Humza Khizer

Pregnant women get whooping cough vaccine for cough during pregnancy and their unborn child between sixteen to thirty-two weeks. Read more at Meri Sehat.

Do Pregnant Women Need Booster Doses for Whooping Cough?

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

Do Pregnant Women Need Booster Doses For Whooping Cough?

Online Consultation

Medilink Consultant clinic

Saad Ullah Siddiqui

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

I Am An Adult, Should I Be Worried About Getting Whooping Cough?

Overview

<a href="https://www.merisehat.pk/disease/whopping-cough">Whooping cough</a> is a very contagious disease, and while the infection is common in infants, people of all ages can contract it.

The symptoms of whooping cough are less severe in adults compared to children. Infants who are not vaccinated are at the highest risk of developing complications and severe symptoms from whooping cough.

&nbsp;

Understanding Adult Whooping Cough

Adults can also be affected by whooping cough; however, it is less severe compared to children<a href="#accordion">[1]</a>.

Their symptoms are less severe in contrast to children because their immunity is stronger from previous infections and vaccinations.

Bordetella pertussis causes whooping cough and this bacteria spread through the air when someone with the infection sneezes or coughs. The symptoms develop five to ten days after being exposed, but for some people, symptoms don&rsquo;t develop for weeks.

Whooping cough has three developmental stages:

&nbsp;

<h5>Stage 1</h5>

The early stage of the disease is very contagious. Furthermore, whooping cough has mild, cold-like symptoms, which last for one to two weeks. For example:

<ul>
	<li>Sneezing</li>
	<li>Runny nose</li>
	<li>Low-grade fever</li>
	<li>Mild cough</li>
	<li>Fatigue</li>
	<li>Watery eyes</li>
</ul>

&nbsp;

<h5>Stage 2</h5>

People develop a persistent and severe cough after some time, and it can leave them gasping for air. The whooping sound of the cough happens when people inhale sharply to catch their breath after coughing a lot. People remain contagious in the second stage, and the symptoms last from one to six weeks.

&nbsp;

<h5>Stage 3</h5>

The cough improves gradually in the final stage and the coughing fits decrease. People are not contagious when they&rsquo;re in stage 3. However, they are at risk of developing other infections, which slows down the process of recovery.

&nbsp;

A doctor diagnoses whooping cough through a person’s medical history and current symptoms.Moreover, doctors misdiagnose whooping cough as a common cold or respiratory infection in most adult cases due to the absence of severe symptoms in adults.However, if a doctor suspects whooping cough in an adult, certain tests are prescribed. These tests include a nasopharyngeal swab, where the doctor collects a sample of the mucus through the nose for the analysis of B. pertussis bacteria.

Whooping cough can lead to insomnia and adults can develop secondary complications from the cough. The violent coughing fits can cause fainting and fractures of the ribs.

The other potential complications in adults are the following:

<ul>
	<li>Difficulty falling asleep or sleepless nights</li>
	<li>Sleep apnea</li>
	<li>Weight loss</li>
	<li>Eye infections</li>
	<li>Pneumonia</li>
</ul>

&nbsp;

The treatment varies based on the duration of the illness and severity of the symptoms, which is usually antibiotics therapy.

Early treatment with antibiotics can reduce the severity and speed up the recovery. Moreover, it also prevents people from transmitting the bacteria. Your physician will prescribe antibiotics to you and your household.

According to CDC, antibacterial treatment is most effective during the first two or three weeks of infection, before the coughing fit starts<a href="#accordion">[2]</a>.&nbsp;

&nbsp;

Key Points

<ul>
	<li>Whooping cough usually occurs in children, but people of any age can be affected by it, even adults.</li>
	<li>Pertussis has the distinct coughing sound that sounds like a whoop.</li>
	<li>Using cough medications is not recommended in pertussis (whooping cough).</li>
	<li>Vaccinated people can also be carriers of whooping cough.</li>
	<li>Several steps can be taken for the management of pertussis and to prevent it from spreading to others.</li>
</ul>

&nbsp;

[1] Zycinska, K., Cieplak, M., Chmielewska, M., Nitsch-Osuch, A., Klaczkow, A., Hadzik-Blaszczyk, M., Kur, Z. and Wardyn, K.A., 2016. Whooping cough in adults: a series of severe cases. In Pathobiology of Pulmonary Disorders (pp. 47-50). Springer, Cham.

[2] Wirsing von König, C.H., Tacken, A. and Finger, H., 1991. Whooping cough in adults. Deutsche Medizinische Wochenschrift (1946), 116(17), pp.649-653.

Staff Writer

Iqra Mazhar

Just A Little Dose

Introduction

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 drugs, 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>

Conclusion

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.

Umna Salah

Baby Loading

There&rsquo;s no doubt that pregnancy tests and ultrasounds are the only credible ways to determine whether or not you&#39;re pregnant. But urine or blood tests may give false positives and ultrasounds may take 17 days post ovulation to identify a healthy pregnancy.

&nbsp;

However, excited or anxious as you are at the mere idea of being pregnant, you&rsquo;re probably looking for additional indications and symptoms, too. A missed period (menses), smell sensitivity, weariness or fatigue, and of course, the infamous nausea and morning sickness all point towards pregnancy. In a recent study, 15.6% of participants even showed anxiety symptoms during early pregnancy<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

As new parents, you&rsquo;ll come across a lot of hearsay about the topic. You need to stop reading too much into signs and let&rsquo;s just keep the fiction separate from the facts to begin with.&nbsp; 
&nbsp;

Understanding The Early Pregnancy

Your first week of pregnancy is determined by the date of your last menstrual cycle. It may seem strange because technically you weren&#39;t even pregnant at that point of time.

&nbsp;

The date of your last menstruation would also determine the estimated delivery date. For this reason, the first few weeks of your 40-week pregnancy might be symptom-free. 
&nbsp;

If you are expecting, you may experience the following signs and symptoms in the first few weeks:

<ul>
	<li>Minimal cramps and spotting</li>
	<li>Missed period</li>
	<li>Fatigue and weariness&nbsp;</li>
	<li>Nausea</li>
	<li>Painful breasts&nbsp;</li>
	<li>Bloating</li>
	<li>Frequent urination</li>
	<li>Traveling sickness</li>
	<li>Fluctuations in the mood&nbsp;</li>
	<li>Fluctuations in body temperature&nbsp; 
	&nbsp;</li>
</ul>

Other indicators may include:

<ul>
	<li>Elevated blood pressure</li>
	<li>Severe exhaustion and heartburn&nbsp;</li>
	<li>Increased heartbeat</li>
	<li>Changes in the breast and nipple</li>
	<li>Bouts of acne</li>
	<li>Noticeable increase in weight</li>
	<li>Pregnancy glow 
	&nbsp;</li>
</ul>

<h5>Implantation Bleeding&nbsp;</h5>

During the first 4 weeks, everything happens on a cellular level. The fertilized egg produces a blastocyst (a fluid-filled collection of cells) that will develop into the organs and body parts of the fetus.

&nbsp;

The blastocyst stays in the endometrium (the uterine lining) for about 10-14 days (week 4) following fertilization. This may result in implantation bleeding, which could be misinterpreted as a light period. This does not happen to everyone. If you experience it, you&rsquo;ll note that it coincides with the time you expect your period to start. 
&nbsp;

Here are a few indicators of implantation bleeding:

<ul>
	<li>Color</li>
</ul>

Each occurrence may be pink or light brown.

&nbsp;

<ul>
	<li>Bleeding</li>
</ul>

Implantation bleeding is typically a few drops of blood. It&#39;s frequently described as very light bleeding that never becomes a flow or requires the use of a pad or tampon.

&nbsp;

<ul>
	<li>Pain and other symptoms </li>
</ul>

The pain is usually milder than with regular menstrual cramps. It may be accompanied by nausea and frequent urination.

&nbsp;

<ul>
	<li>Duration</li>
</ul>

Implantation bleeding usually lasts less than 3 days and does not necessitate treatment. Occasionally, it will last only a few hours.

&nbsp;

NOTE: Although implantation bleeding is not usually a cause for concern, you should talk with a doctor if you experience symptoms such as: persistent bleeding, vaginal blood clots or bleeding that saturates a pad every 30 minutes.&nbsp; 
&nbsp;

<h5>Missed Period&nbsp;</h5>

Your placenta begins synthesizing human chorionic gonadotropin (hCG) shortly after implantation. This hormone assists the body in maintaining pregnancy. It also instructs the ovaries to stop releasing mature eggs (ovum) once a month.

&nbsp;

You are likely to miss your periods starting from 4 weeks post fertilization. If you usually have an irregular period, you should get a pregnancy test to confirm. The majority of home tests are capable of detecting hCG levels in your urine as soon as 8 days following a missed period. 
&nbsp;

<h5>Raised Body Temperature&nbsp;</h5>

An elevated body temperature might also be an indicator. It is also possible that exercise and hot weather can also cause your core temperature to rise more easily. Take precaution and drink plenty of liquids to keep yourself hydrated and maintain your body temperature. 
&nbsp;

<h5>Fatigue&nbsp;</h5>

Throughout pregnancy, you may experience fatigue and weariness at any stage, but it&rsquo;s a typical sign of early pregnancy. This is because your progesterone levels rise, which makes you feel drowsy.&nbsp; 
&nbsp;

<h5>Increased Heart Rate&nbsp;</h5>

During weeks 8-10, your heart will beat harder and more frequently. Palpitations and arrhythmias are common during pregnancy due to hormones. According to a 2016 study review, blood flow increases by 30-50% during pregnancy. This puts more strain on your heart<a href="#accordion">[2]</a>.

&nbsp;

If it was a planned pregnancy, you may have discussed any underlying cardiac problems with your medical team prior to it, right? If not, now is the time to talk about any conditions or treatment that may be required. 
&nbsp;

<h5>Early Changes To Breasts: Tenderness and&nbsp; Swelling&nbsp;</h5>

Breast modifications are possible between weeks 4 and 6. Hormone fluctuations are likely to cause sensitive and sore breasts, which will likely subside within a few weeks as your body adjusts to the hormones.

&nbsp;

Changes in the nipple and breast are also possible around week 11. Hormones continue to cause breast growth. The areola may darken and get bigger. 
&nbsp;

<h5>Changes in Mood&nbsp;</h5>

During pregnancy, your estrogen and progesterone levels are elevated. This increase may affect your mood, making you more emotional or reactive than usual. Mood swings are frequent during pregnancy and you&rsquo;ll often feel sadness or despair, irritation, anxiety, and euphoria.&nbsp; 
&nbsp;

<h5>Frequent Urination &amp; Incontinence&nbsp;</h5>

The amount of blood in the body increases during pregnancy. As a result, your kidneys process more fluid than usual, resulting in extra fluid in your bladder.

&nbsp;

Besides, hormones influence bladder health as well. You may find yourself racing to the restroom more often or accidentally leaking during pregnancy. 
&nbsp;

<h5>Bloating &amp; Constipation&nbsp;</h5>

Comparable to the signs of a menstrual period, bloating is a possibility during early pregnancy. This could be related to hormonal changes, which can also cause your digestive system to slow down. As a result, you may feel constipated and obstructed. Constipation can also promote abdominal bloating. 
&nbsp;

<h5>Morning Sickness, Nausea, &amp; Maybe Vomiting&nbsp;</h5>

Nausea and morning sickness commonly appear between weeks 4 and 6, peaking around week 9. Although it is referred to as morning sickness, it may occur at any time of day or night. The exact cause of nausea and morning sickness is uncertain; however, it is believed that hormones may play a role.

&nbsp;

Many women have mild to severe morning sickness throughout the first trimester of pregnancy. So, you should be mentally prepared for it to get more acute near the end of the first trimester. But, don&rsquo;t worry; it usually subsides as you reach the second trimester. 
&nbsp;

<h5>Smell Sensitivity &amp; Food Intolerance&nbsp;</h5>

Smell sensitivity is a common early pregnancy symptom that is primarily self-reported and has minimal scientific support. However, it may be notable because smell sensitivity triggers nausea and vomiting. It may also induce a severe intolerance to particular meals. According to 2017 research, women have an enhanced or diminished sense of smell during pregnancy<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

Smell sensitivity is very common during the first and third trimesters. Only rarely will you feel as if your sense of smell has diminished; otherwise, it will be sharper and more pronounced throughout the pregnancy. You may find some scents less appealing even though they had never bothered you in the past.

&nbsp;

The good news is that the sense of smell returns to normal within 6-12 weeks after delivery. 
&nbsp;

Weight gain is a normal phenomenon near the end of the first trimester. You may gain between 1 and 4 pounds in the first several months. Calorie guidelines for early pregnancy remain similar to your regular diet, but will increase as the pregnancy advances. 
&nbsp;

<ul>
	<li>Pregnancy weight is frequently visible in the following areas in the latter stages:</li>
	<li>Breasts (approximately 1-3 pounds)&nbsp;</li>
	<li>Uterus (approximately 2 pounds)&nbsp;&nbsp;</li>
	<li>Placenta (approximately 1.5 pounds)</li>
	<li>The amniotic fluid (approximately 2 pounds)</li>
	<li>Increased blood and fluid volume (approximately 5-7 pounds)</li>
	<li>Fat (approximately 6- 8 pounds) 
	&nbsp;</li>
</ul>

<h5>Heartburn&nbsp;</h5>

Hormones can relax the valve that connects your stomach and esophagus. This permits stomach acid to escape, resulting in heartburn. 
&nbsp;

<h5>Pregnancy Skin: Glow OR Acne&nbsp;</h5>

Some individuals may begin to say that you have the &quot;pregnancy glow.&quot; It&rsquo;s the combination of an increased volume of blood and elevated hormone. Your skin appears flushed and glossy due to the increased activity of your body&#39;s oil glands. Be prepared; there&rsquo;s also the possibility of acne.

&nbsp;

<h5>Backache</h5>

More than one-third of pregnant women experience back pain. This is frequently related to ligament relaxation and a shift in posture caused by the growing pregnancy.&nbsp;

&nbsp;

Wearing flat-heeled shoes, utilizing seats with good back support, avoiding carrying heavy objects, and practicing light exercise can all help prevent back pain during pregnancy. Similarly, exercising in water, physiotherapy, and acupuncture can all help reduce back pain during pregnancy. 
&nbsp;

Pregnancy tests detect a specific level of human chorionic gonadotropin (hCG) in your urine. You can take a pregnancy test to check whether or not you are pregnant as soon as you miss your period. You get the most reliable results if you take it at least 1 week after you&#39;ve missed your period.&nbsp;

&nbsp;

While some tests claim to provide accurate results prior to a missed period, taking a test too soon can result in a false negative (the test says you&#39;re not pregnant, but you are).

&nbsp;

Additionally, your healthcare professional can take a blood sample to screen for pregnancy as early as 1 week before a missing period. 
&nbsp;

<h5>Tips</h5>

<ul>
	<li>
	If you obtain a negative result on a home pregnancy test, then it&rsquo;s recommended that you take another one 7 days later to double-check.
	</li>
	<li>Home pregnancy tests are 97% more accurate when used correctly at the right time, according to the National Institute of Child Health and Human Development in 2017<a href="#reference">4</a>. Home pregnancy tests vary in accuracy. Choose one that is known to be accurate.</li>
	<li>A blood test can typically detect pregnancy much earlier, but it must be performed in a medical professional&#39;s office or clinical setting.</li>
</ul>

&nbsp;

During early pregnancy, your body will undergo major changes. You may notice symptoms like nausea, breast discomfort, and of course, the missed period. If you suspect you&#39;re pregnant, a home pregnancy test is a good first step to take. These tests are typically available without a prescription at pharmacies and other shops.&nbsp;

&nbsp;

If you get a positive result, make an appointment with a doctor. They will examine you and run more tests to confirm your pregnancy. You can then begin a prenatal regimen to protect your and your fetus&#39; health. 
&nbsp;

<ul>
	<li>During early pregnancy, your body will undergo major changes.</li>
	<li>Missed periods, nausea, throwing up, breast modifications, exhaustion, fatigue, and frequent urination are all symptoms of a pregnancy.</li>
	<li>If you suspect you&#39;re pregnant, a home pregnancy test is a good first step to take.</li>
	<li>If you get a positive result, make an appointment with a doctor.</li>
	<li>Once your pregnancy is confirmed , your healthcare professional will guide you on the appropriate prenatal regimen.&nbsp;</li>
</ul>

[1] Rubertsson C, Hellström J, Cross M, Sydsjö G. Anxiety in early pregnancy: prevalence and contributing factors. Arch Womens Ment Health. 2014;17(3):221–8.

[2] Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy: review articles. Cardiovasc J Afr. 2016;27(2):89–94.

[3] Dikici O, Muluk NB, \cSahin E, Altintoprak N. Effects of pregnancy on olfaction. ENT Updat. 2017;7(2):104–7.

[4] PAGE JP. How Do I Know If I’m Pregnant. JAMA. 2001;286(14).

Neelam Asad

Madeeha Syed

Natural Remedies For The Cold, Flu And Cough!

The onset of winter is a great time to get some fresh air and exercise outside. The colder weather also brings with it colds, flu, and <a href="https://merisehat.pk/disease/whopping-cough">coughs</a>. While these are all very common ailments, they can be a nuisance. Fortunately, there are lots of natural remedies that you can use to help treat your symptoms without resorting to drugs or side effects. Read on for some great tips on how to manage this winter&rsquo;s common ailments. 
&nbsp;

Natural Remedies

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Honey</h5>
	</li>
</ul>

Honey is a natural cough suppressant, which not only helps you to breathe better, but also feel better. If you have a tickle in your throat that just won&rsquo;t go away, try some honey for relief.

Honey has antibacterial and anti-fungal properties that help it to fight off bacteria in your mouth and throat. It&rsquo;s even been shown to kill MRSA (methicillin-resistant staphylococcus aureus) on the skin! When we say &ldquo;honey&rdquo;, we&rsquo;re talking about all kinds - beri honey from Pakistan, Manuka honey from New Zealand; acacia honey from Australia; chestnut honey from China; buckwheat honey from Germany; and blueberry blossom honey made by bees in Japan. 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Lemon And Ginger Tea</h5>
	</li>
</ul>

Ginger and lemon tea is a great remedy for sore throats, coughs and colds. The combination of ginger and lemon works as an expectorant, which means that it helps the lungs to expel mucus through coughing.&nbsp;

Lemon also has antibacterial properties that can help fight infection. Ginger is an anti-inflammatory, making it helpful in reducing pain associated with sore throats or sore muscles after exercise. It also helps relieve nausea and vomiting.

I like to make my own herbal tea blends by adding honey, mint leaves and cinnamon sticks to boiling water just before drinking &mdash; this makes it more palatable as well as soothing to the throat! 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Onion And Garlic</h5>
	</li>
</ul>

Garlic is a well-known immune booster, and onions have anti-inflammatory properties. Both can be used to treat the common cold and flu. Although studies have been inconclusive on whether garlic can actually prevent illness, taking it in large quantities (one clove of fresh garlic daily) may substantially decrease the duration of an infection.

Although studies have been inconclusive on whether garlic can actually prevent illness, taking it in large quantities (one clove of fresh garlic daily) may substantially decrease the duration of an infection. 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Chicken Soup</h5>
	</li>
</ul>

Chicken soup is a classic cure-all, not only because it&rsquo;s easy to make but also because it contains a variety of nutrients that the body needs when you&rsquo;re feeling under the weather.

Chicken soup is a great source of protein, and in fact, most soups are good for this since they&rsquo;re usually made with meat stock. Chicken soup has plenty of vitamins and minerals like potassium, which helps regulate your body&rsquo;s fluid balance; zinc which can help fight off cold symptoms; and vitamins A and C which support overall wellbeing.

It&rsquo;s also easy to find chicken broth at many grocery stores now, so making homemade chicken soup doesn&rsquo;t require much effort or time spent driving around looking for ingredients! 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Herbs</h5>
	</li>
</ul>

Herbs are often used as natural remedies for the common cold, flu and cough. They can help relieve symptoms and speed up recovery time.

Herbs can be used as alternatives to medication, or in conjunction with medication when needed. Herbal medicines don&rsquo;t have side effects like those caused by antibiotics or other drugs that are prescribed for respiratory problems:

<ul>
	<li>Antibiotics kill bacteria but may also kill off good bacteria in your body that may cause other health problems down the road if they&rsquo;re not replaced through probiotic supplements.</li>
	<li>Some over-the-counter medications such as antihistamines have side effects such as drowsiness and dry mouth, which you might want to avoid if you&#39;ll be spending time around children who need supervision at home or school during cold season. 
	&nbsp;</li>
</ul>

<ul dir="ltr">
	<li>
	<h5>Ginger Ale</h5>
	</li>
</ul>

Ginger ale is a great remedy for the common cold, flu and cough. It also works well for nausea and motion sickness. Ginger ale is often used as an ingredient in other drinks (like Moscow Mules), but you can also drink it straight as a home remedy.

Ginger root has been used for centuries as both medicine and food in Asia, Africa, and Europe. Its warming properties are thought to help relieve sore throats, congestion, and stomachaches by stimulating circulation. 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Spicy Food</h5>
	</li>
</ul>

Spicy food can help clear mucus, congestion and sinus congestion. It can also clear chest, nasal, and throat congestion to help you breathe better.

Spicy foods that are good for your health include:

<ul>
	<li>Chili peppers (especially cayenne pepper)</li>
	<li>Cinnamon</li>
	<li>Ginger root 
	&nbsp;</li>
</ul>

Honey, lemon and ginger tea: Steep one teaspoon of fresh or dried ginger in boiling water for about 10 minutes. Add half a cup of honey and mix well until it dissolves. Strain through cheesecloth into a mug and add freshly squeezed lemon juice to taste.

Onion Soup: Chop one medium onion finely then saut&eacute; in 1 tablespoon butter until golden brown. Add 3 cups chicken broth (or vegetable if vegetarian) and simmer for 30 minutes on low heat until reduced by half.

Garlic: Crush two cloves of garlic using mortar and pestle or blender.

Chicken Soup: Cook some chicken pieces in water with chopped onions, carrots &amp; celery.

&nbsp;

Bottom Line

The best thing you can do for your body when you&rsquo;re sick is to give it the proper rest and nutrition. The natural remedies above are great ways to do this! It&rsquo;s important not only to take care of yourself as soon as you feel a cold coming on, but also to maintain good health overall. This will ensure that if something like the flu does happen again in the future (because it probably will), your body will be able to fight it off more easily and quickly.

Ismail Munir

Let's Talk About Sex During Pregnancy

One of the most pressing questions by couples who are expecting is, if they can have sex during pregnancy.There's no denying that pregnancy is an overwhelming period for both partners as they anticipate parenthood. For a woman, the process is obviously more challenging - her entire body is changing significantly. And even though nurturing her baby in womb would be nothing less than sheer joy, yet it cannot be denied that with all the changes happening internally and externally, a woman may experience mood swings and changes in sex drive.&nbsp;One of the most pressing questions by couples who are expecting is, if they can have sex during pregnancy. A plethora of myths surround the topic, exploiting the concern parents-to-be have for their baby, especially if it is the first pregnancy. They would want to avoid it, but with all the surging hormones, that’s not the ideal solution, is it? So, let’s see what can be done to make the whole process enjoyable, whether sex during pregnancy is possible, when it should be avoided, and what happens after delivery.&nbsp;&nbsp;

Understanding benefits of sex in pregnancy

Well, no, there is no truth to the statement. Sex is not unsafe for the baby if you and your partner have a healthy pregnancy. In fact, it is believed that sex supports and improves pregnancy.&nbsp; Your baby is well protected by the thick muscles of the uterus and is cushioned by the amniotic sac (a fluid filled cavity that surrounds the baby) so there is no potential risk to the baby during intercourse. Moreover, the cervix has a thick mucus plug and it acts as a barrier between the vagina and uterus so there's no way that the baby can get hurt or feel the penetrations<a href="#reference" target="_blank">1</a>.Many people are of the notion that sex during pregnancy induces preterm labor that results in premature birth or baby being delivered before the expected due date (before 37 weeks of gestation). However, studies show no evidence of such a relation and it is concluded that vaginal sex doesn't put the women and baby at risk of premature labor and birth<a href="#reference">1</a>.As women reach the end of their pregnancy, they might experience contractions due to orgasm or sexual penetration, which are referred to as Braxton Hicks contractions. These are mild contractions and are normal in women nearing the due date and it shouldn't arouse suspicion or concern<a href="#reference" target="_blank"> 1</a>.<div> </div>

Pregnancy can effect the sex drive of people in different ways. Some women feel that their sexual drive is fading away while others reach new heights of sexual arousal. As a woman transitions from first trimester to second and then to third, her desire for sex keeps on changing.&nbsp; During the first trimester, a woman is adjusting to the new state of her body. There are the sudden mood changes, there is with frequent nausea and vomiting, and let’s not forget the numerous trips to the loo to urinate. Hence, it’s not surprising that the mom-to-be whether out of frustration or lack of energy has zero desire to indulge in any sexual activity.&nbsp;But that’s going to change. And sooner than you think.&nbsp;The second trimester begins and along with it comes a surge in their sexual desire. The nauseous state of the first trimester has subsided. Also, there’s a spike in the level of certain hormones. Additionally, it is said that blood flow in the body increases by 40% during pregnancy and that this flow is greater in the genitals, which translates into better orgasms<a href="#reference">2</a>. Circumstances favoring, now is the time to benefit from sex during pregnancy. It’s ideal because the body isn't too big yet (as it would likely be in the third trimester) so both partners can be comfortable making love.Speaking of the third trimester, don’t be worried if the sexual drive takes a dip. It happens usually because of anxiety surrounding the impending parenthood. Besides, the baby bump is increasing and that makes many women uncomfortable, too and they consciously avoid getting involved in sex at this stage.&nbsp;

Communication between both partners is important during pregnancy. Tell your partner how you feel about yourself and if you are comfortable with sex during pregnancy.&nbsp; It is best to avoid lying flat during intercourse after the 4th month of pregnancy has passed. It exerts great pressure on the vessels that are taking blood to and from the heart and if these vessels get compressed while you’re lying, the blood supply to the baby might be compromised<a href="#reference">3</a>.This is not to discourage you! On the contrary, you can try new positions that work for both of you. Engage in activities that kindle intimacy such as hugging, cuddling, and kissing.&nbsp;<div> </div>

Pregnancy is an emotionally overwhelming period for both partners. Given that the desire for intercourse and the need for affection also varies for both partners throughout the duration of pregnancy, it is best to indulge in intimacy in ways and at times which works for both partners. Some benefits of sex during pregnancy are listed below:&nbsp;

1. Strengthens The Relationship&nbsp;

According to Terry Hoffman, an Ob-gyn at Mercy Medical Center in Baltimore, men often feel neglected and ignored during pregnancy since all the attention of their partner is directed towards the baby. Hence it is believed that pregnancy sex brings both partners closer and strengthens the relationship<a href="#reference">2</a>.&nbsp;

2. Leads To Better Orgasms

Another benefit that partners experience is better orgasms during pregnancy. This is particularly true for women who feel easily aroused with increased blood flow in the labia and vagina during pregnancy<a href="#reference">1</a>.&nbsp;

3. Improves Fitness And Immunity&nbsp;

Sex helps in burning calories and thus keeps partners fit. Furthermore, sex improves the <a href="https://merisehat.pk/article/how-an-over-prescription-of-antibiotics-affects-your-immune-system">immune system</a>. A study conducted in 2004 revealed that sex increases the level of IgA (a protein created by the body to prevent infections) and protects the individuals from cold and other common infections<a href="#reference">1</a>.

4. Increases Happiness&nbsp;

Lastly, orgasm releases endorphins, which are referred to as happiness hormones, and helps the mother and baby feel happy and relaxed<a href="#reference">1</a>.&nbsp;

<div>&nbsp;</div>

Your healthcare provider would advise you against sex if there are certain conditions in your current pregnancy or even if you have had them in previous ones. The only reason is because sex might aggravate those conditions and that would only increase the risk of complications such as miscarriage or preterm labor.&nbsp; You should not have during pregnancy if you have:<ul><li>Problems with the cervix, which increases the chances of having a miscarriage or early labor&nbsp;</li><li>A risk of miscarriage<a href="#reference">3</a></li><li>Multiple pregnancies with either twins, triplets, or multiples<a href="#reference">4</a></li><li>A low-lying placenta that covers the cervix either partially or fully, a condition called placenta previa<a href="#reference">4</a></li><li>A condition called cervical incompetence where the cervix progresses to labor prematurely&nbsp;</li><li>A history of premature labor&nbsp;</li><li>Experienced unexplained vaginal blood loss</li><li>Complications or high-risk pregnancies where the amniotic fluid leaks or the waters have broken. These conditions increase the risk of infection, hence making sex during pregnancy a no-go area.</li></ul>Seek Help Immediately!&nbsp;Call your healthcare provider if you experience any of the following while having sex in pregnancy<a href="#reference">3</a>.<ul><li>Menstrual-like bleeding</li><li>Pain and discomfort&nbsp;</li><li>Fluid or discharge&nbsp;</li><li>Constant contractions&nbsp;</li></ul><div> </div>

The 6 weeks following the delivery of the baby are known as the postpartum period. This is the time when partners are settling in as parents and with many sleepless nights and tiring days while taking care of the baby, sex is usually the last thing on their mind.&nbsp; For a woman, their body has not stopped changing. It has experienced a lot and is continuing to adjust to this new role during the recovery period. For starters, the episiotomy incision (scar during vaginal birth) or cesarean scar (through C-section) during the birth of the baby takes time to heal. Then, the postpartum bleeding takes 4-6 weeks to resolve. Additionally, fatigue associated with taking care of the baby and sore breasts due to breastfeeding are some of the other factors that contribute to low sex drive in women after birth<a href="#reference">3</a>.Moreover, women may have postpartum blues and might be depressed for a while. Consequently, they might not feel like engaging in activities that previously caused pleasure.&nbsp;It has been proven by research that it takes time for couples to resume sexual activities after giving birth to a baby. Swedish research conducted on 820 first-time parents showed that 6 months following the birth of their first child, the couples could only manage to have sex once or twice in a month<a href="#reference">2</a>.<div> </div>

Pregnancy is undoubtedly a very emotionally demanding phase and both partners may experience different levels of sex drives throughout the period. The change in desire is notably more significant in women than men due to changes in hormone levels, body shape, and increased blood flow in their body. Their libido fluctuates throughout the 3 trimesters, reaching its peak in the second trimester.&nbsp; The myth that sex during pregnancy results in miscarriages and promotes preterm labor and birth has no scientific evidence and, hence, is considered false. On the contrary, several benefits are attributed to having sex during pregnancy including but not limited to the facts that it brings the couples together and keeps them bonded in this very special phase of their life.&nbsp;<div> </div>

Many couples are puzzled about having or not having sex during pregnancy.&nbsp; <ul><li>However, it is completely safe to have sex during pregnancy as it doesn’t harm the baby.</li><li>Pregnancy sex is not associated with miscarriages or increased risk of preterm labor and birth.</li><li>Sex drive may vary in women across the three trimesters with the highest drive being in the second trimester.</li><li>Sex during pregnancy has many benefits such as an increase in intimacy between partner, improved health and immunity, etc.&nbsp;</li><li>There are certain conditions in which sex is not allowed during pregnancy. A woman who is at risk of having miscarriages or preterm birth is advised against sex during pregnancy.&nbsp;</li><li>Many partners find it cumbersome to resume sex immediately after giving birth due to the exhaustion that comes with parenting and taking care of their baby.&nbsp;</li></ul><div> </div>

Cadman B. Sex during pregnancy: Safety tips, positions, effects, and information. Medicalnewstoday.com. https://www.medicalnewstoday.com/articles/321648. Published 2022. Accessed August 18, 2022.

Dworkin-McDaniel N. Sex During Pregnancy: What Every Pregnant Person Should Know. Parents. https://www.parents.com/pregnancy/my-life/sex-relationship/pregnancy-sex-guide/. Published 2022. Accessed August 18, 2022.

Taylor R. Sex During and After Pregnancy. WebMD. https://www.webmd.com/baby/guide/sex-and-pregnancy. Published 2022. Accessed August 18, 2022.

Sex in pregnancy. nhs.uk. https://www.nhs.uk/pregnancy/keeping-well/sex/. Published 2022. Accessed August 18, 2022.

Nawal Adnan

Young babies with whooping cough often suffer from severe symptoms and are admitted to the hospital for their illness. The severity of whooping cough can also lead to death.

Pregnant women can protect their babies from <a href="https://www.merisehat.pk/disease/whopping-cough">whooping cough</a> by getting vaccinated between sixteen to thirty-two weeks. However, if they miss getting the vaccine during their pregnancy, they can still get it till they go into labour.

&nbsp;

Understanding The Need For Pertussis Vaccination In Pregnancy

Whooping cough (pertussis) is a serious infection where the patient coughs and chokes, which makes it difficult to breathe. The cause of the whoop is gasping for breath after each bout of coughing. However, babies don&rsquo;t always make this noise.

&nbsp;

Getting vaccinated during pregnancy can protect your baby from developing whooping cough in the first few weeks after birth<a href="#accordion">[1]</a>. The immunity from the vaccine will pass to the baby through the placenta and provide protection till they are old enough for routine vaccines against whooping cough.

&nbsp;

Women are usually concerned about whether the vaccine is safe to get during pregnancy. However, there is no evidence that suggests that the whooping cough vaccine is unsafe for pregnant women and their unborn children.

The whooping cough vaccine (pertussis-containing vaccine) is used routinely in pregnant women in the UK, since October 2012. Moreover, the Medicines and Healthcare Regulatory Agency (MHRA) monitors it for safety. The MHRA study has found no risk, or evidence of risks, in pregnant women and their babies<a href="#accordion">[3]</a>.&nbsp;

69% of women have gotten the vaccine to date and so far, no safety concerns have been identified in the mother or baby<a href="#accordion">[4]</a>.

Other countries are also currently recommending vaccination against whooping cough.

&nbsp;

The best time to get vaccinated is between sixteen to thirty-two weeks of pregnancy to protect your baby from whooping cough<a href="#accordion">[2]</a>. This increases the chances of your baby being protected from birth because the antibodies are transferred when they are born.

However, if you miss the vaccine due to any reason, you can get it before labor. But the chances of your baby getting the protection are highly unlikely. However, it will protect the mother from getting whooping cough and passing it to their baby after birth.

&nbsp;

UK vaccination program says that it is highly effective for women to get vaccinated against whooping cough because it protects their young babies till they can get their first vaccination at the age of eight weeks.

Babies of women who had been vaccinated at least a week before giving birth had a 91% reduced risk of getting ill with whooping cough in their first few weeks post-birth<a href="#accordion">[5]</a>. This comparison was done between babies whose mothers had been vaccinated and those who had not been vaccinated.

In addition, another benefit of getting vaccinated is that the mothers receive protection from the vaccination, which lowers the risk of infection and passing whooping cough to the baby.&nbsp;

&nbsp;

There isn&rsquo;t a single whooping cough vaccine. The vaccine is a combination, which protects against polio, tetanus, and diphtheria. It is called the Boostrix IPV. The Boostrix IPV vaccine is like the 4-in-1 vaccine. It is a pre-school booster that is given in routine to children before they start school.

&nbsp;

The side effects are mild, which include, swelling, tenderness, swelling, or redness at the site of the vaccination (arm), just like any other vaccine. However, the side effects last for a few days only. Other side effects of the vaccine include fever, irritation, and swelling of the vaccinated arm. Loss of appetite, irritability, and headache are also seen. Although, severe side effects are extremely rare.

&nbsp;

Whooping cough is very infectious and can cause pneumonia and brain damage, especially in young babies. Most of the babies require hospitalization for the treatment of whooping cough. Moreover, if the case is very severe, they may die.

The cases of whooping cough have fallen since 2012 in England among all age groups<a href="#accordion">[6]</a>. The largest fall has been seen in young babies targeted by the pregnancy vaccination program.

However, the cases of whooping cough are high in adults, compared to the pre-2012 levels. The number of cases was high in 2016, with an increase in three to four yearly peaks in the rates of diseases<a href="#accordion">[7]</a>.

Older adults with whooping cough can infect babies; hence, it is necessary that pregnant women get vaccinated and protect their babies.

&nbsp;

<ul>
</ul>

<ul>
	<li>Pregnant women can be vaccinated with the DTaP(-IPV) booster to protect their babies from whooping cough till the age of six months.</li>
	<li>Moreover, maternal antibodies are passed to the baby through the placenta.&nbsp;</li>
	<li>Mothers should consult their physicians and discuss getting vaccinated for pertussis during their pregnancy.</li>
</ul>

&nbsp;

[1] Switzer, C., D’Heilly, C. and Macina, D., 2019. Immunological and clinical benefits of maternal immunization against pertussis: a systematic review. Infectious Diseases and Therapy, 8(4), pp.499-541.

[2] Murthy, S., Godinho, M.A., Lakiang, T., Lewis, M.G.G., Lewis, L. and Nair, N.S., 2018. Efficacy and safety of pertussis vaccination in pregnancy to prevent whooping cough in early infancy. The Cochrane Database of Systematic Reviews, 2018(4).

[3] Donegan, K., King, B. and Bryan, P., 2014. Safety of pertussis vaccination in pregnant women in UK: observational study. Bmj, 349.

[4] D’Heilly, C., Switzer, C. and Macina, D., 2019. Safety of maternal immunization against pertussis: a systematic review. Infectious Diseases and Therapy, 8(4), pp.543-568.

[5] Healy, C.M., 2016. Pertussis vaccination in pregnancy. Human vaccines & immunotherapeutics, 12(8), pp.1972-1981.

[6] Haslam, N., Hoang, U. and Goldacre, M.J., 2014. Trends in hospital admission rates for whooping cough in England across five decades: database studies. Journal of the Royal Society of Medicine, 107(4), pp.157-162.

[7] Esposito, S., Stefanelli, P., Fry, N.K., Fedele, G., He, Q., Paterson, P., Tan, T., Knuf, M., Rodrigo, C., Weil Olivier, C. and Flanagan, K.L., 2019. Pertussis prevention: reasons for resurgence, and differences in the current acellular pertussis vaccines. Frontiers in Immunology, 10, p.1344.