp;or difficulty concentrating</li>
	<li>Headache</li>
	<li>Altered smell or taste</li>
	<li>Sleep disturbances</li>
	<li>Heart palpitations</li>
	<li>Joint or muscle pain</li>
	<li>Menstrual irregularities</li>
	<li>Abdominal pain</li>
	<li>Diarrhea</li>
</ul>

&nbsp;

According to a survey conducted in Pakistan, body aches, low mood, and cough were the most common residual symptom among COVID-19 survivors<a href="#accordion">[7]</a>. Recently, researchers at the University of Birmingham analyzed health records of COVID-positive people in the UK<a href="#accordion">[8]</a>. The study aimed to determine symptoms most commonly present in non-hospitalized patients, 12 weeks after infection. As per the results, loss of smell, hair loss, sneezing, ejaculation difficulties, and reduced libido were the most common long COVID symptoms among the study participants<a href="#accordion">[8]</a>.&nbsp;

But that&rsquo;s not all. Long COVID is also associated with long-term psychological manifestations. A preprint study, analyzing long-term trajectories of psychological symptoms over 22 months of follow-up, reported heightened depressive symptoms and anxiety levels among long COVID patients<a href="#accordion">[9]</a>. Thus, highlighting the importance of mental health monitoring and support for such patients.&nbsp;

&nbsp;

Regardless of whether you have a mild or severe infection, you may be at risk of long COVID. The exact cause behind why the condition develops in some and spares others remains unknown. Moreover, the symptoms and their severity also vary from person to person.&nbsp;

Researchers have proposed various theories regarding the cause of long COVID. While multiple studies are currently underway, the following factors may increase one&rsquo;s risk[10]:

<ul>
	<li>Severe COVID-19 infection</li>
	<li>Underlying health conditions</li>
	<li>Unvaccinated individuals</li>
	<li>COVID-19 re-infection</li>
	<li>Presence of neurological symptoms during acute COVID infection</li>
	<li>Hospitalization or ICU admission during infection</li>
</ul>

However, several cases of long COVID have emerged among healthy individuals without any of the above factors. Therefore, further research is required to gain a deeper understanding of the condition.

&nbsp;

<h4>"COVID infections can lower oxygen saturation. Check out your oxygen levels with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!"</h4>

Researchers hypothesize that the presence of neurological symptoms in long COVID patients points to nerve fiber damage. Therefore, assessing for small nerve fiber damage in the cornea can likely help identify patients with the conditions<a href="#accordion">[11]</a>. However, currently, there is no test to diagnose long COVID in suspected individuals. Moreover, the varying symptoms make it difficult for doctors to correctly diagnose patients.&nbsp;

&nbsp;

&lsquo;Blood washing&rsquo;, also called apheresis, is the process of filtering out individual components of the blood with the help of a machine. It has been used to treat diseases such as sickle cell anemia and leukemia. The procedure involves removing blood through a needle from one arm, passing it through a filtration system, and then returning the filtered blood through a needle into another arm.&nbsp;

In long COVID, doctors use apheresis to remove lipids and inflammatory proteins from the person&rsquo;s blood. Researchers hypothesize that microscopic blood clots, also called micro clots, are to blame for the clogging of capillaries, which then reduces the oxygen supply and leads to long COVID symptoms<a href="#accordion">[1]</a>. Therefore, they propose the removal of inflammatory proteins from the person&rsquo;s blood. Moreover, patients are prescribed blood thinners or anticoagulants along with blood washing. However, the procedure is yet to be proven effective for the condition.&nbsp;

While some people have reported an improvement in symptoms, many have seen no difference. Nevertheless, without any clinical trials, one cannot properly evaluate the procedure&rsquo;s risks and benefits.&nbsp;

&nbsp;

While there is no treatment for long COVID, several prevention strategies can help prevent infections and ultimately post-COVID symptoms. The following is the best way to protect yourself:<ul><li>Wear a mask in crowded areas, especially in indoor settings</li><li>Wash your hands with soap and water</li><li>Cough or sneeze in your elbow</li><li>Get vaccinated against COVID-19</li><li>Avoid close contact with someone experiencing symptoms of COVID-19</li></ul>

Although the novel coronavirus is given a bad name for causing long-term complications, it is not alone. Several other infectious diseases can also have post-infectious sequelae e.g. Epstein-Barr virus (EBV), Lyme disease, Giardia lamblia, and several viral infections. The post-infection sequel in these diseases can result in fatigue, cognitive dysfunction, muscle pain, mood disorders, and neurological symptoms. Furthermore, chronic fatigue syndrome commonly follows viral infections.&nbsp;It is important to acknowledge any new symptoms that may occur after an acute COVID infection, and not dismiss them as a ‘thing in our head’. Moreover, since long COVID can affect anyone irrespective of their health status, it is important to remain cautious of catching the infection. Thus, continue practicing social distancing, wearing a mask, washing your hands, and staying up to date with your COVID-19 vaccines.&nbsp;

<ul>
	<li>Long COVID is defined as the persistence of symptoms in a person with a history of COVID-19, usually 3 months from the onset of the infection. Moreover, the symptoms last for at least 2 months and cannot be explained by any other diagnosis.&nbsp;</li>
	<li>The WHO has a list of 33 symptoms of long COVID. Fatigue, shortness of breath, joint or muscle pain, sleep disturbances, brain fog, hair loss, altered taste or smell, and mental health disorders are the common symptoms of long COVID.&nbsp;</li>
	<li>Researchers hypothesize that certain factors may increase the risk of long COVID. These include severe acute COVID infection, underlying health conditions, unvaccinated status, ICU admission, and repeated COVID infections. However, these factors do not explain why long COVID continues to affect people with mild infections or without any of the mentioned factors.</li>
	<li>Due to a lack of available treatments, many long COVID patients have turned to various unproven treatment procedures such as &lsquo;blood washing&rsquo;, or apheresis.&nbsp;</li>
</ul>

&nbsp;

[1] Davies M. Long covid patients travel abroad for expensive and experimental “blood washing” BMJ 2022; 378 :o1671 doi:10.1136/bmj.o1671

[2] Cucinotta, D., & Vanelli, M. (2020). WHO Declares COVID-19 a Pandemic. Acta bio-medica : Atenei Parmensis, 91(1), 157–160.

[3] World Health Organization. (n.d.). WHO Coronavirus (COVID-19) Dashboard. WHO Health Emergency Dashboard.

[4] World Health Organization. (2021, October 6). A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. WHO | World Health Organization.

[5] The Lancet. (2021). Understanding long covid: A Modern Medical Challenge. The Lancet, 398(10302), 725.

[6] BMJ 2022;377:e069676

[7] Qamar, M. A., Martins, R. S., Dhillon, R. A., Tharwani, A., Irfan, O., Suriya, Q. F., Rizwan, W., Khan, J. A., & Zubairi, A. (2022). Residual symptoms and the quality of life in individuals recovered from COVID-19 infection: A survey from Pakistan. Annals of medicine and surgery (2012), 75, 103361.

[8] Subramanian, A., Nirantharakumar, K., Hughes, S. et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med (2022).

[9] Fancourt, D., Steptoe, A., & Bu, F. (2022). Long-term psychological consequences of Long Covid: A propensity score matching analysis comparing trajectories of depression and anxiety symptoms before and after contracting long covid vs short covid.

[10] CDC. (2022, July 11). Long COVID or Post-COVID Conditions - Long COVID or Post-COVID Conditions. CDC.

[11] Bitirgen G, Korkmaz C, Zamani A, et al. Corneal confocal microscopy identifies corneal nerve fibre loss and increased dendritic cells in patients with long COVID. British Journal of Ophthalmology Published Online First: 26 July 2021.

Nimrah H. Sattar

Are Blood Pressure Fluctuations Putting Your Health At Risk?

Blood pressure is a vital indicator of heart health. Normal blood pressure fluctuates throughout the day due to various factors, However significant fluctuations can be a cause for concern and may indicate underlying health issues.

Understanding Risks Of Labile Hypertension

Nearly 15% of adults in Canada reportedly have labile hypertension, with the condition being more common in menopausal women and men over 60.<a href="#accordion">[1]</a>

However, it often goes underdiagnosed, possibly due to similar conditions like white coat hypertension, paroxysmal hypertension, and masked hypertension. <a href="#accordion">[2]</a>

This can be dangerous, especially because frequent fluctuations stress the cardiovascular system and cause long-term damage. 
&nbsp;

Variations in blood pressure within a specific range are typically normal. Activities such as exercise, stress, and sleep can cause blood pressure to fluctuate. These normal variations are unique to each individual. However, large variations may require immediate medical attention.<a href="#accordion">[3]</a> 
&nbsp;

There can be several reasons why a reading of your blood pressure goes up and down within minutes:

<ul>
	<li>Physical activity</li>
	<li>Emotional stress or anxiety&nbsp;</li>
	<li>Dietary factors, like high salt intake, caffeine, or dehydration&nbsp;</li>
	<li>Medications, such as NSAIDs, oral steroids, oral contraceptives, and stimulants for ADHD 
	&nbsp;</li>
</ul>

Sudden blood pressure changes can result from:

<ul>
	<li>Problems with the autonomic nervous system</li>
	<li>Cardiovascular conditions like arrhythmias&nbsp;</li>
	<li>Hormonal imbalances</li>
	<li>Medication side effects 
	&nbsp;</li>
</ul>

You should be concerned if you experience symptoms such as dizziness, fainting, headaches, chest pain, blurry vision, or shortness of breath, along with fluctuating blood pressure.&nbsp;

Some people ignore symptoms due to:

<ul>
	<li>Myths And Misconceptions-&nbsp;Belief that only consistent high blood pressure is dangerous or that these symptoms are due to stress or normal aging</li>
	<li>Lack Of Awareness-&nbsp;Not knowing that fluctuating blood pressure can be harmful</li>
	<li>Symptoms Overlap-&nbsp;Mistaking signs for other health issues, like anxiety</li>
	<li>Transient Nature-&nbsp;Symptoms may come and go, leading to underestimation</li>
	<li>Self-Diagnosis-&nbsp;Assuming fluctuations are normal without consulting a doctor</li>
	<li>Infrequent Monitoring-&nbsp;Not regularly checking blood pressure to notice variations</li>
</ul>

It&#39;s crucial to recognize these symptoms and understand the risks associated with fluctuating blood pressure, ensuring timely medical consultation.

Consistently large fluctuations, even without symptoms, should also be evaluated by a healthcare professional. 
&nbsp;

Managing labile hypertension often involves:

<ul>
	<li>Lifestyle changes</li>
	<li>Medication, such as diuretics, anti-anxiety medications, beta-blockers, or SSRIs</li>
	<li>Regular blood pressure monitoring to track fluctuations</li>
</ul>

If left untreated, individuals are at increased risk of:

<ul>
	<li>Heart attacks and heart failure</li>
	<li>Stroke</li>
	<li>Impaired kidney function 
	&nbsp;</li>
</ul>

Significant and frequent changes in blood pressure can be indicative of underlying health issues. Monitoring blood pressure, understanding the causes of fluctuations, and seeking medical advice when necessary can help manage and mitigate the risks associated with blood pressure variability. If you suspect you have labile hypertension, it is important to consult with a healthcare provider to develop an appropriate treatment plan.

&nbsp;

<ul>
	<li>Blood pressure variation throughout the day is normal.</li>
	<li>Labile hypertension, which is characterized by fluctuations between normal and high readings, can be dangerous.</li>
	<li>Diet, medications, physical activity, and stress medications can cause quick blood pressure changes.</li>
	<li>Symptoms like dizziness, chest pain, and headaches should be checked by a doctor.</li>
	<li>Fluctuating blood pressure can lead to heart disease, stroke, and kidney damage.</li>
	<li>Treatment often involves lifestyle changes, medication, and regular monitoring.</li>
</ul>

[1] M A. Labile hypertension: Causes, treatment, and more. SRx Health. January 2, 2023.

[2] Labile hypertension: Definition, causes, symptoms, treatment, and more. Medical News Today.

[3] Craig O. Weber M. Discover if it’s normal for your blood pressure to fluctuate. Verywell Health. May 3, 2024.

7 Common Blood Pressure Mistakes And How To Fix Them For Accurate Readings

Measuring blood pressure at home is a convenient and effective way to monitor your cardiovascular health. However, many people make common mistakes that can lead to inaccurate readings.

Understanding Blood Pressure Mistakes

<ol>
	<li style="list-style-type:decimal">
	<h5>Incorrect Cuff Size</h5>
	</li>
</ol>

If a cuff is too large or too small, it can lead to inaccurate readings.&nbsp;

Fix: A study found that using the wrong cuff size can lead to significant inaccuracies in blood pressure readings.<a href="#accordion">[1]</a> Make sure the cuff fits snugly around your arm without being too tight. Measure the circumference of your upper arm and choose a cuff that matches the size. Most blood pressure monitors come with guidelines on selecting the right cuff size. 
&nbsp;

<ol start="2">
	<li>
	<h5>Improper Arm Position</h5>
	</li>
</ol>

Holding the arm too high or too low during measurement can result in false readings.

Fix: The American Heart Association (AHA) emphasizes the importance of keeping the arm at heart level to ensure accurate readings.<a href="#accordion">[2]</a> You can rest the arm on a table or use a pillow for support. 
&nbsp;

<ol start="3">
	<li>
	<h5>Measuring Over Clothes</h5>
	</li>
</ol>

Clothing can interfere with the accuracy of the readings.

Fix: Always place the cuff on bare skin. Roll up your sleeve or remove any clothing that covers your upper arm. 
&nbsp;

<ol start="4">
	<li>
	<h5>Talking Or Moving</h5>
	</li>
</ol>

Talking, moving, or being restless can affect the reading.

Fix: A study found that talking can increase systolic blood pressure by 10 mmHg.<a href="#accordion">[3]</a> Sit still and remain quiet during the measurement. 
&nbsp;

<ol start="5">
	<li>
	<h5>Not Resting Before Measurement</h5>
	</li>
</ol>

Taking a blood pressure reading without resting can lead to elevated readings.

Fix: The European Society of Hypertension recommends resting before measurements to avoid transient increases in blood pressure. Rest for at least 5 minutes in a quiet environment before measuring the blood pressure.<a href="#accordion">[4]</a> Avoid caffeine, exercise, and smoking for 30 minutes before taking a reading.<a href="#accordion">[5]</a> 
&nbsp;

<ol start="6">
	<li>
	<h5>Taking Only One Reading</h5>
	</li>
</ol>

Relying on a single blood pressure reading can provide an inaccurate assessment of the blood pressure.

Fix: The AHA suggests averaging multiple readings to get a more accurate measure of blood pressure. Take 2-3 readings, 1 minute apart, and record the average.<a href="#accordion">[6]</a> This approach helps to account for variability and provides a more accurate picture of the blood pressure. 
&nbsp;

<ol start="7">
	<li>
	<h5>Using The Wrong Device</h5>
	</li>
</ol>

Using an outdated or inaccurate blood pressure monitor can result in unreliable readings.

Fix: Use a validated, calibrated digital blood pressure monitor.<a href="#accordion">[6]</a> Ensure that the device is regularly checked and maintained for accuracy. One study highlights that digital monitors are reliable and user-friendly, making them ideal for home use. 
&nbsp;

<ul>
	<li>Accurate blood pressure measurement is essential for effective monitoring and management of hypertension.&nbsp;</li>
	<li>Avoiding these common mistakes and following proper techniques can ensure reliable readings at home.&nbsp;</li>
	<li>Always consult a healthcare provider for the best practices for managing and monitoring blood pressure.</li>
</ul>

[1] When it comes to accurate blood pressure readings, cuff size matters. www.heart.org. January 24, 2023. Accessed July 17, 2024.

[2] Steps for accurate BP measurement. Accessed July 17, 2024.

[3] Rehman S, Hashmi MF. Blood Pressure Measurement. [Updated 2022 Dec 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan

[4] Mahe G, Comets E, Nouni A, et al. A minimal resting time of 25 min is needed before measuring stabilized blood pressure in subjects addressed for vascular investigations. Sci Rep. 2017;7(1):12893. Published 2017 Oct 10. doi:10.1038/s41598-017-12775-9

[5] Measure your blood pressure. Centers for Disease Control and Prevention. Accessed July 17, 2024.

[6] Monitoring your blood pressure at home. www.heart.org. May 24, 2024. Accessed July 17, 2024.

Why You Might Need Your Blood Pressure Taken In The Leg

This method is typically reserved for specific medical conditions, such as peripheral artery disease (PAD), lymphedema, and aortic coarctation, or for individuals with certain injuries, burns, multiple IV lines, or those who have undergone surgeries like mastectomy or arm amputations.&nbsp;

It may also be preferred in scenarios where arm measurements are not feasible or accurate. 
&nbsp;

Understanding Leg Blood Pressure Measurements

While it is possible to measure blood pressure at home with the correct equipment, it is generally recommended to have it done in a clinical setting for several reasons:

<ul>
	<li>Accuracy-&nbsp;Healthcare professionals are trained to ensure proper technique and interpretation of the readings</li>
	<li>Special Equipment-&nbsp;Most home blood pressure monitors are designed for arm use; leg BP measurements require a larger cuff and sometimes specific settings</li>
	<li>Monitoring Conditions-&nbsp;Conditions like PAD or aortic coarctation require professional evaluation and ongoing monitoring</li>
</ul>

When measuring blood pressure in the leg, it&#39;s crucial to account for factors that can influence readings. Temperature, stress levels, and recent physical activity can all impact blood pressure readings, potentially leading to inaccurate results.&nbsp;

For instance, several studies show that temperature variations could significantly affect blood pressure measurements, necessitating controlled environments for consistency. Ensuring the person is calm and has been resting for at least 5 minutes before taking the measurement can help improve accuracy.<a href="#accordion">[1]</a><a href="#accordion">[2]</a>

Note: It&rsquo;s best to check the blood pressure at the same time every day. Keep a log and discuss it with the healthcare professional at every visit.&nbsp; 
&nbsp;

A sphygmomanometer or an automatic blood pressure monitor with a leg cuff setting is mostly used to measure blood pressure in the leg.&nbsp; 
Make sure:<a href="#accordion">[4]</a>

<ul>
	<li>The blood pressure cuff is appropriately sized for the thigh.</li>
	<li>The person is lying down on their back. They should be relaxed, with the leg slightly bent at the knee and the thigh properly supported.</li>
	<li>The cuff is placed around the thigh, about the midpoint between the hip and knee, and is snug but not too tight.</li>
	<li>Find the popliteal artery pulse at the back of the knee. This is where the stethoscope will be placed in case of a manual sphygmomanometer.</li>
	<li>Inflate the cuff until the pulse can no longer be heard or felt, then slowly release the pressure. For manual measurement, use the stethoscope to listen for the return of the pulse as the cuff deflates.</li>
	<li>The first sound heard is the systolic BP, and the point where the sound disappears is the diastolic BP. 
	&nbsp;</li>
</ul>

To measure BP at the ankle:<a href="#accordion">[4]</a>

<ul>
	<li>Use an appropriately sized cuff for the ankle.</li>
	<li>Place the cuff just above the malleolus (the bony prominence on each side of the ankle).</li>
	<li>Locate the posterior tibial artery or dorsalis pedis artery using palpation.</li>
	<li>Inflate the cuff until the pulse can no longer be felt, then slowly release the pressure.</li>
	<li>Record the systolic and diastolic BP as described for the thigh method. 
	&nbsp;</li>
</ul>

It&rsquo;s also important to first determine the best site for BP measurement.

<ul>
	<li>Avoid leg measurements if there is an underlying condition or infection, trauma, or a bulky bandage covering the leg.&nbsp;</li>
	<li>It is recommended to rotate the BP sites in the elderly more frequently compared to pediatrics or even young adults because their skin is more fragile and, therefore, can be damaged more easily. 
	&nbsp;</li>
</ul>

In some cases, ABI is used alongside leg BP measurements to assess peripheral artery disease. ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure at the arm. A low ABI can indicate blockages or narrowing in the arteries, which is crucial for diagnosing PAD. 
&nbsp;

While the normal blood pressure range for arm measurements is typically less than 120/80 mmHg, leg BP measurements can vary slightly.&nbsp;

Typically, systolic BP in the leg is 10-40 mmHg higher than in the arm due to the larger muscle mass and artery size. Diastolic BP remains relatively similar. Based on the NICE threshold for BP in the arm, the normal range would be 155/90 mmHg.<a href="#accordion">[3]</a>

Any significant deviations from these ranges should be discussed with a healthcare provider to rule out vascular issues. 
&nbsp;

Leg BP measurements are not typically part of routine checks unless specific conditions warrant it. Regular monitoring is essential for those diagnosed with conditions affecting leg arteries. 
&nbsp;

Always consult with a healthcare provider before attempting to measure leg BP at home.&nbsp;

Symptoms like occipital headache, fatigue, nosebleeds, and facial flushing indicate a risk of hypertension.&nbsp;

On the other hand, mental confusion, dizziness, restlessness, cool or mottled skin over extremities, and pale or dusky mucous membranes mean a risk of low BP.<a href="#accordion">[4]</a> 
&nbsp;

While leg BP measurements are less common, they are crucial for diagnosing and managing certain medical conditions. Proper technique and equipment are essential for accurate readings, and it is usually best to have these measurements done in a clinical setting. 
&nbsp;

<ul>
	<li>Indications for leg BP measurements include peripheral artery disease (PAD), lymphedema, aortic coarctation, injuries, burns, and surgeries like mastectomy.</li>
	<li>Home measurement is possible but generally not recommended.</li>
	<li>Properly using a blood pressure monitor and following recommended techniques are key to controlling blood pressure effectively.</li>
	<li>Understanding the normal blood pressure range and being aware of high blood pressure symptoms are crucial for effective monitoring.</li>
	<li>Always consult your doctor for guidance.</li>
</ul>

[1] The influence of the ambient temperature on blood pressure and how it will affect the epidemiology of hypertension in Asia - Park - 2020 - the journal of clinical hypertension - wiley online library. Accessed July 17, 2024.

[2] How to accurately measure blood pressure at home. www.heart.org. January 24, 2023. Accessed July 17, 2024.

[3] E040749.full.pdf. Arm Based on LEg blood pressures (ABLE-BP). Accessed July 17, 2024.

[4] Blood pressure: Auscultation of lower extremity (ambulatory). Blood Pressure: Auscultation of Lower Extremity (Ambulatory). Accessed July 17, 2024.

High blood pressure, or hypertension, is a common health issue that affects around 1.28 billion people worldwide. It is often referred to as the &quot;silent killer&quot; because it can cause serious health problems, including heart disease, kidney failure, and stroke, without obvious symptoms.<a href="#accordion">[1]</a>

While medications and lifestyle changes are standard treatments, laughter therapy, quite surprisingly, is gaining attention as one of the natural ways to lower blood pressure.

Several studies demonstrate the long-term benefits of laughter therapy for blood pressure, for e.g. participants who engaged in regular laughter exercises had sustained reductions in their blood pressure levels over several months and could be&nbsp; a useful complementary treatment for hypertension.<a href="#accordion">[2]</a> 
&nbsp;

Understanding benefits of laughter therapy

This therapy can include watching funny movies, participating in laughter <a href="https://merisehat.pk/article/yoga-a-life-changing-approach">yoga</a>, attending humor workshops, or simply engaging in activities that make you laugh. The premise is simple: laughter can have a positive impact on your physical and mental health. 
&nbsp;

Laughter therapy works by triggering several physiological changes in your body:<a href="#accordion">[3]</a> 
&nbsp;

<ul>
	<li>
	<h5>Release Of Endorphins</h5>
	</li>
</ul>

Endorphins are the body&rsquo;s natural feel-good chemicals. They promote a sense of general well-being and can provide temporary pain relief. 
&nbsp;

<ul>
	<li>
	<h5>Reduction Of Stress Hormones</h5>
	</li>
</ul>

Stress hormones like cortisol and adrenaline can lead to stress and anxiety. 
&nbsp;

<ul>
	<li>
	<h5>Improved Blood Circulation</h5>
	</li>
</ul>

A healthy blood flow can help protect against heart attacks and other cardiovascular problems. According to a study, laughter expands the inner lining of blood vessels, called the endothelium, which increases blood flow and reduces blood pressure.<a href="#accordion">[4]</a> 
&nbsp;

<ul>
	<li>
	<h5>Muscle Relaxation</h5>
	</li>
</ul>

The whole body feels relaxed for up to 45 minutes after laughing. 
&nbsp;

While laughter therapy should not replace traditional medical treatments, it can be a valuable complementary approach to managing hypertension. It can effectively reduce stress and potentially lower your blood pressure. So, go ahead and find something that makes you laugh &ndash; it&#39;s good for your heart! 
&nbsp;

<ul>
	<li>Laughter therapy involves laughter to promote overall health and well-being.</li>
	<li>It can include activities like watching funny movies, participating in laughter yoga, or attending humor workshops.</li>
	<li>Laughter is one of the most effective stress management techniques; it decreases stress and anxiety while improving mental well-being and mood.</li>
	<li>Laughter therapy can help lower blood pressure and can be used as a complementary approach alongside traditional medical treatments for managing high blood pressure.</li>
</ul>