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Nuclear Stress Test Explained

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Can I EFT My Way To Happiness?

Introduction

Climate change, political unrest, inflation, overpopulation, debts, pandemic and the list goes on and on. In the midst of all of this, it is no surprise that humans are facing a mental health crisis. According to Gallup&rsquo;s latest Global Emotions Report, 40% of adults reported feeling stressed or worried<a href="#accordion">[1]</a>. Approximately 190 million people reported greater stress levels in 2020 than in the previous years<a href="#accordion">[1]</a>. Moreover, the poll labeled 2020 as the most stressful year in recent history.&nbsp;

&nbsp;

The increasing stress levels in the population has compelled people to look for complementary therapies such as yoga, acupuncture, and meditation.&nbsp;

&nbsp;

One such intervention that has recently gained popularity is the practice of the emotional freedom technique (EFT). Similar to acupuncture, massage, and tai chi, EFT relies on a body-mind connection and aims to relieve <a href="merisehat.pk/disease/stress">stress</a> and improve one&rsquo;s mental health.&nbsp; 
&nbsp;

Understanding the Science Behind Emotional Freedom Technique (EFT)

In 1979, Dr. Roger Callahan was working with a patient named Mary who had an extreme fear of water<a href="#accordion">[2]</a>. Despite trying several different anxiety reduction techniques such as clinical hypnosis, behavioral therapy, progressive relaxation, and systematic desensitization, he was unable to make any progress.&nbsp;

&nbsp;

One day, Mary complained that whenever she thought of water, she felt a strange sensation in the pit of her stomach. Relying on the acupuncture point linked to the stomach meridian, Dr. Callahan asked Mary to tap right below the eye. Much to everyone&rsquo;s surprise, Mary immediately reported having completely recovered from her phobia. So much so that she got up and ran to the swimming pool to splash water on her face. Prior to the tapping, Mary could not even walk near the edge of the pool due to her fear.&nbsp;

&nbsp;

Callahan concluded that tapping at a certain point while thinking of the fear can help reduce or eliminate the fear completely. He called his technique Thought Field Therapy (TFT).&nbsp;

&nbsp;

Later, his student Gary Craig developed his own tapping technique, the Emotional Freedom Technique (EFT). Also called EFT tapping, it is an alternative therapy that is often used for treating post-traumatic stress disorder (PTSD) besides many other conditions.&nbsp;

&nbsp;

EFT involves tapping all the meridians in sequence, in no particular order, while repeating a reminder phrase at each tapping point. The reminder phrase addresses the person&rsquo;s fears and thoughts related to the problem. For example, one can say &lsquo;Even though I have (state the problem), I deeply and completely accept myself&rsquo;.&nbsp;

&nbsp;

Based on the Chinese practice of acupuncture, EFT relies on the movement of the body&rsquo;s energy. By tapping certain points, it aims to stimulate the energy pathways and improve the flow of energy.&nbsp;

<div>&nbsp;</div>

There are 9 major tapping points in EFT which are as follows:&nbsp;&nbsp; 1. Karate Chop (KC) – It corresponds to the small intestine meridian and is located on the outside soft part of the hand between the wrist and the pinky finger, the same part that you would use to karate chop something.2. Eyebrow Point (EB) – It corresponds to the bladder meridian and is located at the beginning of the eyebrows, close to the bridge of the nose.3. Side of Eye (SE) – It corresponds to the gallbladder meridian and is located on the bone near the corner of the eyes.4. Under Eye (UE) – It corresponds to the stomach meridian and is located on the bone directly beneath the eyes.5. Under Nose (UN) – It corresponds to the governing vessel meridian and is located between the upper lip and the nose.6. Chin Point (CP) – Also known as Under the Mouth (UM), it corresponds to the central meridian and is located between the chin and the lower lip.7. Collarbone Point (CB) – It corresponds to the kidney meridian and is located where the collarbone, sternum, and first rib meet in the center.&nbsp;8. Under Arm (UA) – It corresponds to the spleen meridian and is located on the side, 4 inches below the armpit.&nbsp;9. Top of Head (TH) – It corresponds to the governing vessel meridian and is located directly on the top of the head. The person or the practitioner can tap on specific points while repeating the chosen phrase. Use 2 or more fingertips and repeat the taps 5 times on each point.

Over the years, EFT tapping has proven effective for various conditions. A study including more than 200 participants assessed 6 clinical EFT workshops and found the tapping technique to improve multiple psychological markers of health<a href="#accordion">[3]</a>. There was a significant decline in anxiety, depression, post-traumatic stress disorder (PTSD), pain, and cravings. Moreover, the participants reported an increase in happiness.&nbsp;

&nbsp;

A 2016 systematic review assessed the EFT&rsquo;s effect on anxiety scores across 14 studies<a href="#accordion">[4]</a>. Compared to the control group, the emotional freedom technique demonstrated a significant decrease in anxiety scores.&nbsp;

&nbsp;

Yet another study looked at the EFT&rsquo;s effect on depression and found it to be more effective than other interventions in reducing depressive symptoms<a href="#accordion">[5]</a>. EFT has also been shown to decrease cortisol levels ,thus, contributing to reducing stress in individuals<a href="#accordion">[6]</a>.&nbsp; 
&nbsp;

As more and more people move toward complementary and alternative treatment options, several ancient techniques are becoming popular among people once again.&nbsp;

&nbsp;

Acupuncture is a part of Traditional Chinese Medicine (TCM). Where EFT was a tactile, non-penetration technique, acupuncture involves the insertion of very fine needles at certain points in the body. The various acupuncture points in the body correspond to meridians or pathways that allow energy to flow through the body. While it is unclear how the technique brings about success, it is believed that by targeting certain points in the body, acupuncture can restore the body&rsquo;s energy balance.&nbsp;

&nbsp;

According to the National Center for Complementary and Integrative Health, acupuncture can help treat neck pain, back pain, osteoarthritis, knee pain, and headache<a href="#accordion">[7]</a>. Moreover, compared to a sham (placebo) control, the practice has shown success in treating chronic pain<a href="#accordion">[8]</a>. However, the therapy is associated with a few risks such as bruising, bleeding or soreness at the needle insertion site. Therefore, it is mostly contraindicated in people on warfarin therapy.&nbsp;

&nbsp;

Tai chi is another ancient Chinese tradition that relies on the flow of energy through the body through various postures and movements. Although initially developed as a self-defense method, it is effective in regulating mood, and improving symptoms of depression and anxiety<a href="#accordion">[9][10]</a>.&nbsp; 
&nbsp;

Conclusion

Unlike conventional treatments, the emotional freedom technique is inexpensive, less time-consuming, painless, and it can be self-administered. Other alternative therapies such as acupuncture and tai chi have also been shown to improve one&rsquo;s mental health. However, despite the benefits, alternative therapies are often met with criticism.&nbsp;

&nbsp;

It is important to note that complementary medicine does not advocate for complete avoidance of western medicine. Instead, it provides patients, who are resistant to available interventions, with an alternative treatment option.&nbsp;

&nbsp;

While the majority of these methods are not associated with any adverse effects, it is best to first consult an experienced professional before starting any form of therapy.&nbsp;

<div>&nbsp;</div>

Key Points

<ul><li>Emotional Freedom Techniques, also called EFT tapping, is an alternative therapy often used for treating post-traumatic stress disorder (PTSD) and many other conditions.&nbsp;</li><li>It involves tapping all the meridians in sequence, in no particular order, while repeating a reminder phrase at each tapping point. The reminder phrase addresses the person’s fears and thoughts related to the problem. For example, one can say ‘Even though I have (the problem), I deeply and completely accept myself.’&nbsp;</li><li>There are 9 major tapping points in EFT. During the process, the person or the practitioner can tap on specific points while repeating the chosen phrase. Using 2 or more fingertips, the taps should be repeated at least 5 times on each point.</li><li>Other alternative therapies for stress include acupuncture, chi, aromatherapy, yoga, and meditation.&nbsp;</li><li>Although EFT is a relatively safe technique with no reported side effects, it's best to consult an experienced professional before starting the therapy.&nbsp;</li></ul>

[1] GALLUP. Global emotions report.

[2] History of tapping (including EFT). Thriving Now.

[3] Bach D, Groesbeck G, Stapleton P, Sims R, Blickheuser K, Church D. Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health. J Evid Based Integr Med. 2019;24:2515690X18823691. doi:10.1177/2515690X18823691

[4] Clond M. Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis. J Nerv Ment Dis. 2016;204(5):388-395. doi:10.1097/NMD.0000000000000483

[5] Nelms JA, Castel L. A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials of Clinical Emotional Freedom Techniques (EFT) for the Treatment of Depression. Explore (NY). 2016;12(6):416-426. doi:10.1016/j.explore.2016.08.001

[6] Stapleton P, Crighton G, Sabot D, O'Neill HM. Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial. Psychol Trauma. 2020;12(8):869-877. doi:10.1037/tra0000563

[7] Acupuncture: In depth. National Center for Complementary and Integrative Health.

[8] Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018;19(5):455-474. doi:10.1016/j.jpain.2017.11.005

[9] Yeung A, Chan JSM, Cheung JC, Zou L. Qigong and Tai-Chi for Mood Regulation. Focus (Am Psychiatr Publ). 2018;16(1):40-47. doi:10.1176/appi.focus.20170042

[10] Saeed SA, Cunningham K, Bloch RM. Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation. Am Fam Physician. 2019;99(10):620-627.

Nimrah H. Sattar

Medilink Consultant clinic

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Nuclear Stress Test FAQs

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;

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

Safia Mehmood

What Are Adaptogens? Unpacking Nature's Stress Busters

Overview

Did you know that there are more than one type of plants that can help you with stress? The ones that I am going to tell you about do not butcher your lungs while they are at it.

<a href="https://merisehat.pk/disease/stress">Stress </a>is an inevitable part of our lives. From bustling city life to the demands of our daily routines, stress is a constant companion. Unfortunately, we cannot just switch it off or pin point where we want to concentrate the stress at and there are times when things just get too overwhelming to deal with on your own.

In this scenario, adaptogens have gained the spotlight as nature&#39;s stress-busters. But what are adaptogens, and how do they really work? Today, we dive deep into the world of adaptogens, exploring their benefits for stress and the need to understand their side effects and the right supplements. 
&nbsp;

Science Behind Adaptogens

Adaptogens are natural substances, primarily from plants, known for helping the body resist various stressors. They stem from traditional medicine systems like Ayurveda and Traditional Chinese Medicine and are gaining popularity in modern wellness circles. 
&nbsp;

Adaptogens work by interacting with our body&#39;s stress response system, known as the Hypothalamic-Pituitary-Adrenal (HPA) axis. These natural wonders help balance cortisol levels, the so-called &#39;stress hormone,&#39; thereby aiding in stress reduction. On a molecular level, adaptogens work with mitochondria and stress pathways, impacting stress-related proteins and neuropeptides, which contributes to their anti-fatigue and cognitive-enhancing properties. 
&nbsp;

Ashwagandha: Known for regulating stress hormones and easing anxiety. You can take 1-6 grams of ashwagandha daily by either consuming its dry root powder or creating a tincture out of it

Rhodiola Rosea: Also known as golden root. It helps control cortisol levels, aiding the body in coping with stress. You can take it in capsules or create a tincture out of it. Rhodiola is to be taken on an empty stomach but not before bedtime since it is a stimulant.

Ginseng: Boosts energy, lowers blood sugar, and modulates cortisol. Ginseng root powder, tincture and capsules are very commonly found now and can be taken with water for its adaptogenic effect.

Holy Basil: Offers anti-inflammatory and antioxidant effects to balance stress hormones. It can be taken twice or thrice a day. You can incorporate it in cooking, use its oil or mix it in your green smoothies.

Each of these adaptogens has a unique profile of active ingredients and mechanisms by which they exert their effects. Understanding these can help in selecting the right adaptogen for your specific needs. 
&nbsp;

<h5>Adaptogens For Stress</h5>

The primary use of adaptogens lies in their ability to reduce stress. By modulating the body&rsquo;s response to stress, adaptogens enhance mental clarity and physical endurance. Some, like Rhodiola Rosea, even boast nootropic effects, improving memory and cognitive function. 
&nbsp;

<h5>Side Effects And Considerations</h5>

While adaptogens are generally considered safe, they are not devoid of side effects. They can interact with certain medications and exacerbate existing conditions. It is essential to consult a healthcare provider before incorporating adaptogen supplements into your routine. 
&nbsp;

<h5>Extended Benefits Of Adaptogens</h5>

Beyond stress reduction, adaptogens offer a myriad of health benefits. They can aid in balancing hormones, enhancing immune function, and even supporting cardiovascular health. For instance, adaptogens like Ashwagandha have shown promise in regulating thyroid function, which can be particularly beneficial for those dealing with thyroid imbalances. 
&nbsp;

<h5>Incorporating Adaptogens</h5>

Adaptogen supplements come in various forms &ndash; powders, capsules, teas, and more. Quality is crucial, so opting for third-party tested brands is wise. You can always make your own adaptogen but it requires a lot of practice to get the process right to ensure that no biochemicals are volatile in nature or prone to spoilage due to temperature, moisture or exposure to air 
&nbsp;

<h5>Holistic Approach To Stress Management</h5>

While adaptogens can play a significant role in stress management, they should be part of a broader, holistic approach to wellness. This includes a balanced diet, regular physical activity, adequate sleep, and mindfulness practices. Together, these elements can create a foundation for a healthier, more balanced life. 
&nbsp;

Bottom Line

Adaptogens offer a harmonious way to manage stress and enhance well-being. They work at a cellular level to offer benefits from improved mental clarity to a stronger immune system. However, they are not a magic cure. A balanced lifestyle, complete with a nutritious diet and regular exercise, is essential. If you&#39;re considering adaptogens, a personalized consultation with a healthcare provider is the best way to start.

Umna Salah

Stop Stress Eating: Expert Tips Inside!

How often have you found yourself reaching for that bag of chips or indulging in a pint of ice cream not because you&#39;re hungry but because you&#39;re stressed, bored, or seeking solace from difficult emotions?

In today&#39;s fast-paced world, many of us struggle with emotional eating. Sure, emotional eating provides temporary comfort. But then it frequently results in feelings of guilt and dissatisfaction afterward. Also, this habit leads to weight gain. 
 
&nbsp;

understanding food and emotions

Emotional eating is often prompted by unpleasant feelings rather than genuine hunger cues. In these moments, food becomes a coping mechanism, providing the desired comfort or distraction. This pattern of behavior adds to stress levels, perpetuating the cycle of emotional eating. 
&nbsp;

Here are some signs to look out for to differentiate between emotional hunger and physical hunger:<a href="#accordion">[3]</a>

<ul>
	<li>Emotional hunger is triggered suddenly, compared to physical hunger</li>
	<li>Emotional hunger usually involves cravings for specific comfort foods</li>
	<li>Emotional hunger makes you eat till you&rsquo;re uncomfortably full</li>
	<li>Emotional hunger focuses more on the taste, smell, or texture of the food</li>
	<li>Emotional hunger causes you to feel powerless and bad about yourself 
	&nbsp;</li>
</ul>

Mindful eating stems from the practice of mindfulness, where individuals focus on the present moment without making judgments. When applied to eating, it encourages individuals to cultivate awareness of their thoughts and feelings related to the overall experience, including the taste, texture, and smell of food. 
&nbsp;

According to one model, the four aspects of mindful eating are:<a href="#accordion">[1]</a>

<ul>
	<li>What to eat</li>
	<li>Why you eat what you eat</li>
	<li>How much to eat</li>
	<li>How to eat 
	&nbsp;</li>
</ul>

These cues are meant to help you:<a href="#accordion">[2]</a>

<ul>
	<li>Check your body&#39;s signals of hunger and fullness, consuming food when you&#39;re hungry and stopping when you feel satisfied. This practice curbs overeating tendencies and aids in managing food consumption.</li>
	<li>Observe your eating habits without criticism or self-judgment. Instead of labeling foods as &quot;good&quot; or &quot;bad,&quot; approach eating with curiosity and compassion.</li>
	<li>Savor each bite. By slowing down and focusing on the present moment, you may derive more satisfaction from your meals.</li>
	<li>Evaluate the factors that make you overeat, including emotional or environmental triggers. By recognizing these triggers, you can respond mindfully rather than reactively, choosing healthier coping strategies. 
	&nbsp;</li>
</ul>

A randomized study showed that participants following mindfulness intervention for 12 months had a decreased intake of sweets and were able to maintain optimal fasting blood glucose levels.<a href="#accordion">[1]</a> 
&nbsp;

It is especially a powerful tool to help with weight loss because it:<a href="#accordion">[2]</a>

<ul>
	<li>Improves emotional regulation</li>
	<li>Promotes decision-making and intentional portion control</li>
	<li>Greater satisfaction with meals</li>
	<li>Alleviate stress 
	&nbsp;</li>
</ul>

Here&rsquo;s how you can lose weight naturally:<a href="#accordion">[1]</a>

<ul>
	<li>Start small, like incorporating these techniques into one meal or snack each day.</li>
	<li>Avoid distractions, like working, watching TV, or driving, while eating. Distracted eating is related to overeating and weight gain. Socializing with family and friends in person can enhance the experience. However, talking on the phone can have the opposite effect.</li>
	<li>Engage in mindful cooking and meal preparation, including the ingredients and cooking process.</li>
	<li>Be gentle with yourself. Accept that progress may be gradual and that setbacks are a natural part of the process.</li>
	<li>Don&rsquo;t skip meals or deprive yourself. Try setting meals at around the same time each day because not eating for a long time increases the risk of overeating whatever is available for quick and easy consumption. Or go for a higher-quality diet, such as fruits as snacks instead of sweets and smaller servings of calorie-dense foods.</li>
	<li>Keep a food diary. It will help you analyze the pattern between your moods and food and seek support when needed. 
	&nbsp;</li>
</ul>

Mindful eating offers a holistic approach to combating emotional eating and promoting weight loss. By cultivating awareness, non-judgmental observation, and a deep connection with the eating experience, individuals can develop healthier habits and enhance their overall well-being. 
&nbsp;

<ul>
	<li>Emotional eating is habitually turning to food for comfort, distraction, or relief from stress, boredom, sadness, or other emotions.</li>
	<li>Consuming food in response to emotions rather than physical hunger can lead to overeating and weight gain.</li>
	<li>Mindful eating improves emotional regulation, supports weight loss and maintenance goals, alleviates stress, and promotes overall well-being.</li>
</ul>

[1] Mindful eating. The Nutrition Source. July 14, 2023. Accessed March 29, 2024.

[2] Bjarnadottir A. Mindful eating 101 - A beginner’s guide. Healthline. January 4, 2023. Accessed April 1, 2024.

[3] Melinda Smith MA. Emotional eating and how to stop it. HelpGuide.org. February 28, 2024.

Shermeen Zuberi

Madeeha Syed

Do Virginity Tests Even Work?

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;

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.

Understanding And Managing Stress And Anxiety In Men

&nbsp;

&nbsp;

&nbsp;

Stress and<a href="https://merisehat.pk/article/how-to-manage-anxiety"> anxiety</a> are common experiences that affect individuals of all genders. While it is often assumed that men are less likely to experience stress and anxiety, research suggests that men do face these challenges but may express them differently. In this detailed article, we will explore the nature of stress and anxiety in men, discuss their causes and symptoms, and provide strategies for understanding and effectively managing these conditions. 
&nbsp;

Stress: Stress is the body&#39;s response to demanding or threatening situations. It can be triggered by various factors, such as work pressures, relationship difficulties, financial concerns, or major life changes. Stress can manifest physically, emotionally, and cognitively, and prolonged stress can negatively impact overall well-being.

Anxiety: Anxiety refers to excessive and persistent worry or fear about everyday situations. It can be generalized, causing a constant sense of unease, or specific, such as phobias or panic disorders. Anxiety can manifest as physical symptoms, intrusive thoughts, and behavioral changes, and it can significantly interfere with daily life. 
&nbsp;

Causes And Symptoms

Societal Expectations: Traditional masculine ideals that emphasize self-reliance, stoicism, and emotional restraint can contribute to stress and anxiety in men. The pressure to conform to these norms may discourage men from seeking help or expressing their emotions, leading to increased stress and anxiety.

Work-Related Stress: Men often face stressors related to their careers, including long work hours, job insecurity, and the pressure to succeed. Balancing work and personal life, especially when fulfilling multiple roles, can be challenging and contribute to stress.

Relationship Issues: Difficulties in intimate relationships, strained family dynamics, and challenges related to parenting can all contribute to stress and anxiety in men. Additionally, societal expectations of being the primary provider or caregiver can intensify these pressures.

Health Concerns: Physical health issues, chronic conditions, or the fear of illness can generate significant stress and anxiety in men. Hormonal imbalances, such as low testosterone, can also affect mental well-being.

Symptoms: Men may experience a range of symptoms related to stress and anxiety, including irritability, restlessness, sleep disturbances, difficulty concentrating, muscle tension, fatigue, changes in appetite, and increased substance use. 
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Management Tips

Here are some effective ways for you to tackle your stress and anxiety: 
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<ul>
	<li>Awareness And Education: Understanding stress and anxiety is the first step in managing them effectively. Men should learn about the signs, causes, and impact of stress and anxiety to recognize and address these issues proactively.</li>
	<li>Healthy Coping Mechanisms: Encourage the adoption of healthy coping mechanisms, such as regular exercise, engaging in hobbies, practicing relaxation techniques (e.g., deep breathing, meditation), maintaining a balanced diet, and getting sufficient sleep. These strategies can help reduce stress levels and promote overall well-being.</li>
	<li>Seeking Support: Men should feel empowered to seek emotional support from friends, family, or mental health professionals. Opening up about concerns and emotions can provide relief and help in gaining new perspectives and coping strategies.</li>
	<li>Work-Life Balance: Strive for a healthy work-life balance by setting boundaries, delegating tasks, and prioritizing self-care. Taking breaks, engaging in leisure activities, and spending quality time with loved ones can help reduce stress levels.</li>
	<li>Professional Help: If stress and anxiety become overwhelming or significantly impact daily functioning, seeking professional help is crucial. Mental health professionals can provide therapy, counseling, or other evidence-based interventions tailored to individual needs.</li>
	<li>Stress Management Techniques: Explore stress management techniques such as cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), or stress management courses. These approaches can help individuals develop skills to manage stress and anxiety effectively and build resilience in the face of challenging situations.</li>
	<li>Lifestyle Changes: Adopting a healthy lifestyle can contribute to better stress and anxiety management. This includes regular physical activity, maintaining a nutritious diet, limiting alcohol and caffeine consumption, and avoiding tobacco or substance use.</li>
	<li>Time For Relaxation: Incorporate relaxation techniques into daily routines, such as practicing deep breathing exercises, engaging in mindfulness or meditation practices, or indulging in activities that promote relaxation and enjoyment.</li>
	<li>Cognitive Strategies: Develop cognitive strategies to reframe negative thinking patterns and manage anxious thoughts. This may involve challenging irrational beliefs, practicing self-compassion, and focusing on positive aspects of life.</li>
	<li>Stress Reduction Techniques: Explore stress reduction techniques like time management, prioritizing tasks, and learning effective problem-solving skills. Developing organizational skills and setting realistic goals can help reduce stress levels.</li>
	<li>Supportive Networks: Cultivate a network of supportive individuals who can provide encouragement, understanding, and a safe space to share concerns. Participating in support groups or joining social activities can also contribute to a sense of belonging and overall well-being. 
	&nbsp;</li>
</ul>

Stress and anxiety can affect men&#39;s mental and physical health, but with awareness, understanding, and appropriate strategies, these conditions can be effectively managed. It is crucial to challenge societal expectations, seek support when needed, and prioritize self-care. By adopting healthy coping mechanisms, making lifestyle changes, and seeking professional help, when necessary, men can enhance their overall well-being and lead fulfilling lives with reduced stress and anxiety. Remember, managing stress and anxiety is a continuous process, and it is essential to be patient and kind to oneself throughout the journey to better mental health. 
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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>. 
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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;

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<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. 
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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>

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<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. 
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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.

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<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.

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<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. 
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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. 
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<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.