Madeeha Syed

Explore the effectiveness of virginity tests. Meri Sehat delves into the cultural practice, its accuracy, and the ethical implications surrounding it.

Do Virginity Tests Even Work?

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Saad Ullah Siddiqui

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Nuclear Stress Test FAQs

Introduction

With terms like &ldquo;nuclear&rdquo; + &ldquo;stress&rdquo;, the name itself may sound intimidating for a lot of you. However, it&rsquo;s just a common test that could help you determine whether every time you heave a bag upstairs is normal or a symptom of restricted blood flow and poor heart health<a href="#accordion">[3]</a>. 
&nbsp;

A nuclear stress test is an innovative diagnostic technique for heart problems. It may be necessary to:

<ul>
	<li>Identify heart diseases, such as<a href="https://merisehat.pk/disease/coronary-artery-disease"> coronary artery disease</a> and irregular heartbeat</li>
	<li>Verify the effectiveness of the treatment for specific heart issues</li>
	<li>Ensure the heart is capable of withstanding anesthesia before surgery&nbsp;</li>
	<li>Ensure that the fitness regimen your doctor recommends for you is safe 
	&nbsp;</li>
</ul>

Your doctor will observe how well your cardiovascular system works when you&rsquo;re at rest as well as when you&rsquo;re exercising. You will be given an IV infusion of a radioactive tracer before the procedure begins. The tracer will enable the nuclear camera to capture images of the heart muscle&#39;s blood flow during the entire process.&nbsp;

&nbsp;

Along with these pictures, the protocol entails that your heart&rsquo;s activity is also monitored through ECG and blood pressure. 
&nbsp;

Understanding FAQs About a Nuclear Stress Test

It may be conducted at a hospital or an outpatient clinic, i.e., under supervision of a technologist, nurse, and/or doctor.&nbsp;

&nbsp;

You&rsquo;ll be instructed to arrive for the test wearing comfortable shoes and clothes and to avoid applying any cream or oil to your skin on that day. As a precaution, the doctor may also have advised you to avoid some or all of your medications a few days before the test if they&rsquo;re likely to interfere with the test. And, likewise, they may ask you to not smoke, drink, and even fast for a couple of hours prior to the test.

&nbsp;

You may be allowed an inhaler if you&rsquo;re asthmatic&nbsp;as long as you&rsquo;ve informed the doctor and the medical team beforehand<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

During the procedure, your body will then be wired to an ECG machine, a blood-pressure cuff will be wrapped around your arm, and you may be asked to breathe through a tube.

&nbsp;

The test usually takes 2-4 hours, but some people are required to take the test over 2 days so you may want to confirm it with your doctor and plan accordingly. 
&nbsp;

If you do not exercise regularly, your doctor may opt for pharmacologic stress testing instead of the treadmilm<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

Again, there&rsquo;s no need to worry. It&rsquo;s a chemical stress procedure that mimics exercise by boosting blood flow to your heart. If your test result reveals that your heart is healthy at rest, but experiences a shortage of blood flow during stress (exertion), it means that the artery transporting oxygenated blood from the heart to the rest of your body is constricted. 
&nbsp;

Is There any Side Effect of Nuclear Stress Tests?

The radioactive tracer has no negative side effects. It has no effect on your kidneys since it doesn&#39;t include iodine<a href="#accordion">[4]</a>. 
&nbsp;

While it&rsquo;s a generally safe testing, you may experience the following complications<a href="#accordion">[2]</a>:

<ul>
	<li>Irregular cardiac rhythms, chest pain, and heart attacks affect 1 in 10,000 people&nbsp;</li>
	<li>IV insertion and the radioactive tracer injection may cause some discomfort&nbsp;</li>
	<li>An allergic response can triggered by the tracer or radioactive dye&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/anxiety">Anxiety</a>, trembling, nausea, dizziness, and chest discomfort are possible due to medications used in the test 
	&nbsp;</li>
</ul>

Depending on your particular medical condition and even your sex and age, there may be other risk factors involved, too. Make sure to inform your doctor of all your medical conditions so they can decide the level of radiation you&rsquo;ll be exposed to during the test. 
&nbsp;

The radioactive liquid will remain in your body for 24-36 hours after the examination<a href="#accordion">[5]</a>. Here&rsquo;s how you can take care of yourself and your loved ones: 
&nbsp;

<ul>
	<li>Drink plenty of liquids: This is to help you flush the radioactive fluids out of the body. Ask your doctor which fluids are best for you and how much you need to consume daily.</li>
	<li>Wash your hands with soap and water: Your body releases the radioactive liquid throughout your stool and urine movements. Make sure you wash your hands after you have a bowel movement or you urinate. Anybody who comes in contact with your feces or pee should wash their hands as well.</li>
	<li>Breastfeed as directed: Ideally, though, you should avoid it for a day at least after your test.</li>
	<li>Restrict cuddling: This is especially true if there are children under<a href="#accordion">[3]</a>. Hug them briefly or wait for at least 18 hours after the test to hold them close. 
	&nbsp;</li>
</ul>

If your test results are abnormal, you might require cardiac catheterization or further testing. The medical terminology in a stress test result can be perplexing, therefore, it's crucial to schedule a consultation with your doctor to understand the results of your stress test.&nbsp;

Conclusion

A heart stress test is a very safe way to measure how your heart responds to an increased workload. It can diagnose many heart problems, including heart artery blockages and arrhythmias. It can also show if your heart is strong enough to handle anesthesia for surgery or to start a new exercise program. If your stress test is abnormal, it could mean that you need more testing on your heart. <o:p></o:p>

[1] Iskandrian AS, Verani MS, Heo J. Pharmacologic stress testing: mechanism of action, hemodynamic responses, and results in detection of coronary artery disease. J Nucl Cardiol. 1994;1(1):94–111.

[2] Vilcant V, Zeltser R. Treadmill stress testing. In: StatPearls [Internet]. StatPearls Publishing; 2022.

[3] Nuclear stress test: Benefits and side effects. Medical News Today..

[4] What to expect: Nuclear stress testing. Heart House.

[5] Nuclear stress test (discharge care). Drugs.com.

[6] Nuclear stress test. Mayo Clinic.

Neelam Asad

Iqra Mazhar

Nuclear Stress Test Explained

Nuclear stress test (also known as cardiac PET study or cardiac SPECT study or myocardial perfusion imaging (MPI) study) is a nuclear imaging test that measures the amount of blood flow in your heart while you are exercising and resting.&nbsp;

During the procedure, a liquid containing a trace amount of radioisotope is injected into one of your veins. It travels through your bloodstream and eventually reaches your heart. Once the radiation has entered your heart, a gamma camera (a special camera) is used to detect the radiation and reveal any problems with your heart (function or blood flow)<a href="#accordion">[1]</a>. 
&nbsp;

Understanding The Nuclear Stress Test

The test results determine whether or not your heart muscle receives adequate blood flow and oxygen when working hard.

&nbsp;

<ul>
	<li>
	<h5>Symptoms Of Heart Disease</h5>
	</li>
</ul>

If you experience heart disease symptoms, such as chest pain or shortness of breath, you may have to undergo a nuclear stress test.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Determining <a href="https://merisehat.pk/disease/coronary-artery-disease">Coronary Artery Disease</a></h5>
	</li>
</ul>

Coronary arteries are the main blood channels that carry oxygen, nutrients, and blood to your heart. Fatty deposits or plaques present in these arteries reduce the flow of oxygenated blood to your heart muscle.

If you are experiencing symptoms like shortness of breath or chest pain, your doctor will order a nuclear stress test because it will help diagnose whether you have coronary artery disease. The test results will also help identify how severe or advanced the condition is<a href="#accordion">[4]</a>.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Making A Treatment Strategy</h5>
	</li>
</ul>

Since a nuclear stress test measures how much activity your heart is able to withstand, your doctor will use it to select the best course of treatment for you and, later again, to check the efficacy of that treatment. 
&nbsp;

The nuclear stress test is performed at a medical facility.

<ul>
	<li>A technician inserts an intravenous line into your arm and injects a radioactive substance, such as thallium or sestamibi, before the test begins<a href="#accordion">[5]</a>.</li>
	<li>After a few minutes, you need to lie down for 15-45 minutes.&nbsp;</li>
	<li>A special camera scans your heart and takes pictures to show how the substance moved through your blood and into your heart while you were resting.</li>
	<li>During this period, electrodes are also placed on your arms, chest, and legs. These electrodes are connected to an ECG machine. Your heart rhythm will be monitored throughout the test.</li>
	<li>At the same time, the technician or the nurse ensures you wear the BP cuff correctly on your arm. Your blood pressure will be monitored throughout the test, too.</li>
	<li>Next, if the doctor asks to combine the nuclear test with the traditional exercise stress test, you have to walk on a treadmill or pedal on an exercise machine. The technique is to start walking slowly and slowly increase the speed for the length of the test.</li>
	<li>If you are unable to exercise, a vasodilator, such as adenosine or persantine, is prescribed to dilate the arteries in your heart. In other cases, you may be given a drug such as dobutamine that causes your heart to beat faster and harder.</li>
	<li>When your heart is functioning as hard as it possibly can, a radioactive substance is injected into one of your veins one more time and you have to wait 15-45 minutes again.</li>
	<li>Again, the specialized camera scans your heart and produces images.</li>
	<li>At this stage, you&rsquo;re permitted to get up from your seat or table and have a snack or beverage.</li>
	<li>You have to continue exercising till you reach the target heart rate or till you start to feel distressed or have other symptoms.</li>
	<li>At the end of the test, your doctor compares the first and second sets of images on their computer, i.e., compare how your heart functions at rest and under stress, whether you have heart disease, or whether your heart condition is worsening.</li>
</ul>

&nbsp;

<h5>1. Pre-Test Preparation</h5>

The point to remember is that the test is of no use if you&rsquo;re uncomfortable or in any undue physical stress. So, prioritize your comfort and your health:

<ul>
	<li>Wear loose-fitting clothing and shoes with non-slip soles.&nbsp;</li>
	<li>Avoid eating or drinking a couple of hours before the test is scheduled to take place. If you need to take medications, you will be permitted to take them with a few sips of water.</li>
	<li>However, a lot of medicines affect blood test results. Inform your doctor of any medicine you&rsquo;re taking; they&rsquo;ll tell you if you need to change their dose or entirely stop taking them before this test.</li>
	<li>Coffee, tea, chocolates, and caffeine-containing pain relievers should be avoided at all costs at least 24 hours before the test.</li>
</ul>

&nbsp;

<h5>2. During the Test</h5>

Some people experience the following symptoms during the test:&nbsp;

<ul>
	<li>Chest pain</li>
	<li>Fatigue and weariness</li>
	<li>Cramps in the legs or feet</li>
	<li>Breathing difficulty</li>
	<li>Nausea</li>
	<li>Headache</li>
	<li>A sting followed by a warm sensation when the vasodilator medicine is injected</li>
</ul>

Generally, it&rsquo;s nothing serious. However, you need to immediately notify the person performing the test if you feel any of these symptoms. 
&nbsp;

That feeling of stress on your heart may be an indicator of something serious, but let&rsquo;s not jump to any conclusions, okay? You&rsquo;ve had your test and you&rsquo;re nervous already; read on to find out what the test results mean and whether you require additional testing.

&nbsp;

<ul>
	<li>
	<h5>Normal&nbsp;</h5>
	</li>
</ul>

Stress tests categorize the majority of patients evaluated for stable CAD as low risk<a href="#accordion">[3]</a>.&nbsp;A normal result is an indicator that you were able to exercise for the same amount of time as or longer than most people your age and gender. The reason for your test and your family history of heart or other medical issues are also factored into this result.

The result also shows that you did not experience any significant changes in your blood pressure and ECG and that there are no blockages or ruptures in the coronary artery.

&nbsp;

<ul>
	<li>
	<h5>Abnormal</h5>
	</li>
</ul>

This implies that the blood flow to a portion of your heart has decreased due to some narrowing in one or more arteries supplying blood to that muscle. Additionally, the blood flow may be affected due to scarring of the heart muscle caused by a previous heart attack.

An abnormal result means you require either an angiography/angioplasty or a bypass surgery to open the blocked arteries<a href="#accordion">[6]</a>. It&rsquo;s highly probable that your doctor changes your medications or their dosage following this result. 
&nbsp;

Generally, the thallium stress test has no side effects. Yes, the medicine stings when it&rsquo;s first injected, but that feeling quickly goes away.&nbsp;

The test may cause headache, nausea, and a racing heart. And while the radioactive material is eliminated via urine or feces, it does not cause any complication at the time of injection.

In rare instances, the test may involve the following complications:&nbsp;

<ul>
	<li>Abnormal heartbeat or arrhythmia.&nbsp;</li>
	<li>Elevated angina or discomfort&nbsp;</li>
	<li>Breathing difficulty</li>
	<li>Asthmatic symptoms</li>
	<li>Large fluctuations in blood pressure</li>
	<li>Rashes on the skin</li>
</ul>

If you have any of these signs and symptoms at any point during or after your test, you should notify the test administrator and/or your doctor.

<div>&nbsp;</div>

A stress test reveals how well your heart works and how much strain it&rsquo;s able to withstand. It assists in the diagnosis of several heart diseases and also assesses how well the treatment plan is working.&nbsp;Typically, the test consists of walking on a treadmill while a medical professional will monitor your heart activity. If need be, you may be given a specific medicine to achieve a similar effect. 
&nbsp;

Key Points

<ul><li>A heart stress test reveals how effectively your heart functions.</li><li>You'll use a treadmill or receive drugs during the stress test to put your heart under stress. During the test, your ECG, heart rate, and blood pressure will be monitored by a doctor or technician.</li><li>You may be at risk of having a heart attack if your heart stress test results are abnormal. In that case, more tests will be required to confirm the diagnosis.</li></ul>

[1] Gopal S, Murphy C. Nuclear Medicine Stress Test. In: StatPearls [Internet]. StatPearls Publishing; 2022.

[2] Sabharwal NK, Stoykova B, Taneja AK, Lahiri A. A randomized trial of exercise treadmill ECG versus stress SPECT myocardial perfusion imaging as an initial diagnostic strategy in stable patients with chest pain and suspected CAD: cost analysis. J Nucl Cardiol. 2007;14(2):174–86.

[3] Miller TD, Askew JW, Anavekar NS. Noninvasive stress testing for coronary artery disease. Cardiol Clin. 2014 Aug;32(3):387–404.

[4] Nuclear stress test. Mayo Clinic.

[5] Nuclear stress test: Medlineplus medical encyclopedia. MedlinePlus.

[6] What to expect: Nuclear stress testing. Heart House.

Overview

Karachi-based writer Amna Khan was about to get married. She was 25-years-old and her parents had arranged for a match with a doctor based in London, United Kingdom. After the wedding dates were finalised, Amna&rsquo;s mother took her to the gynaecologist for a &lsquo;check up&rsquo;.

The purpose of the trip? To check of Amna was still &lsquo;intact&rsquo;. It was perhaps one of the most traumatising experiences of Amna&rsquo;s life. 
&nbsp;

&ldquo;It was humiliating,&rdquo; whispered Amna to her female colleagues and friends the next day at work. They were gathered in the bathroom, the one place they got together to exchange pleasantries and have quick conversations. &ldquo;My mother wouldn&rsquo;t believe me,&rdquo; says Amna. &ldquo;She forced me to go. I felt like a sacrificial lamb that was being checked to see if I was good enough. I didn&#39;t matter. My words, thoughts, feelings&hellip; nothing mattered. I had to open my legs for a stranger to poke through and certify that everything was okay. I was so scared and humiliated.&rdquo; 
&nbsp;

problems with this practice

Let me make it clear: virginity tests do not work. Virginity testing is a controversial and widely discredited practice that has been used for centuries to determine whether a woman has had sexual intercourse. The tests typically involve a physical examination of the female genitalia to look for signs of sexual activity, such as the presence or absence of the hymen. However, there are many problems with this practice. 
&nbsp;

First, the hymen is a thin membrane that partially covers the vaginal opening and it can be torn or stretched by a variety of activities other than sexual intercourse, such as sports, tampon use, or even just regular physical activity. Therefore, the presence or absence of the <a href="https://merisehat.pk/article/the-great-hymen-myth">hymen</a> is not a reliable indicator of whether or not a woman has had sex 
&nbsp;

Second, the tests are often invasive and can be traumatising for the women being tested. The tests may involve a doctor or other medical professional inserting fingers or instruments into the vagina, which can be painful and humiliating. 

The tests involve a physical examination of the genitalia. It typically involves looking for the hymen. This practice is repulsive and unethical. Not only this, there is no need for it. The most ideal way to check for someone&rsquo;s virginity is by simply asking them. 
&nbsp;

Third, virginity testing is not based on sound medical science. There is no medical or scientific evidence to support the idea that a woman&rsquo;s virginity can be determined through a physical examination. In fact, many medical organisations, including the World Health Organization, have spoken out against the practice, citing its lack of scientific validity and potential for harm.

In some cultures, a woman&rsquo;s virginity is highly valued, and there is a lot of pressure on young women to remain &ldquo;pure&rdquo; until marriage. This pressure can lead families and communities to subject young women to virginity testing, either to confirm their &ldquo;purity&rdquo; or to prove that they have been &ldquo;defiled.&rdquo; In some cases, women who &ldquo;fail&rdquo; the test may face social ostracism, violence, or even honour killings. 
&nbsp;

Finally, virginity testing is a form of gender-based violence and a violation of women&rsquo;s human rights. The tests are often forced on women by their families or communities, and they can lead to shame, stigma, and even violence against women who are found to have &ldquo;failed&rdquo; the test. 
&nbsp;

Bottom Line

Virginity tests do not work, and they are a harmful and discredited practice that should be abandoned. Instead, we should focus on promoting comprehensive sex education, gender equality, and respect for women&rsquo;s bodily autonomy and human rights.