AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

Anti-malarial drugs are good for the treatment of malaria but not Covid-19. The malaria parasite life cycle is different from the coronavirus. Read more at Meri Sehat.

Debunking Myths About COVID-19 & Anti-Malarial Drugs

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

Madeeha Syed

What Anti-Vaxxers Get Wrong About the Polio Vaccine

Overview

Polio is a thing of the past, right? You don&rsquo;t see it much in the news anymore and it&rsquo;s not something we really have to worry about. Well, anti-vaxxers would like you to think that this is true. But it isn&rsquo;t. Polio still exists today and, if you&rsquo;re not vaccinated against it, you could get polio or spread it to someone else who might die from it. It&rsquo;s important for everyone not just parents with children to know how vaccines work and why they&rsquo;re safe.&nbsp;

<div>&nbsp;</div>

Anti-Vaxxers  About  Polio Vaccine

The anti-vaccine movement is growing increasingly popular, despite the fact that many of its arguments are based on erroneous historical facts. Here are just a few:

<ul>
	<li>Vaccines aren&rsquo;t effective</li>
	<li>They do not cause infertility</li>
	<li>No, your government is not injecting you with nanochips to track you</li>
	<li><a href="https://merisehat.pk/disease/autism" target="_blank">They cause autism</a></li>
	<li>They&rsquo;re not necessary because polio hasn&rsquo;t been around for decades now</li>
</ul>

&nbsp;

It&rsquo;s important to remember that, as we speak, polio is still a problem in many countries. In fact, the World Health Organisation still refers to it as an &ldquo;endemic&rdquo; disease. Since 1988 , when the UN certified that polio had been eradicated in every country on Earth, there have been only 21 cases of wild poliovirus found globally: 16 in Somalia and five in Pakistan (the last case on this list occurred just this past September).

But while anti-vaxxers are right that vaccines can&rsquo;t prevent all disease outbreaks, they&rsquo;re wrong about why we need them at all. Because the truth is this: vaccines aren&rsquo;t just useful for preventing one infectious illness, they&rsquo;re also useful for preventing other diseases from spreading by stopping people from getting sick with them too. That&rsquo;s why some people think of vaccines as a sort of &ldquo;immunity insurance&rdquo; against outbreaks rather than just something you need when you actually start showing symptoms of an illness like measles or mumps (which are both very contagious). 
&nbsp;

Thimerosal is a preservative that prevents the growth of harmful bacteria in vaccines. It has been used since the 1930s, and thimerosal-free vaccines have been available for several years. There is absolutely no scientific evidence that links thimerosal to any health problems. In fact, all credible studies have shown just the opposite. In fact, it&rsquo;s safe to use as a preservative in food items, too!

Although many anti-vaxxers will try to tell you otherwise, thimerosal isn&rsquo;t dangerous or toxic at all. It&rsquo;s just an additive used by doctors and manufacturers alike in order to make sure our vaccinations remain effective while they&#39;re being stored and transported around the world!

<div>&nbsp;</div>

It&rsquo;s important to note that the polio vaccine does not cause cancer. Nor does it cause autism, any other brain defect, autoimmune disease, or death. The idea that vaccines are some kind of hoax like climate change denialism or flat-Earth-ism is a conspiracy theory with no basis in reality. We know this because there is plenty of evidence to prove that vaccines work and are safe for children (and adults). 
&nbsp;

Vaccines Are Safe

Polio Vaccine Is Important, Polio Vaccine Is Safe: You may be thinking that anti-vaxxers are a bunch of crazy people, but there&rsquo;s actually a lot to like about them. They&rsquo;re confident in their beliefs and not afraid to stand up for what they believe in. They&rsquo;re also highly educated, which makes them more likely than others to be able to articulate their beliefs effectively.

What anti-vaxxers get wrong about polio vaccines is that it&rsquo;s not just one type of vaccine; it&#39;s two types: oral polio vaccine (OPV) and inactivated polio vaccine (IPV). The OPV is commonly used in Pakistan due to its ease of administration. The oral polio vaccine also eradicates the need for the presence of a healthcare professional and highly sterile equipment. This has allowed Pakistan to conduct vaccinations on a mass level. Whereas the IPV on the other hand, requires the presence of proper healthcare workers, sterile equipment and multiple doses. IPV is far more effective than OPV but since we are on a mission to completely eradicate polio from the face of earth, whatever vaccine you can get your hands on, works.&nbsp;

Many countries stopped using OPVs long ago because they discovered that although it could prevent children from getting paralysed by wild versions of poliovirus, these viruses would still circulate around the community throughout childhood &mdash; which meant other kids might get infected anyway! The risk/benefit ratio was no longer proportionate. 
&nbsp;

Bottom Line

I hope that this has helped to clear up some of the misconceptions about polio vaccines. It is important to note that the polio vaccine is not a one-size-fits-all approach, and there are many factors involved in deciding whether or not you should receive it. However, these arguments do not mean that anti-vaxxers are wrong about everything: they are right in their belief that public health decisions should be made on the basis of science rather than fear mongering.&nbsp;

Umna Salah

Online Consultation

Ismail Munir

Common Menstrual Myths In The Society

Introduction

If you belong to the latter group, then chances are that once you got over the dying part and gathered the courage to speak to a family member, they informed you of your body&#39;s natural function and likely a few additional pieces of information regarding menses. As per results from a recent study, only 28% of women in Karachi, Pakistan had adequate menstrual health knowledge prior to their first <a href="https://www.merisehat.pk/article/natural-remedies-to-help-regulate-your-periods">period</a>.<a href="#accordion">[1]</a> 
&nbsp;

Understanding Myths Associated With Menstruation

Almost 50% of Pakistan&#39;s population is composed of females.<a href="#accordion">[2]</a>&nbsp;Despite the high prevalence of females, awareness of women&#39;s health issues is limited. There is an unfortunate stigmatization of menstruation in low-income countries, for e.g., sanitary napkins are often sold in brown paper bags and menstrual concerns are not a widely discussed topic. This stigmatization of menstruation and lack of awareness leads to the spread of incorrect practices and knowledge among women. This could be a source of concern as these practices can later have harmful implications on the lives of women and girls.&nbsp;

Every woman has been likely exposed to several myths and superstitions pertaining to periods. The following article will help to shed light on some of these myths.&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>No Baths Allowed</h5>
	</li>
</ul>

A multi-center study conducted on menstrual hygiene practices among Pakistani girls reported that 39% of girls avoid bathing during menstruation.<a href="#accordion">[3]</a>The most common reason for avoiding taking a bath is that it can cause an irregular flow.<a href="#accordion">[1]</a>&nbsp;However, such practices can affect one&#39;s hygiene and predispose girls to reproductive tract infections. Moreover, research has pointed out that there is no link between irregular flow and bathing during menstruation. Instead, warm baths are often encouraged to help relieve painful menstrual cramps in women.<a href="#accordion">[4]</a>&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Don&#39;t Eat The Pickle</h5>
	</li>
</ul>

Cold water, pickles, eggs, and milk are just some of the food items various cultures advise against consuming during menstruation. Approximately 50% of Pakistani girls report avoiding &#39;cold foods&#39;(e.g., yogurt, ice cream) as they fear that it will stop their periods and increase the chances of blood clots.<a href="#accordion">[3]</a>&nbsp;Similarly, &#39; hot foods&#39; (e.g., liver, eggs, dry fruits) are also avoided for fear of menstrual irregularities. However, there is a lack of scientific evidence linking cold or hot food to menstrual cycle abnormalities.&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Avoid Exercising</h5>
	</li>
</ul>

Among the general population in Karachi, approximately 53% of women restrict physical activity during menstruation to avoid heavy periods.<a href="#accordion">[1]</a>&nbsp;Walking, sitting, and lifting weights are some of the commonly avoided physical activities among girls and women. However, research shows that aerobic exercise can be beneficial for painful menstrual cramps.<a href="#accordion">[5]</a> 
&nbsp;

Conclusion

In many low- and middle-income countries, periods are considered impure and a process of dirty or impure blood leaving the body. This is likely due to a lack of education regarding reproductive health. Young adolescent girls are often too shy or scared to discuss menstrual issues with their mothers. Moreover, a majority of adult women are also not aware of the physiology of menstruation or good hygiene practices. As a result, there is a high prevalence of misinformation among girls and women. Almost 70% of Pakistani university-going girls believe the source of bleeding in menstruation to be the vagina instead of the uterus.<a href="#accordion">[3]</a>

Therefore, there is a need for the introduction of regular menstrual education awareness programs in schools and universities. Furthermore, primary care physicians should be aware of the common myths and misconceptions regarding menstrual health in a population. Health education campaigns on a community level can ultimately help destigmatize reproductive health issues.&nbsp; 
&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>Menstruation is a natural phenomenon in a woman&#39;s life that is often stigmatized in various cultures.</li>
	<li>A lack of awareness has led to the development of various myths and practices regarding menstruation. The most common of which is avoidance of taking a bath during periods, not eating certain foods, and avoiding exercise.</li>
	<li>Community-based health education programs can help destigmatize menstruation and propagate correct information and practices among girls and women.</li>
</ul>

[1] Ali, S. A. et al., 2020. Perceptions, Practices, and Challenges Regarding Menstrual Hygiene Among Women in Karachi, Pakistan: A Comparison Between General Population and Healthcare Workers. Cureus, 12(8).

[2] Pakistan Bureau of Statistics, n.d. Census 2017. [Online].

[3] Mansoor, H. et al., 2020. Menstrual knowledge and practices of Pakistani girls: A multicenter, cross-sectional study. Heliyon, 6(1).

[4] Jo, J. & Lee, S. H., 2018. Heat therapy for primary dysmenorrhea: A systematic review and meta-analysis of its effects on pain relief and quality of life. Scientific Reports, Volume 8.

[5] Dehnavi, Z. M., Jafarnejad, F. & Kamali, Z., 2018. The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. Journal of Education and Health Promotion, 7(3).

Nimrah H. Sattar

Humza Khizer

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

14 Labor Induction Myths Debunked

There are a wide range of reasons why it might be essential to induce labor. Most frequently, it&rsquo;s because the delivery is overdue or there are some kinds of pregnancy problems. Despite the fact that in 2017, 43.1% of women expecting their first child had their labor induced, the process is still seen as an emergency intervention and hence requires understanding<a href="#accordion">[1]</a>.

&nbsp;

According to NHS Maternity Statistics, the rate of induction of labor in England has climbed from 21% (March 2010) to 34% (March 2021)<a href="#accordion">[2]</a>. Under the guidance of a skilled gynecologist, labor induction is a safe procedure.

&nbsp;

This article will shed light on various myths and pertinent facts about elective or natural labor.&nbsp; 
&nbsp;

Understanding Myths Surrounding Labor Induction

<h5>Myth #1: Acupuncture Helps Induce Labor</h5>

Fact: <a href="https://merisehat.pk/article/is-acupuncture-the-right-choice-for-you">Acupuncture</a> indeed has a noble past, and many individuals speak of its claimed advantages. Generally, acupuncture has no negative effects as long as it is administered by a trained professional who observes standard medical safety procedures. There isn&#39;t much information available, though, about this technique&#39;s efficacy in inducing labor. 
&nbsp;

<h5>Myth #2: Eating Spicy Food Induces Labor</h5>

Fact: Well, spicy food does not directly contribute to induction. It&rsquo;s an old wives&#39; tale &ndash; since spicy food triggers diarrhea or otherwise excites intestines, it might in turn result in uterine contractions.

&nbsp;

A word of caution is needed here: This isn&#39;t an authorized way to induce labor. It&#39;s not a good idea to induce diarrhea because it might lead to dehydration. There&rsquo;s also a possibility of having a severe case of heartburn. 
&nbsp;

<h5>Myth #3: Sex Induces Labor</h5>

Fact: Yes, in some circumstances, it might be helpful. Semen contains a minor quantity of prostaglandins, which are hormones that encourage cervical ripening. This coupled with female orgasms can bring on uterine contractions and the release of oxytocin, (sometimes referred to as the &quot;love hormone&quot;) during sex. However, experiencing a few contractions post sex doesn&#39;t mean it&rsquo;ll lead to regular contractions or a full-fledged labor.

&nbsp;

Moreover, several smaller studies suggest that having intercourse might not necessarily influence how quickly a pregnant woman goes into labor.

&nbsp;

A pregnant person may be hopeful that this strategy will succeed for a variety of reasons. However, it&#39;s vital to remember that not all pregnant women can have safe sex. If the doctor&rsquo;s advised against it and asked to maintain pelvic rest due to a placenta previa or another pregnancy problem, then the pregnant woman should refrain from having intercourse. 
&nbsp;

<h5>Myth #4: Walking or Exercising Induces Labor</h5>

Fact: This is not likely because walking has little effect on prostaglandin release. The idea behind walking is that gravity, balance changes, and movement can assist in lowering the baby into the pelvis and accelerating labor. However, while studies suggest that walking is an excellent form of exercise for expectant mothers, there is no evidence of its role in inducing labor.&nbsp;

&nbsp;

Regular walks help expecting mothers to feel good about themselves, assist them in getting the baby into the proper position for delivery, as well as enable them to develop strength for childbirth throughout their pregnancy (not just at the end!). Walking, or at the very least, staying upright whenever feasible, has been reported to speed up labor after it has begun. 
&nbsp;

<h5>Myth #5: Pineapple Induces Labor</h5>

Fact: NO. Pineapple contains a protein-breaking enzyme called bromelain, which makes it a crucial component of numerous meat tenderizers.

&nbsp;

Bromelain is thought to break down the tissue in the cervix and soften it in order to prepare for delivery. This is the reason why it&rsquo;s used in labor induction. However, there is no solid scientific proof for this hypothesis.

&nbsp;

Although bromelain may be effective on meat, the human body does not respond well to it. Additionally, pineapple may induce heartburn during pregnancy. 
&nbsp;

<h5>Myth #6: It&rsquo;s Better To Wait till 41+ Weeks Than Opt For Elective Induction</h5>

Fact: False. The recent guidelines by&nbsp; NICE (National Institute for Health Care and Excellence) states that there is an increasing body of evidence that pregnancies that reach, or pass, 41 weeks are associated with a small increase in the risk of stillbirth and perinatal death and that induction of labor reduces this risk<a href="#accordion">[3]</a>. 
&nbsp;

<h5>Myth #7: Nipple Stimulation Induces Labor</h5>

Fact: Nipple stimulation releases oxytocin, which might result in contractions, and anything that initiates labor would help, even when it is not directly related to dilatation.

&nbsp;

Before attempting nipple stimulation, always consult a doctor. When carrying a high-risk pregnancy, it should be avoided because prolonged and intense nipple stimulation can cause stress to the fetus.&nbsp;

&nbsp;

There are three options for nipple stimulation: manually, with a breast pump, or with a spouse. Just be careful not to overdo it; only massage one breast at a time for 5 minutes each. 
&nbsp;

<h5>Myth #8: Eating Dates Helps&nbsp;</h5>

Fact: Yes, frequent consumption of dates provides the body with a good amount of nourishment. Dates possess the hormone potuchin, which serves to bind the uterus and its muscles in an effort to lessen postpartum bleeding. And then, there is the hormone oxytocin, which can encourage uterine muscular contractions to speed up labor<a href="#accordion">[4]</a>. However, please exercise moderation when it comes to food consumption. Please consult your doctor to know the safe amount of dates to consume. 
&nbsp;

<h5>Myth #9: Castor Oil Induces Labor</h5>

Fact: No, and it&#39;s not advised. Castor oil can produce diarrhea and cramping in the intestines, which may make the uterus &quot;irritable&quot; . The cervix does not dilate as a result of these cramps, but these cramps can be exceedingly uncomfortable for the patients.

&nbsp;

Additionally, castor oil might induce feces release in an unborn child (meconium). Meconium can be consumed prior to birth when it combines with amniotic fluid. In rare cases, it might lead to pneumonia in the newborn. Please refrain from attempting castor oil! 
&nbsp;

<h5>Myth #10: Herbal Teas And Cohosh Induce Labor</h5>

Fact: It&#39;s untrue! Medical studies to support the safety of these products for mothers have not been conducted. Cohosh is one plant that contains phytoestrogens, which increases the risk of clotting in pregnant women and, therefore, should be avoided.

&nbsp;

Gamma-linolenic acid or GLA, which is a precursor to prostaglandins, is found in evening primrose oil. It is said to aid in &quot;ripening the cervix.&quot; Although there is no medical proof that it is effective, there is also no evidence that it is hazardous. However, it is best to avoid it.&nbsp;&nbsp; 
&nbsp;

<h5>Myth #11: A Second Labor Is Less Painful and Easy</h5>

Fact: It&#39;s true that successive labors tend to be shorter because the previous birth already stretched the cervix, pelvic floor muscles, and birth canal. But even if they last a shorter time, the discomfort is still there. 
&nbsp;

<h5>Myth #12: A C-Section Is Necessary In Case Of Twins</h5>

Fact: A vaginal birth is entirely conceivable if there are no problems; it&rsquo;s true despite the fact that more than half of all twin births in the UK occur via Cesarean. A vaginal birth ought to be achievable if the first twin is lying head-down. 
&nbsp;

<h5>Myth #13: Full Moon Helps Ease Labor Induction</h5>

Fact: According to an urban legend, more women have labor around full moons. There is absolutely no evidence to support the claim.&nbsp; Despite the absence of proof, many midwives still believe they will have a busy shift around the full moon! 
&nbsp;

<h5>Myth #14: Elective Induction Reduces Labor Time&nbsp;</h5>

Fact: The duration of labor varies from woman to woman and from pregnancy to pregnancy, but induced labor, which is started by using artificial hormones to trigger uterine contractions, can last for a few hours to a few days. It can take longer for first-time mothers or those less than 37 weeks pregnant. Before beginning the induction process, it is impossible to predict how the body will react to the medications being utilized. 
&nbsp;

Although it usually takes less time, labor induction can occasionally last 2-3 days. It takes longer if it's the first pregnancy. Eat very little -before visiting the hospital. Keep in mind that the medications used to induce labor may cause stomach discomfort and very severe contractions. Inform the doctor in case the pain is unbearable. Most of the time, a successful labor induction results in vaginal delivery. Don’t rely on myths. Just go along with the doctor's suggestions.

<ul><li>When the doctor administers medication or punctures the water to initiate labor, this process is referred to as inducing labor (also known as labor induction).</li><li>Only medical needs should justify inducing labor. The best course of action is to wait for labor to begin naturally if the pregnancy has been a healthy one.</li><li>Ask about delaying labor induction until at least 39 weeks if the doctor advises, so the baby has time to grow within the womb.</li><li>Never believe in myths without any medical research evidence.</li></ul>

[1] Can I. Induction of Labour.

[2] Wilkes E, Gamble J, Adam G, Creedy DK. Reforming maternity services in Australia: Outcomes of a private practice midwifery service. Midwifery. 2015;31(10):935–40.

[3] guideline NG207 N. Inducing labour. 2021;

[4] Kuswati K, Handayani R. Effect of Dates Consumption On Bleeding, Duration, And Types of Labor. J Midwifery. 2019;4(1):85–91.

Neelam Asad

Iqra Mazhar

Debunking Myths Of Kidney Stones

<a href="https://www.merisehat.pk/disease/kidney-stones-66">Kidney stones</a> are notorious for being one of the most painful and difficult ailments an individual can be diagnosed with. And they are becoming more prevalent. Today over half of all urology patients in Pakistan have a kidney stone and 3-5% of the population is at risk of developing a kidney stone at some point in their lives[1]. Diet, an abundance of body weight, and certain ailments and medications are among the leading reasons for kidney stones. From the kidneys to the bladder, any segment of the urinary tract can be hindered by renal stones. 
&nbsp;

Although a common occurrence, there are a ton of myths and misinterpretations surrounding kidney stones, their causes, and ways to prevent their formation. 
&nbsp;

Potential causes include drinking too little water, excessively working out, weight reduction surgery, obesity, or eating salty or sugary food. In certain individuals, diseases and family ancestry may also play a role. Moreover, consuming an excess of fructose (present in table sugar and high fructose corn syrup) corresponds to a growing chance of fostering a kidney stone<a href="#accordion">[2]</a>. 
&nbsp;

There are four main kinds of kidney stones: 
&nbsp;

<ul>
	<li>Calcium Stones: Calcium stones are the most common type of kidney stones<a href="#accordion">[3]</a>.&nbsp;Calcium oxalate stones are formed due to calcium mixing with the oxalate present in urine. Consuming oxalate-rich foods such as spinach, peanuts, and chocolates can increase one&rsquo;s risk of these stones. On the other hand, calcium phosphate stones are less prevalent than oxalate ones. They are typically caused by hyperparathyroidism, renal tubular acidosis, and urinary tract diseases<a href="#accordion">[4]</a>. 
	&nbsp;</li>
	<li>Uric Acid Stones: Uric acid stones are often associated with diabetes, body weight fluctuations, and several metabolic disorders. These stones are formed due to excessively acidic urine<a href="#accordion">[3]</a>. 
	&nbsp;</li>
	<li>Struvite Stones: The most well-known reason for struvite stones is urinary tract infections (UTIs) that lead to urine pH imbalances These stones can be significantly large and cause urinary obstruction<a href="#accordion">[3]</a>. 
	&nbsp;</li>
	<li>Cystine Stones: This is the least common type of kidney stone. It occurs in people with cystinuria, a genetic condition that results in increased levels of the amino acid cystine in the urine.&nbsp; 
	&nbsp;</li>
</ul>

&nbsp;

Understanding kidney stones and some common myths

Have you ever received unsolicited medical advice from a neighbour? A friend? Or maybe an aunt with no blood relation to you?&nbsp; Technically, anyone but a medical practitioner? Then you have stumbled upon the right page. If there is anything desis love more than chai it is reliance on pseudo-helpful home remedies and ancestral healing concoctions. And why should kidney stones be any different? Here, we have listed the top 5 myths about kidney stones, believing which would do you more harm than good: 
&nbsp;

<h5>1. Toss Out Dairy</h5>

It has been misconstrued that you need to opt for non-milk options and adapt to a dairy-free life as research suggests otherwise. The calcium in milk is essential for several bodily functions such as blood clotting, assisting muscular contractions, regulating healthy heart contractions and relaxations, nerve functioning, strong bones and teeth, and, most of all, preventing kidney stones<a href="#accordion">[5]</a>. 
&nbsp;

Many individuals dread calcium since calcium consumption has been linked to the formation of kidney stones, yet the reality of the situation could not be further from such a restrictive diet. If there is a possibility that your calcium intake is excessively low, you are in fact in danger of increasingly absorbing oxalate, a typical compound we eat in numerous food sources. Excessive retention of oxalate can prompt additional oxalate in your urine and that can give rise to calcium oxalate stones. 
&nbsp;

<h5>2. Like A Stomachache</h5>

We trace the origin of this myth to just a lack of knowledge of anatomy, where any region of the abdomen below the chest and above the legs has been coiled under the umbrella term stomach. While you will experience incredible levels of discomfort and sharp pain in your lower abdominal region, it will feel more like a spasm. At the point when you have spasms, your stomach muscles flex with incomparable force and intensity which causes serious pain. As the stone travels through the urinary tract, the pain might differ in levels of intensity. Kidney stones can cause a tightening of muscles, and for certain individuals, the stabbing sensation of pain is like that experienced in menstrual cramps. To rule out the dismissing excuse of a stomachache, keep an eye out for other symptoms of kidney stones, which include nausea, discomfort while urinating, and a pungent smell of urine<a href="#accordion">[5]</a>. 
&nbsp;

<h5>3. Kidney Stone Is Always Painful</h5>

Kidney stones are defined as hard sediments of minerals within the urinary tract that obstructs the path of urine, cause infection, and bring a mammoth of pain. However, they are not always bearers of pain, especially when they are in the initial stages of formation. Other symptoms might indicate the formation of a kidney stone such as blood while urinating, severe nausea, and uncontrollable vomiting. 
&nbsp;

A type of kidney stone termed &lsquo;Silent Stone&rsquo; fails to exhibit characteristic kidney stone symptoms and is diagnosed by an imaging test or a routine checkup. In Pakistan, the results of a study in a urology department found that 3% of all urology patients suffered from silent kidney stones<a href="#reference" target="_blank">1</a>. Therefore, routine visits to a GP are necessary to catch any unprecedented discovery and receive timely treatment before the development of any complications. 
&nbsp;

<h5>4. Cranberry Juice Is The Elixir Of All</h5>

Cranberry juice is a perfectly viable option and beverage for when you have a urinary tract infection or as a preventive measure to forestall one. It thickens and solidifies your urine, which drains the contaminated substances out and wards off the probability of having it again. However, if you have a kidney stone, it exacerbates the issue. Cranberry contains high measures of oxalate, which is a primary mineral found in kidney stones. Therefore, if you want to get rid of kidney stones, skip the cranberry juice. 
&nbsp;

With regards to halting kidney stones, lemon juice is a far better alternative to cranberry juice. Citrus refreshments have been associated with an increment of citrate levels in urine, which can limit and restrict stone development. Nonetheless, research shows the amount you drink has a lot more prominent effect than what you drink. You must hydrate yourself sufficiently with 100 ounces of liquids daily - anything that those liquids might be - to keep the kidneys flushed out and the abundance and prevalence of stone-forming salts lower. 
&nbsp;

<h5>5. Sodas Cause Kidney Stones</h5>

As an organization dedicated to garnering public attention towards medical illnesses, we feel obligated to suggest avoiding sodas and fizzy beverages as their high sugar and preservative concentrations can cause several complications. But, as morally honest fact bearers, we must admit that soft drinks are not the sole contributors to kidney stones. The truth of the matter is phosphoric acid is the main culprit. The ingredient is commonly found in dark-colored soft drinks. The other issue with soda is that it is an infamous diuretic because of the addition of caffeine. This raises the normal concentration of salt in your urine, which advances kidney stones<a href="#accordion">[6]</a>. So, if you choose to consume a soft drink, compensate the ounces with an equivalent measure of water and you will diminish that concentration. Then again, you could stay away from soft drinks through and through and replace them with better options. 
&nbsp;

<h4>"A high Heart rate variability is a an important indicator of good health. Head on over to our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>and check your heart rate variability today!" </h4>

The only conclusion that can be drawn from busting several myths is another myth that the internet knows it all. While many verified health blogs and revered medical journals will supply you with an influx of information, it is important to realize that each body is different. For any disease or illness or even kidney stones, always consult a doctor, a urologist, and a certified dietician who can guide you, assist you, and support you with reasonable and sustainable solutions. 
&nbsp;

Tip of the day: Be old school and book that appointment ASAP. 
&nbsp;

This article gathered to debunk some of the most common myths surrounding kidney stones that patients have heard from their acquaintances or on the internet. With the intent to inform rather than offend the key takeaways from this article are:

<ul>
	<li>There are four types of kidney stones: calcium stones, uric acid stones, struvite stones, and cystine stones.</li>
	<li>The body should not be deprived of calcium as its deficiency can lead to kidney stones.</li>
	<li>Kidney stones are not always painful and can be silent.</li>
	<li>Kidney stones cause a more severe pain than a stomachache.</li>
	<li>Kidney stones cannot be cured with cranberry juice; opt for lemon juice instead.</li>
	<li>Stay hydrated!&nbsp; 
	&nbsp;</li>
</ul>

[1].Buchholz, N., Abbas, F., Khan, R., Talati, J., Afzal, M., & Rizvi, I. (2003). The Prevalence of Silent Kidney Stones - an Ultrasonographic Screening Study. Journal of the Pakistan Medical Association, Vol 53, 1-5.

[2].National Kidney Foundation. (2022). Kidney Stones. Retrieved from National Kidney Foundation:

[3].U.S. Department of Health and Human Services. (n.d.). Definition & Facts for Kidney Stones. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved July 28, 2022,

[4].Loughlin, K. R. (2019, May 17). What causes kidney stones (and what to do). Retrieved from Harvard Medical School:

[5].Urology Specialists of Georgia. (2022). Debunking 3 Common Kidney Stone Myths. Retrieved from Urology Specialists of Georgia:

[6].Uribarri, J., Oh, M. S., & Carroll, H. J. (1989). The First Kidney Stone. Annals of internal medicine, 111(12), 1006–1009.

Zarlish Kazmi

COVID-19: The Chronicles of CKD

Studies have shown that <a href="https://www.merisehat.pk/disease/chronic-kidney-disease">chronic kidney disease (CKD)</a> patients are more vulnerable to COVID-19 infection and mortality, than the general population.

In December of 2019, the emergence of <a href="https://www.merisehat.pk/disease/covid-19">COVID-19</a> led to countries and governments implementing several compulsory measures to curb the spread of the virus. These included quarantine measures, restricting mass gatherings and events, closure of schools and businesses, and reducing the frequency of public transport. While these measures have had a great impact on everyone&rsquo;s mental health, the unpredictability of the virus has further exacerbated the psychological distress.

&nbsp;

Understanding The Effect Of COVID On CKD

Throughout the pandemic, researchers have hypothesized that the SARS-CoV-2 virus not only affects the respiratory system but also other organs and systems in the body. So the question arises are the kidneys also at risk of the effects of COVID-19?&nbsp;&nbsp;

People with severe COVID and no underlying kidney problems often show signs of kidney damage such as blood in the urine. Moreover, studies have shown that chronic kidney disease (CKD) patients are more vulnerable to COVID-19 infection and mortality than the general population<a href="#accordion">[1]</a>. The infection can lead to a high frequency of renal abnormalities, including protein and blood in the urine with elevated levels of creatinine and urea in the blood<a href="#accordion">[2]</a>. Additionally, CKD is associated with an increased risk of pneumonia and pneumonia-related deaths in COVID-19 patients<a href="#accordion">[3]</a>. However, despite all this evidence, there is a lack of information on the impact of COVID-19 on various stages of CKD.&nbsp;

Chronic kidney disease (CKD), or chronic kidney failure, results in the loss of kidney function. The organs lose their ability to filter excess fluid and waste products from the blood. As a result, fluids, electrolytes, and waste products build up in the blood leading to kidney damage. The common signs and symptoms of CKD include nausea, vomiting, fatigue, loss of appetite, muscle cramps, swelling of feet and ankles, hypertension, and shortness of breath. CKD eventually results in end-stage kidney failure, which requires frequent dialysis or a kidney transplant.

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<h4>"Infections can lower your heart rate variability. Head on over to the <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>and get your reading today!" </h4>

Studies have shown that 30% of patients hospitalized with COVID-19 develop kidney injury. Whereas more than 50% in the intensive care unit may require dialysis<a href="#accordion">[4]</a>. However, with improvements in treatment, there has been a significant decrease in the rates of dialysis. The risk of kidney disease is higher in patients with co-existing chronic conditions such as high blood pressure and diabetes.&nbsp;

The impact of the coronavirus on the kidneys is quite complex. Below are some explanations of how COVID-19 may damage the kidneys:&nbsp;

&nbsp;

<h5>1. The Virus May Target The Kidney Cells&nbsp;</h5>

Kidneys have receptors that enable the coronavirus to attach to them and infect the renal cells. The virus invades the cells, replicates, and damages the kidney tissues. Researchers have also found similar receptors on the cells of the lungs and heart, making them vulnerable as well.&nbsp;

&nbsp;

<h5>2. A Lack Of Oxygen Can Cause Kidneys To Malfunction&nbsp;</h5>

In severe COVID, pneumonia can cause critically low levels of oxygen. It is hypothesized that these abnormally low levels can contribute to renal problems in COVID patients.

&nbsp;

<h5>3. Cytokines Can Destroy Kidney Cells&nbsp;</h5>

From what we know so far, the body releases too many cytokines at a much higher rate than normal as a reaction to the coronavirus infection. This is known as a &lsquo;cytokine storm&rsquo;. The immune response to COVID-19 can be quite extreme in some people, causing a sudden influx of cytokines. Cytokines are small proteins that communicate with the immune system and fight off infections. This immune response can cause severe inflammation that can destroy healthy tissue, including tissues of the kidneys.&nbsp;

A cytokine storm is not only a common complication of COVID-19 but also other respiratory diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).&nbsp;

&nbsp;

<h5>4. COVID-19 Blood Clots Can Clog The Kidneys&nbsp;</h5>

The kidneys&rsquo; function is to filter out waste products, toxins, and extra water. However, COVID-19 can significantly impair renal functioning by forming blood clots within renal vessels. The cytokine storm associated with the viral infection results in the release of clotting factors into the bloodstream. Thus, resulting in clot formation within the blood vessels in the lungs, legs, and kidneys.&nbsp;

&nbsp;

People with chronic kidney disease, or any other chronic medical condition, are at a higher risk of developing severe illness. Additionally, people on dialysis have a weaker immune system which makes it more difficult to fight off infections. Similarly, people with kidney transplants are on anti-rejection medications, also known as immunosuppressive medications, to keep the immune system less active. This makes it more difficult to fight infections. While it is important to keep taking these medications, it is equally important to wash your hands, maintain good hygiene and follow COVID-19 precautions.&nbsp;

Though kidney patients need to continue with their follow-ups and dialysis treatments, it is also essential to take the following precautions:

<ul>
	<li>Limit close contact in public spaces and keep away from those who are sick.</li>
	<li>Wear a mask outdoors and indoors.</li>
	<li>Wash your hands often.</li>
	<li>Avoid crowds.</li>
	<li>During an outbreak, try and stay at home.</li>
</ul>

&nbsp;

<ul><li>During the lockdown period, a lack of personal protective equipment, and limited transport for follow-ups and acquiring drugs caused an increased threat to the health of CKD patients.</li><li>Studies have shown that compared to the general population, chronic kidney disease patients have an increased risk of severe illness.&nbsp;</li><li>COVID-19 can also lead to kidney damage. Thus, kidney patients need to take precautions to prevent the severe consequences of infection.</li></ul>

[1] Okoro, R.N., 2021. COVID-19 pandemic: The role of community pharmacists in chronic kidney disease management supportive care. Research in Social and Administrative Pharmacy, 17(1), pp.1925-1928.

[2] Naicker, S., Yang, C.W., Hwang, S.J., Liu, B.C., Chen, J.H. and Jha, V., 2020. The novel coronavirus 2019 epidemic and kidneys. Kidney International, 97(5), pp.824-828.

[3] Henry, B.M. and Lippi, G., 2020. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. International urology and nephrology, 52(6), pp.1193-1194.

[4] Hirsch, J.S., Ng, J.H., Ross, D.W., Sharma, P., Shah, H.H., Barnett, R.L., Hazzan, A.D., Fishbane, S., Jhaveri, K.D., Abate, M. and Andrade, H.P., 2020. Acute kidney injury in patients hospitalized with COVID-19. Kidney international, 98(1), pp.209-218.

Staff Writer

Medilink Consultant clinic

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

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

Cannabis Abuse – Flying The Wrong Airplane In Adolescence

In recent years, the legalization of marijuana has become more common. This is partially due to research showing that the substance does not cause cancer like many had previously thought. However, it has also led some people to believe that cannabis usage is harmless. Thus, encouraging them to use it more often in adolescence. This might be true for adults as well, but studies have shown that young people who consume it might suffer from long-term problems related to memory loss, anxiety disorders, and other <a href="https://merisehat.pk/article/Mental%20Health">mental health issues</a>, which can be problematic later in life.

&nbsp;

Understanding Dangers Of Cannabis Abuse In Adolescence

In Pakistan, the use of the actual leaves itself is not very common due to the high prices. It is a drug that is solely enjoyed by the younger generation of the elite or upper middle class.&nbsp;

&nbsp;

The most common way of consumption in Pakistan is through ingestion, by making edible items out of the plant like brownies or gummies. However, a much cheaper alternative, that contains many of the same components as marijuana, is hash.&nbsp;

&nbsp;

Hash consumption in Pakistan is rampant in people of all classes due to its low-cost nature and easy availability. Hash is consumed by mixing it with cigarette components; smoking the mixture gives the user a feeling of lightheadedness.

&nbsp;

Recent studies in adolescent cannabis abusers show that their IQ drops with their utilization of marijuana.&nbsp;&nbsp;

&nbsp;

The usage of THC or tetrahydrocannabinol (the main component in cannabis) causes the reduction of gray matter in the brain as well as certain changes to white matter. This results in an imbalance in neurotransmitters, which leads to memory impairment and poor concentration.&nbsp;

&nbsp;

These effects worsen when exposure to THC is prior to 16 years of age. The data, thereby, suggests that the younger the users are, the longer the detrimental effects would last<a href="#accordion">[2]</a>.

&nbsp;

This is especially important because the brain continues to develop until age 25, and chronic use of cannabis in young adults might affect its development. Additionally, research shows that adolescents who have a family history of schizophrenia are at an even higher risk when using marijuana before age 16.&nbsp;

&nbsp;

While gray matter is directly related with intelligence, there are no reported direct ties of marijuana with low IQ<a href="#accordion">[5]</a>.

&nbsp;

Given how marijuana affects intelligence and mental health, it&#39;s important for parents to be aware of this information so they make informed decisions about their children&#39;s usage patterns.&nbsp;

&nbsp;

Consumption of cannabis at a young age could cause social anxiety and depression disorders due to neurobiological reasons<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

Utilization of THC affects regulation of serotonin (which is responsible for mood regulation), dopamine (which is responsible for controlling reward and pleasure centers), and norepinephrine (which is responsible for vigilance and concentration)<a href="#accordion">[7]</a>.

<h5>&nbsp;</h5>

Lack Of Motivation To Perform Daily Activities

Sometimes, heavy use of THC reduces motivation, due to activation of specific proteins in the brain. This change in motivation makes it more difficult for individuals who abuse it heavily to perform daily tasks, and even leads them to drop out of school<a href="#accordion">[3]</a>.

&nbsp;

One reason why this happens is because THC affects the brain&#39;s reward system, which is responsible for motivation, memory, and learning. THC has been shown to increase dopamine levels (a neurotransmitter involved in reward) by up to 60% after just 1 dose.&nbsp;

&nbsp;

However, research also shows that chronic use could decrease dopamine levels by as much as 50%. At first glance, these numbers seem contradictory &mdash; how could someone experience both increases and decreases? It turns out there are ways that cannabis use affects the brain&#39;s reward system differently depending on the person&rsquo;s age as well as the amount of dosage taken<a href="#accordion">[4]</a>.

&nbsp;

Decreased Cognitive Learning Ability&nbsp;

The ability to plan, organize, solve problems, make decisions, remember and control emotions and behavior is called executive function. This is a set of skills that allows us to accomplish tasks and achieve goals.

&nbsp;

Cannabis use has been proven to impair cognitive functions on a number of levels. The usage of cannabis on a developing brain worsens the impact greatly as compared to its impact on adults. While there is enough evidence that supports the claim of cannabis having detrimental effects on adolescent brains, the longevity of these effects remains to be elucidated.

&nbsp;

Individuals with cannabis-related impairment in executive functions have been found to have trouble learning and applying the skills required for successful recovery, which puts them at increased risk for relapse to cannabis use<a href="#accordion">[6]</a>.

&nbsp;

To conclude, marijuana abuse is dangerous for adolescents. It affects their cognitive and emotional development in a negative way, as well as impairs their ability to perform daily tasks. While cannabis is beneficial with respect to human health, these benefits are only for adult users consuming it in low doses. Young people should avoid using cannabis or other substances at all costs; it would help them steer clear of problems such as addiction or dependence later on in life.

<ul><li>Usage of cannabis in adolescents is known to trigger anxiety and depression.&nbsp;</li><li>Marijuana abuse in adolescence runs the risk of the individual dropping out from school due to diminished ability to learn, and reduced cognitive learning capacity.</li><li>Neurotransmitters like epinephrine, dopamine, and serotonin are greatly imbalanced due to THC use and abuse which might lead the individual towards addiction.</li><li>It is common in individuals who abuse marijuana to easily lose interest in many of the tasks they used to perform. They might even lose the motivation to carry out basic daily life tasks, which is believed to give rise to more addiction.</li></ul>

[1] Daniel K. Hall-Flavin, M., n.d. Marijuana and depression: What's the link?. Mayo Clinic

[2] Emmet Power, S. S. C. H. A. O. N. D. C. a. M. C., 2021. Intelligence quotient decline following frequent or dependent cannabis use in youth: a systematic review and meta-analysis of longitudinal studies. Psychol Med, 51(2), pp. 194-200.

[3] Ileana Pacheco-Colón, M. J. M. L. a. R. G. P., 2019. Non-Acute Effects of Cannabis Use on Motivation and Reward Sensitivity in Humans: A Systematic Review. Psychol Addict Behav..

[4] Michael A P Bloomfield, A. H. A. N. D. V. a. O. D. H., 2017. The effects of Δ9-tetrahydrocannabinol on the dopamine system. Nature, p. 369–377.

[5] Nicholas J. Jackson, J. D. I. j. R. K. ,. D. I. C. T. W. G. I. M. M. A. R. a. L. A. B., 2016. Impact of adolescent marijuana use on intelligence: Results from two longitudinal twin studies. PNAS, 113(5), pp. 500-508.

[6] Rebecca D. Crean, P. N. A. C. B. a. B. J. M. P., 2012. An Evidence Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions. J Addict Med, 5(1), pp. 1-8.

[7] Washington.edu, n.d. Marijuana.

Just A Little Dose

Microdosing, as the name suggests, is the process of administration of small doses of new or pre-approved chemicals to improve physiological functions.

 
Microdosing sounds a lot like drug abuse, doesn&rsquo;t it? But that&rsquo;s far from the truth. The aim of microdosing is to enhance brain functioning and, in many cases, even treat mental illness through unconventional ways to minimize the side effects and possible dependency on drugs. 
&nbsp;

Understanding The Pros And Cons Of Microdosing

Microdosing, as the name suggests, is the process of administration of small doses of new or pre-approved chemicals to improve physiological functions. The microdose is also referred to as sub pharmacological dose.&nbsp;

&nbsp;

The pharmacokinetic predictors are the users, ensuring the dosage does not have an impact on the clearance, distribution or bioavailability of the compound<a href="#accordion">[1]</a>.

&nbsp;

Microdosing is often used in the process of drug development to determine the therapeutic index of the drug. This practice dates back all the way to the 16th century.

<div>&nbsp;</div>

In order for a dose to be considered sub pharmacological or a microdose, it has to be 1/10th or 1/20th of the normal dose. The target is to avoid the high and/or the intoxication associated with the drug, along with ensuring that possible addiction to the drug does not occur. Since the phenomenon is not widely supported by scientists or healthcare practitioners, there is no set schedule and people who are practicing this have been doing it all on their own based on their own observations and hypotheses<a href="#accordion">[2]</a>. A lot of the positive results are disregarded by many professionals in the name of a placebo effect, but is it what microdosing really is?&nbsp;

&nbsp;

So far, these are the benefits that have been promised by people practicing microdosing from all over the world:

<ul>
	<li>Microdosing on psychedelics has been associated with improved mood.</li>
	<li>Some psychedelics are used to treat anxiety and depression. They exert effects similar to serotonin reuptake inhibitors.</li>
	<li>Improved sleep and an increased sense of well-being.</li>
	<li>Microdosing may help manage symptoms of ADHD.</li>
	<li>It improves cognition.</li>
	<li>It boosts energy.</li>
	<li>It enhances psychomotor performance especially in people over 55 years of age.</li>
</ul>

<div>&nbsp;</div>

Lysergic acid diethylamide is known for its hallucinogenic effects in people and it is very commonly used by artists of all kinds to change their perspectives and broaden their horizons. It is now widely used for microdosing as well. 5-10% of the usual dose if taken, can induce mood enhancing effects, is beneficial for cognitive health, and even helps deal with pain.&nbsp;

&nbsp;

LSD microdosing was an open secret. The game changed when Apple founder Steve Jobs talked about how LSD played a vital role in his life.&nbsp;

&nbsp;

LSD microdosing should never be done continually. It is always better to start off with microdosing 2 days and then skip 2 days (avoid microdosing). So, you can be microdosing from Monday to Friday and leaving the weekends sober. Alternatively, it can also be done by taking small doses of LSD every other day.

&nbsp;

The following effects of LSD microdosing have been reported by many users<a href="#accordion">[8]</a>:&nbsp;&nbsp;

<ul>
	<li>Reduced anxiety</li>
	<li>Reduced depression</li>
	<li>Enhanced energy levels</li>
	<li>Reduced pain</li>
	<li>Headache&nbsp;</li>
	<li>Better sleep quality</li>
</ul>

<div>&nbsp;</div>

Though it is important to bear in mind that many, if not all of the previously mentioned&nbsp; effects, might be placebo effects as suggested by&nbsp; several researchers including the research conducted by the University of Chicago. The main issue is that these beneficial effects are reported in uncontrolled environments by regular users who have literally no idea of psychiatry and how the brain works.&nbsp;

&nbsp;

According to the research done by University of Chicago, they administered small doses of the psychedelic to people but ensured that the people were unaware of it in order to truly monitor their impact &ndash; without involving the bias from the subject&rsquo;s thoughts or attitudes towards the drug that would automatically alter the results. It was found that while the people experienced a little high, there was no actual mood enhancement or improved cognitive action in the brain<a href="#accordion">[9]</a>.

<div>&nbsp;</div>

Psilocybin is one of the most common substances that is used for microdosing. Researchers are heavily invested in trying to determine the true extent of its therapeutic uses and its impact on depression and anxiety: the two mental illnesses it is mostly used for treating. Microdosing Psilocybin has garnered mixed perspectives over the years, with experts on one hand calling it a mere placebo effect, and on the other there are studies that discuss its impact on the brain<a href="#accordion">[6]</a>.

&nbsp;

According to many researches based on experiments and data extracted from people who practice microdosing psilocybin, there has been a significant impact on their cognitive function and mental concentration<a href="#accordion">[3]</a>. However, research also indicates that&nbsp; full doses of the substance may lead to permanent behavioral changes, making it a very slippery slope with different possible outcomes, some of which may not even be desirable.&nbsp;

&nbsp;

Psilocybin administration is sometimes mixed with other substances like lion&rsquo;s mane mushrooms or niacin. This combination may not have a huge impact on younger users, but it is known to increase psychomotor functions in people over 55 years i.e., psychomotor performance was limited to older adults<a href="#accordion">[4]</a>.

&nbsp;

Interestingly, in many case studies, psilocybin users have been compared to placebo groups and both groups have reported similar effects<a href="#accordion">[7]</a>. Its impact on mood and mental health is still considered to be minimal and gradual.&nbsp;

&nbsp;

The issue is that since these <a href="https://merisehat.pk/article/the-rise-of-new-weight-loss-drugs-a-comprehensive-overview-and-accessibility-concerns">drugs</a>, especially psilocybin are illegal, there is little to no long-term extensive research on its use and its long-term effects. However, data accumulated from long-term abusers of such drugs suggests that prolonged use of psilocybin may lead to valve damage or cardiac valvulopathy<a href="#accordion">[5]</a>.

<div>&nbsp;</div>

The biggest risk with microdosing is the entire unsupervised practice itself. In many cases, people are just subjecting themselves to long-term health issues with no actual outcome because many studies have proven that in most cases, the benefits are caused due to placebo effects and the drugs may not have any significant impact on the individual at all.

&nbsp;

Despite this, the ever-growing community of microdosers is attracting a lot of people who are not well-versed with science. This not only gives rise to misuse and possible overdosing incidents; it also promotes the practice of illegal substance use that can potentially cause irreversible damage to the user.

<div>&nbsp;</div>

<ul>
	<li>Microdosing has been used in professional practices for a very long time for the determination of therapeutic index of the drugs.</li>
	<li>Currently, the process is used for inducing psychiatric effects on people with mental illnesses or just to enhance your brain function.</li>
	<li>While microdosing can be done on any drugs, the most commonly used type of drugs are psychedelics, including psilocybin and LSD</li>
	<li>Many researchers have reported that there is no robust evidence backing the self-proclaimed therapeutic effects of microdosing and these benefits are solely due to placebo effects.&nbsp;</li>
</ul>

<div>&nbsp;</div>

[1] Anderson T, Petranker R, Christopher A, et al. Psychedelic microdosing benefits and challenges: An empirical codebook. Harm Reduction Journal. 2019;16(1). doi:10.1186/s12954-019-0308-4

[2] Smith DG. More people are microdosing for mental health. but does it work? The New York Times.

[3] Nichols DE. Psychedelics. Pharmacological Reviews. 2016;68(2):264-355. doi:10.1124/pr.115.011478

[4] Rootman JM, Kiraga M, Kryskow P, et al. Psilocybin microdosers demonstrate greater observed improvements in mood and mental health at one month relative to non-microdosing controls. Nature News.

[5] Radcliffe S. Microdosing psilocybin mushrooms may improve mental health and mood. Healthline.

[6] Siebert A. Microdosing psychedelics is trendy, but does it work? here's what science says. Forbes.

[7] Kuypers KPC. The therapeutic potential of microdosing psychedelics in depression. Therapeutic Advances in Psychopharmacology. 2020;10:204512532095056. doi:10.1177/2045125320950567

[8] Microdosing LSD: Benefits, risks, and more. Medical News Today.

[9] Loomis I. Study of LSD microdosing doesn't show a therapeutic effect. UChicago Medicine.

Doctor, Do I Have Malaria, Dengue, Or Something Else?

The human body is a complex system with multiple defense mechanisms to protect against infections. A fever, often a symptom of disease, is actually an indication that the body&#39;s immune system is doing its job of protecting you. However, fever can result from a wide variety of illnesses and diagnosing the disease based on just one symptom is never enough. Moreover, in a country like Pakistan where several deadly mosquito-borne diseases are endemic, a fever can lead to panic among people. Especially during the months of September to December when these diseases are most common.

According to the World Health Organization (WHO), malaria is a major cause of mortality and morbidity in Pakistan. Moreover, the country shares the highest burden of mosquito-borne diseases, such as <a href="https://www.merisehat.pk/disease/dengue">dengue</a>, <a href="https://www.merisehat.pk/disease/malaria">malaria</a>, and Chikungunya<a href="#accordion">[1]</a>. Climate change, urbanization, poor health conditions, lack of accessible healthcare, and natural disasters are all to blame for the increase in these diseases. Although the exact distribution and magnitude of these diseases remain unclear, it is evident that their prevalence will continue to rise in the coming years.&nbsp;

&nbsp;

Understanding Different Mosquito Borne Diseases

As per estimates, malaria and dengue are the most prevalent mosquito-borne diseases with 214 million and 390 million global cases a year respectively<a href="#accordion">[2]</a>.

&nbsp;

Malaria - In Pakistan, malaria accounts for 50,000 new deaths per year<a href="#accordion">[3]</a>. Transmitted by the bite of a female Anopheles mosquito, malarial parasites can cause a wide variety of symptoms in humans. These include fever with chills, sweating, headache, nausea, fatigue, and muscle or joint pain. There are currently four different Plasmodium parasites that cause malaria in humans: P. falciparum, P. vivax, P. ovale, and P. malariae. P. falciparum and P. vivax account for the greatest number of malaria cases in Pakistan.

&nbsp;

Dengue - In contrast, the dengue virus is transmitted by the bite of the Aedes aegypti mosquito. The mosquito is also responsible for causing other mosquito-borne diseases such as Zika, chikungunya, and yellow fever.

Pakistan recorded its first dengue outbreak in 1994 when 1,000 people got infected. Since then, the country has recorded several outbreaks of the disease. In 2021, Pakistan reported a record 48,906 dengue cases and 183 deaths across all provinces<a href="#accordion">[4]</a>. Every year, the country faces seasonal waves of illness with different dengue viruses (DENV-1, DENV-2, DENV-3, DENV-4) causing outbreaks. The most common symptoms include fever, headache, rash, muscle and joint pain, and, in severe cases, internal or external bleeding.

&nbsp;

Chikungunya - The chikungunya virus first emerged in Pakistan in the 1980s, mostly among the rodent population. However, it wasn&#39;t until 2011 that cases began appearing among the human population. The virus typically causes fever, joint pain, skin rash, headache, and nausea.&nbsp;

In 2016, the city of Karachi recorded one of its worst outbreaks which affected approximately 30,000 individuals<a href="#accordion">[5]</a>. Since the overlap of symptoms of dengue causes doctors to often misdiagnose the cases, experts predict that the actual prevalence of chikungunya might be much higher. The rise in cases and the mosquito levels could likely lead to an increase in other mosquito-borne diseases.

&nbsp;

The presence of various mosquito-borne diseases all in one place at one time can make it confusing for both doctors and patients to determine what&#39;s causing the symptoms. Therefore, it&#39;s important to know the similarities and differences between the different illnesses.&nbsp;

&nbsp;

Malaria Symptoms - These usually appear 10-15 days after a mosquito bite and include:

<ul>
	<li>High fever with chills followed by excessive sweating as the body temperature falls</li>
	<li>Body aches</li>
	<li>Headaches</li>
	<li>Nausea and vomiting</li>
	<li>Diarrhea</li>
	<li>Anemia</li>
	<li>Jaundice</li>
</ul>

&nbsp;

Dengue Symptoms - Symptoms of dengue can begin within 4-10 days of a mosquito bite and usually persist for 2-7 days. These include:

<ul>
	<li>High fever</li>
	<li>Severe headache</li>
	<li>Pain behind the eyes, in muscles, and in joints</li>
	<li>Nausea and vomiting</li>
	<li>Skin rash</li>
	<li>Sever dengue can result in severe stomach pain, bleeding from gums, blood in stool or urine, difficulty breathing, and fatigue.</li>
</ul>

&nbsp;

Chikungunya Symptoms - Symptoms begin within a week of a mosquito bite and is characterized by:

<ul>
	<li>Fever</li>
	<li>Joint pain and swelling</li>
	<li>Headache</li>
	<li>Rash</li>
	<li>Fatigue</li>
</ul>

&nbsp;

Fever, headache, joint or muscle pain, and nausea are common symptoms among all three diseases. However, there are also many differentiating features. For example, in dengue pain behind the eyes and a rash is a characteristic feature. While in malaria, a fever is always accompanied by severe chills and then a period of sweating as the person&#39;s body temperature returns to normal. Moreover, the episodes of fever come every 24-72 hours, depending on the type of malarial parasite causing the infection.&nbsp;

Although all three diseases have similar symptoms, laboratory investigations can often prove helpful in differentiating between the three. Therefore, it is advised to immediately consult a doctor if one lives in an endemic region, especially during a period when mosquito-borne diseases are most prevalent.&nbsp;

&nbsp;

Several precautionary measures can prevent infections and help reduce the burden of disease.&nbsp;

&nbsp;

Personal Protection - Various protection measures help prevent mosquito bites. These include:

<ul>
	<li>Using mosquito repellents, especially when stepping out at hours when mosquitoes are most active.</li>
	<li>Wearing clothes that reduce exposure to mosquitoes.</li>
	<li>Sleeping under insecticide-treated bed nets.</li>
</ul>

&nbsp;

Vector Control - These strategies are aimed at reducing the population of mosquitoes. They include:

<ul>
	<li>Spraying of insecticides and larvicides in areas where mosquitoes are frequently present.</li>
	<li>Preventing water from collecting in old tires, empty pots, or stagnate water ponds as these act as breeding grounds for mosquitoes</li>
</ul>

&nbsp;

Along with these preventive strategies, it is also important to increase patient education regarding various mosquito-borne diseases. A lack of information on the causes and manifestations can lead to panic and a delay in seeking help.&nbsp;

&nbsp;

Mosquito-borne diseases are most prevalent in tropical and subtropical countries. The warm climate not only helps the mosquitoes complete their life cycle but also increases mosquito activity. In Pakistan, the changing climate has caused a shift in the mosquito population. With warmer summers and warmer winters, the diseases have also changed their occurrence. In cities like Karachi, where the temperature remains above 15 degrees Celsius in the winter, outbreaks occur more frequently during the winter. Moreover, the heavy monsoon season causes water to collect in the form of pools and puddles, which then act as breeding grounds for mosquitoes. Thus, contributing to the spread of disease.

The increase in natural disasters such as floods in the country has led to the displacement of people to temporary camps. Overcrowding, poor hygiene, lack of clean drinking water, and the lack of healthcare facilities and resources at these camps have also contributed to an increase in outbreaks and mosquito populations.&nbsp;

However, climate change is not the only factor causing the spread of disease. Deforestation, agriculture, urbanization, poor socioeconomic conditions, failed vector control strategies, and drug resistance has also increased infections. Moreover, the destruction of forests and trees has resulted in the mosquito population breeding indoors.

The increase in mosquito population not only heightens the risk of existing diseases, but also others such as the deadly Zika virus. Therefore, there is a need for proper surveillance methods across the country such as the development of screening labs and educating the public on various vector control methods. Since there are no vaccines available in Pakistan for the prevalent mosquito-borne diseases, vector control measures provide the best protection against these diseases. However, current vector control measures are insufficient due to the rising insecticide resistance among viruses and parasites.&nbsp;

&nbsp;

Key points

<ul></ul><ul><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Pakistan shares the highest burden of mosquito-borne diseases such as malaria, dengue, and chikungunya.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Mosquitoes thrive more in tropical and subtropical regions. Therefore, Pakistan's warm climate is a significant factor in the prevalence of these diseases.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Malaria is a major cause of mortality and morbidity in Pakistan, causing 50,000 new deaths each year.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">The malarial parasite enters humans through the bite of an infected female Anopheles mosquito. This results in symptoms such as fever and chills, sweating, headache, anemia, nausea, and body aches.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">The dengue virus is transmitted via the bite of an infected Aedes aegypti mosquito and results in high fever, joint pain, rash, pain behind the eye, and in severe cases external and internal bleeding.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">The Aedes aegypti mosquito can also spread Zika, chikungunya, and yellow fever.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">In 2016, Pakistan recorded one of its worst chikungunya outbreaks, with almost 30,000 infections.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Chikungunya typically appears as fever, joint pain, skin rash, headache, and nausea.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Malaria, dengue, and chikungunya continue to be the most common mosquito-borne diseases in Pakistan. However, an overlap of symptoms often makes it difficult to differentiate between the three. The common symptoms include fever, headache, nausea, and joint or muscle pain.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Since the diseases can often be fatal, an early and accurate diagnosis is crucial to recovery. Adequate laboratory testing, a complete history, and patient awareness of all three diseases can help identify the infection.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Vector control strategies, such as destruction of mosquito breeding grounds and protection from mosquito bites, are key to preventing mosquito-borne diseases.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Climate change, urbanization, poor health conditions, lack of accessible healthcare, population rise, and increasing drug resistance has led to an increase in these diseases in recent years.</li></ul>

[1] WHO, n.d. Pakistan: Malaria and other vector-borne diseases. [Online].

[2] Chong, S. E. et al., 2017. The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection. Malaria Journal, 16(2).

[3] Qureshi, H., Khan, M. I., Ambachew, H. & Ye, D.-Q., 2020. Baseline survey for malaria prevalence in Khyber Pakhtunkhwa Province, Pakistan. Eastern Mediterranean Health Journal, 26(41).

[4] WHO, 2021. Disease outbreak news - Pakistan. [Online].

[5] Badar, N. et al., 2019. Epidemiological trend of chikungunya outbreak in Pakistan: 2016–2018. PLOS Neglected Tropical Diseases, 13(4).

[6] Ali, I. & Dasti, J. I., 2018. Chikungunya virus; an emerging arbovirus in Pakistan. Journal of the Pakistan Medical Association, 68(2).

Five Myths About Weight Loss

While the acceptance of diversity in bodily sizes is on a steady rise, certain &lsquo;thin body&rsquo; lobbyists will still try to promote unhealthy weight loss methods. This article aims to explore five of the most prevalent weight loss myths and how we can move forward towards a healthier lifestyle.

&nbsp;

Understanding of Weight loss myths

<h5>You Shouldn&rsquo;t Eat Dessert</h5>

While an excess consumption of carbohydrates will catalyse the production of fat, both in terms of storage reserves and insulin spikes, a moderate consumption of sugary foods and bread is actually essential for your health.&nbsp;

Our body requires a diverse range of micro- and macronutrients as well as glucose in order to survive. Since carbohydrates break down immediately into glucose, it temporarily relieves the body of additional effort that is required to create glucose from other foods.&nbsp;

Not only do our bodies need this rest, but it is also highly unsustainable to avoid desserts for the long term and can have catastrophic impacts on impulse control. 
&nbsp;

<h5>Cooking With Olive Oil Is Healthier</h5>

Olive oil is a miracle substance. It contains large amounts of antioxidants, prevents heart disease and stroke, and is a powerful anti-inflammatory. It also promotes healthy weight loss due to large quantities of monounsaturated fatty acids. But it cannot remain stable in heat.&nbsp;

This miracle oil is extremely gentle and exposing it to high degrees of heat actually makes it more absorptive of free radicals in the air. In fact, even in environments where there&rsquo;s not a lot of heat, olive oil should not be directly exposed to the atmosphere. The best way to store olive oil is to cap it up tightly and put it in a cool, dry place like the fridge.&nbsp;

Coconut oil can easily replace olive oil in healthy cooking efforts as it remains stable in heat and contains a lot of the benefits of olive oil as well.&nbsp; 
&nbsp;

<h5>There Is A Miracle Weight-loss Elixir Out There</h5>

To put it simply, they do not exist. They&rsquo;re called laxatives, are extremely bad for digestion, and can in fact contribute to eating disorders.

&nbsp;

<h5>Mangoes Cause Weight Gain</h5>

If you&rsquo;ve been avoiding mangoes this season, now is the time to remedy this mistake. Mangoes are widely believed to promote weight gain due to their meaty, sweet content. In truth, however, mangoes promote satiety and can therefore be used for weight loss when consumed in moderation.&nbsp;

&nbsp;

<h5>You Need To Control Your Hunger</h5>

Not eating when you&rsquo;re hungry is actually the surest way to gain weight faster. This is because it cultivates issues with impulse control and denies our bodily intelligence. Our bodies are incredibly wise and will inform us of whatever we need whenever we need it. For example, craving chocolate is your body&rsquo;s signal for magnesium and craving vegetables is your body&rsquo;s signal for fiber and vitamins. 
&nbsp;

It might be tempting to try out a yo-yo diet or quick fix for weight loss but the best way to optimize health and maintain a good body weight is actually to lean into your body&rsquo;s intuition and give it what it needs with compassion.

Zuha Malik

COVID-19: Unmask Your Mental Health

The COVID-19 pandemic has drastically changed people&rsquo;s lifestyles. The new normal is a combination of altered daily routines, uncertainty, social isolation, and financial pressures. People are constantly worried about getting sick, their jobs being affected, and the pandemic never-ending. Moreover, the rumors and overload of misinformation can make individuals feel out of control or unclear about their goals. The pandemic can lead to <a href="https://www.merisehat.pk/article/how-to-manage-anxiety">feelings of anxiety</a>, stress, fear, and loneliness which can all worsen with time

According to surveys, there is an increase in the number of adults who report symptoms of stress, anxiety, insomnia, and <a href="https://www.merisehat.pk/disease/depression">depression</a> during COVID-19 compared to the ones before the pandemic. Some people have also increased their consumption of alcohol and smoking, both of which can trigger depression and anxiety. Moreover, substance abusers, especially those addicted to tobacco or opioids, are at a higher risk of COVID-19 and adverse outcomes such as hospitalizations and death<a href="#accordion">[1]</a>. This is because addictions can harm the function of the lungs, and weaken the immune system. Furthermore, they lead to chronic conditions, like heart and lung diseases, which can increase the risk of serious COVID-19 complications. Therefore, it is important to learn self-care strategies and get the required care.

&nbsp;

Understanding The Impact Of COVID On Mental Health

The high number of cases during the COVID-19 pandemic has placed immense stress on healthcare professionals (HCPs). Long work hours and limited resources further add to their mental distress. Therefore, the mental health of caregivers should be given equal importance.

A cross-sectional study, conducted across multiple hospitals in Karachi, Pakistan, assessed depression and anxiety scores of healthcare professionals posted in the COVID-19 wards. The Depression Anxiety Stress Scale-21 was used to calculate their scores. According to the results, 72.3% of the participants suffered from moderate to extremely severe depression, 85.7% suffered from moderate to extremely severe anxiety, and 90.1% of participants reported moderate to extreme levels of stress<a href="#accordion">[2]</a>.

The presence of psychological ailments such as stress, anxiety, and depression in HCPs points to the need for regular mental health checks. However, that cannot be possible without the intervention of higher authorities.

&nbsp;

The COVID-19 pandemic caused the implementation of social restrictions, leading to an increase in mental health issues among people.&nbsp;

A study conducted in Lahore, Pakistan measured the impact of COVID-19 on anxiety levels and obsessional thinking in clinical and non-clinical populations. The online survey consisted of a demographic profile and two scales: CAS (Coronavirus Anxiety Scale) and OCS (Obsession with COVID-19 Scale). All the participants were aged eighteen and above. A total of 240 people filled out the survey, comprising 20% men and 80% women.

According to the results, there was a positive correlation between anxiety and obsessions related to COVID-19. Overall results of the study depicted that the average adult population of Lahore does not suffer from dysfunctional anxiety or obsessions linked with COVID-19<a href="#accordion">[3]</a>. In contrast, studies conducted in other countries have indicated high levels of anxiety and obsession related to COVID-19 within their population.&nbsp;

&nbsp;

<h4>"Not all COVID infections lower the oxygen saturation. Check out your oxygen levels with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!" </h4>

The CDC claims that people with specific mental health conditions have a higher risk of COVID-19. They may require hospitalization and ICU admission. Moreover, the severity of the symptoms can also lead to death among these patients.

The mental disorder schizophrenia ranks second to aging as a risk factor for COVID-19<a href="#accordion">[4]</a>. A study published in JAMA Psychiatry demonstrated higher COVID-19 mortality rates among schizophrenics<a href="#accordion">[5]</a>. However, other factors could also play a role, for example, age, race, medical conditions, and sex. Another study reported higher odds of COVID-related death and hospitalizations in people with mood disorders<a href="#accordion">[6]</a>.

Therefore, it is recommended that people who are at a higher risk of severe COVID-19 work in collaboration with their healthcare providers for the management of their condition. Moreover, getting vaccinated and keeping up with booster shots are a must.

&nbsp;

Stress is a normal human response to unforeseen circumstances. Everyone reacts to stress differently and it is completely normal to be stressed during a pandemic. However, multiple challenges, for example, the effects of COVID-19 can push you beyond your coping capabilities. As a result, many people develop mental health concerns like anxiety symptoms and depression during this period. Despite multiple efforts, some of them will feel helpless, sad, and angry, which further hinders their overall quality of life.&nbsp;

If you notice a decline in your mental health, ask for help.

&nbsp;

[1] Volkow, N., 2020. New evidence on substance use disorders and COVID-19 susceptibility. NIDA.

[2] Sandesh, R., Shahid, W., Dev, K., Mandhan, N., Shankar, P., Shaikh, A. and Rizwan, A., 2020. Impact of COVID-19 on the mental health of healthcare professionals in Pakistan. Cureus, 12(7).

[3] Majeed, S., Schwaiger, E.M., Nazim, A. and Samuel, I.S., 2021. The Psychological Impact of COVID-19 Among Pakistani Adults in Lahore. Frontiers in Public Health, 9.

[4] Mohan, M., Perry, B.I., Saravanan, P. and Singh, S.P., 2021. COVID-19 in people with schizophrenia: potential mechanisms linking schizophrenia to poor prognosis. Frontiers in Psychiatry, 12, p.684.

[5] Nemani, K., Li, C., Olfson, M., Blessing, E.M., Razavian, N., Chen, J., Petkova, E. and Goff, D.C., 2021. Association of psychiatric disorders with mortality among patients with COVID-19. JAMA psychiatry, 78(4), pp.380-386.

[6] Ceban, F., Nogo, D., Carvalho, I.P., Lee, Y., Nasri, F., Xiong, J., Lui, L.M., Subramaniapillai, M., Gill, H., Liu, R.N. and Joseph, P., 2021. Association between mood disorders and risk of COVID-19 infection, hospitalization, and death: a systematic review and meta-analysis. JAMA psychiatry, 78(10), pp.1079-1091.

A pandemic is often a cause of panic, and rightly so, as things are often difficult to make sense of at the start or even in the middle. The looming threat of a deadly illness can lead to irrational fears among people. As expected, the <a href="https://www.merisehat.pk/disease/covid-19">COVID-19 pandemic</a> also gave birth to some strange fears across the world. These ranged from thinking 5G networks cause <a href="https://www.merisehat.pk/disease/covid-19">COVID-19</a> to drinking disinfectants as a preventive measure. There has also been a lot of misinformation about coronavirus treatments. While some have touted eating garlic to be lifesaving, others have stuck to drinking camel urine.

According to the World Health Organization (WHO), as of 19th May, the world has reported more than 520 million COVID-19 cases and 6 million deaths<a href="#accordion">[1]</a>. Although the first COVID-19 case emerged in November 2019, Pakistan did not report a case until February 2020<a href="#accordion">[2]</a>. However, the fear of an outbreak had already gripped the country way before the detection of the first case. Soon enough, people were sharing various home remedies and myths about the novel coronavirus. Moreover, the pandemic also led to the prescription and use of unauthorized drugs for the treatment of COVID-19. These included antibiotics and antimalarial drugs, among others.&nbsp;

&nbsp;

Understanding The Dangers Of Unsubstantiated COVID Treatments

At the start of the pandemic, scientists conducted multiple studies in hopes to find a cure for the novel coronavirus. They investigated existing drugs such as ivermectin, anti-viral drugs, and antimalarial medications chloroquine and hydroxychloroquine as experimental therapies for COVID-19. Short on time, many doctors also began prescribing these drugs to COVID patients, without any conclusive scientific evidence of their effectiveness.&nbsp;

To make matters worse, the then U.S President, Donald J. Trump admitted to taking the antimalarial hydroxychloroquine as a preventive strategy. Many of Trump&#39;s advisers and doctors supported his decision. The statement was backed by a French trial that had demonstrated a decrease in viral load after just 6 days of treatment with hydroxychloroquine<a href="#accordion">[3]</a>. However, many experts labeled the results from the small-scale study anecdotal and insufficient.&nbsp;

As a result of the drug demonstrating anti-viral effects in experimental models, the U.S. Food and Drug Administration (FDA) further granted both chloroquine and hydroxychloroquine emergency use authorization early in the pandemic. And researchers around the world began conducting large clinical trials to evaluate the drug&#39;s safety and effectiveness against COVID-19. However, many of the trials had to be stopped in the middle due to the drug&#39;s adverse effects on participants. Moreover, many failed to show a significant benefit compared to a placebo group. In a study done among rheumatoid arthritis patients, researchers found a similar incidence of COVID-19 among both groups: 0.89% in hydroxychloroquine users and 0.62% in non-users<a href="#accordion">[4]</a>. Thus, showing that the antimalarial drug does not provide protection against the novel coronavirus.&nbsp;

As a result of the negative results in multiple trials, the FDA later revoked its emergency use authorization for chloroquine and hydroxychloroquine<a href="#accordion">[5]</a>. According to the regulatory body, the benefits no longer outweighed the risks associated with drug use. Thus, resulting in a reversal of the decision.&nbsp;

Despite the evidence, several countries such as Brazil, Pakistan, and India continued administering the antimalarial. Pakistan even banned exports of the drugs to have more available for the treatment of COVID-19. However, the increased prescription and self-medication of the drug resulted in a shortage for those that truly needed them.

&nbsp;

Both chloroquine and hydroxychloroquine are used for the treatment of malaria. Chloroquine works by preventing the malarial parasite from multiplying within the red blood cells. There was a time when it was hailed as a highly effective drug and was widely used to treat malaria. However, over the years, malaria strains have developed resistance to the drug. Therefore, in areas with chloroquine resistance, doctors usually prescribe other antimalarials such as mefloquine or atovaquone.&nbsp;&nbsp;

Hydroxychloroquine is a safer and more soluble metabolite of chloroquine. Both are used for treating or preventing malaria. However, due to their immunosuppressive effects, they are also FDA-approved for treating autoimmune conditions, such as lupus and rheumatoid arthritis.

The most common side effects of using antimalarial drugs are headache, nausea, diarrhea, itchiness, hives, double vision, anxiety, and hair discoloration. Although both are fairly safe, long-term use of these drugs can lead to retinal toxicity, heart toxicity, and even death. Moreover, in COVID-19 patients, antimalarial drugs have been shown to exert severe cardiac side effects. These include disturbances in the heart&#39;s rhythm and, in certain cases, sudden death.&nbsp;

&nbsp;

Chloroquine and hydroxychloroquine are not the only antimalarial drugs that people have used to treat COVID-19. Many have also experimented with the Artemisia plant in the form of herbal teas or supplements to cure the viral disease.&nbsp;

One of the commonly used antimalarial drugs, artemisinin-based combination therapies (ACTs) are produced from extracts of the Artemisia plant. However, no study has found the drug or the plant to exert a positive effect against COVID-19. The WHO has also found no evidence of the plant&#39;s effectiveness against the novel coronavirus.&nbsp;

One antimalarial drug, atovaquone, has shown anti-viral activity in a lab study. Atovaquone is an effective antimalarial drug used in combination with proguanil. Sold under the brand name Malarone, the medication is highly effective in treating chloroquine-resistant malaria. Moreover, atovaquone is also used to treat toxoplasmosis and mild pneumocystis pneumonia infections. Due to the drug&#39;s anti-viral effects against viruses such as Zika and dengue, scientists conducted a laboratory study investigating its effect on infected human lung cells.

The study not only demonstrated the drug&#39;s ability to prevent coronavirus replication in cells but also its effectiveness against various coronavirus variants<a href="#accordion">[6]</a>. Based on these results, researchers are now conducting clinical trials of atovaquone for COVID-19 treatment.

&nbsp;

The start of the COVID-19 pandemic led to scientists scrambling for a cure or breakthrough in the treatment of the novel coronavirus. Since developing new treatments can take a lot of time, researchers turned to drug repurposing. This involves investigating new uses for existing drugs. The strategy is often employed for its time and cost-effectiveness, especially in times like the pandemic.&nbsp;

During the COVID-19 pandemic, researchers repurposed various drugs such as remdesivir, ivermectin, steroids, antidepressants, vitamin C and D, Zinc, and even immunosuppressants. While this led to several safe and effective coronavirus treatments, it also helped establish which drugs don&#39;t work.&nbsp;

Antimalarial drugs, such as chloroquine and hydroxychloroquine, are among the treatment options that did not show a favorable profile against COVID-19. Although, at the start of the pandemic, many countries adopted the drugs without any validated scientific evidence. Antimalarial use was further exacerbated when the then U.S. President Donald J. Trump reported using hydroxychloroquine as a precautionary step. Despite the lack of evidence, people rushed to get their hands on a prescription for the medicine. Moreover, the increased demand led to pharmaceutical companies putting all their resources into increasing drug production. This diverted attention from the production of important pandemic supplies, like face masks, ventilators, and gowns. Experts have criticized people for hoarding these medications and causing shortages for those suffering from malaria, lupus, or rheumatoid arthritis. Moreover, recent trials and studies have proven hydroxychloroquine and chloroquine as ineffective against COVID-19. Many have also related severe side effects to the drug&#39;s use.&nbsp;

Therefore, the WHO urges people to not self-medicate with these or any drugs that have not been backed by any health regulatory body. Moreover, physicians are advised to refrain from administering such treatments to COVID-19 patients.

In conclusion, prevention is the best strategy against COVID-19. Washing hands, maintaining social distancing, and wearing a mask continue to be the best precautionary steps for preventing COVID-19.

&nbsp;

<ul></ul><ul><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">The COVID-19 pandemic began in November of 2019 and has infected more than 520 million people across the world.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">The pandemic gave rise to several myths and theories about the spread and treatment of COVID-19. From eating garlic to drinking disinfectants, people have done some rather outlandish things to protect themselves.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">One such myth surrounded the use of antimalarial drugs to treat COVID-19. Early in the pandemic, several scientists also supported the theory, citing successful result from small scale in-vitro studies.&nbsp;</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">As the use of chloroquine and hydroxychloroquine increased worldwide, it also led to the development of severe side effects among COVID-19 patients.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Multiple trials also investigated the effects of these drugs on the novel coronavirus. However, none could demonstrate any benefits. Moreover, many clinical trials ended halfway due to the occurrence of severe cardiac side effects among trial patients taking hydroxychloroquine.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Other than chloroquine and hydroxychloroquine, people have also explored the Artemisia plant for its anti-viral properties. The plant's extracts are used for making artemisinin-based combination therapies (ACTs) for malaria. However, studies have not found the plant to have anti-COVID activity.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">So far, atovaquone is the only antimalarial that has shown anti-viral properties against COVID-infected lung cells. The laboratory study is now being converted into a clinical trial to help scientists better understand the drug's mechanism of action and safety.&nbsp;</li></ul>

[1] WHO, 2022. WHO Coronavirus (COVID-19) Dashboard. [Online].

[2] Habib, M. & Abbas, M., 2021. Facing the Threat of COVID-19 in Pakistan: A Nation’s Dilemma. Value in Health Regional Issues, Volume 24, pp. 90-95.

[3] Gautret, P. et al., 2020. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents.

[4] Favalli, E. G. et al., 2020. Role of antimalarials in COVID-19: observational data from a cohort of rheumatic patients. Annals of the Rheumatic Disease, 80(5).

[5] FDA, 2020. Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine. [Online].

[6] Carter-Timofte, E. M. et al., 2021. Antiviral Potential of the Antimicrobial Drug Atovaquone against SARS-CoV-2 and Emerging Variants of Concern. ACS Infectious Diseases, 7(11), pp. 3034-3051.