Humza Khizer

Toxic shock syndrome (TSS) is commonly associated with tampon use in women. Toxic shock syndrome symptoms include fever and sunburn-like rash needing treatment.

Toxic Shock Syndrome – Frequently Asked Questions

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Ismail Munir

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Boys Can Wear Pink Too!

Introduction

Toxic masculinity is defined as a set of masculine behaviors that can have a negative impact on men and society as a whole. 
&nbsp;

Boys will be boys - a phrase we&#39;ve all heard countless times. It&#39;s the excuse a mother gives when the first-grade teacher complains of her son pulling a girl&#39;s hair. Or what you hear when high school boys fight it out during recess. Over the years, people have used the phrase multiple times to declare certain behaviors expected of boys and men. Not only has it hindered holding men accountable for acts of aggression, sexual assault, and other crimes, but it&#39;s also promoted flawed gender stereotypes, for men and women both.&nbsp; 
&nbsp;

It can be said that gender stereotypes have existed since forever. The early male homo sapiens were hunters and gatherers who used their physical strength to provide for their families. They relied on these traits of aggression and ruthlessness to exert their power and dominance over other men. As humans evolved, these behaviors persisted. From hunters to rulers, men then began to demonstrate their strength by waging wars, plundering cities, and leaving a trail of destruction on their way to the top.&nbsp; 
&nbsp;

Although society has modernized and evolved, these patterns of male behavior continue to be unfortunately celebrated. Behaviors such as acting aggressive, refusing to take part in chores around the house, and avoiding emotions are often labelled as &#39;manly&#39;. Anyone who&#39;s not living up to these rules is not considered masculine enough.&nbsp; 
&nbsp;

However, the way society views masculinity has greatly changed over the years, i.e., we are now aware of the &#39;toxic&#39; nature of such &#39;masculine&#39; traits and how damaging they can be for men&#39;s mental health.

&nbsp;

In 2019, men&#39;s shaving brand Gillette released a commercial highlighting the harmful effects of normalizing toxic masculine traits of bullying and sexual harassment. The video urged men to take accountability for their actions and call out fellow men acting inappropriately towards other men and women. Although the ad itself received a lot of criticism, it also started a conversation around toxic masculinity. But can men really be blamed for such toxic traits? Or are we as a society to blame for normalizing such behaviors? 
&nbsp;

Toxic masculinity is defined as a set of masculine behaviors that can have a negative impact on men and society as a whole. As per a study in the Journal of Clinical Psychology, these regressive traits promote &#39;devaluation of women, homophobia, and wanton violence<a href="#accordion">&#39;[1]</a>. Moreover, such behaviors are also associated with lower willingness to intervene among adolescents, especially when witnessing sexual harassment and homophobic bullying<a href="#accordion">[2]</a>.&nbsp; 
&nbsp;

Understanding The Dangers Of Toxic Masculinity

Traits of toxic masculinity emphasize the importance of physical strength, self-reliance, aggression, lack of emotion, sexual virility, and dominance in men. Living up to these exaggerated masculine traits can place additional stress on men and lead them to engage in harmful behaviors. 
&nbsp;

Research has shown that college men pressured to conform to masculine norms of self-reliance, sexual promiscuity, and violence have higher rates of depression<a href="#accordion">[3]</a>.&nbsp;Moreover, when men are taught dominance and risk-taking as norms of masculinity, they tend to engage in high-risk behaviors such as drug abuse, drinking, not wearing a seatbelt, and gambling<a href="#accordion">[4].</a>&nbsp; 
&nbsp;

Heterosexual ideals are often propagated among men, as part of traditional masculinity. Anything deflecting from it is viewed as feminine and socially unacceptable. Moreover, feminine ideals are thought to be equivalent to homosexuality. As a result, gay men often face internalized homophobia, and men who identify as straight but do not conform to these heterosexual ideals are often a target of homophobic bullying.&nbsp; 
&nbsp;

As a result, the American Psychological Association (APA) has introduced new guidelines to tackle these problems in boys and men<a href="#accordion">[5]</a>. These guidelines warn therapists of the psychological impact of traditional masculinity and its link to misogyny, aggression, and negative health outcomes in the male population. 
&nbsp;

So how do we address toxic masculinity?

&nbsp;

<h4>"Men often deal with society’s unrealistic expectations, triggering their anxiety and stress. Check out our s<a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">ehat scan</a> and see how well you’re handling the stress!"</h4>

While our genetics govern a lot of our personality, the environment around us also influences behaviors. What you see around you as a child, you tend to conform to that as an adult. For example, a boy who&#39;s seen his father work every day of the week with no breaks believes that is the norm; as a man, one must never stop and rest. Or if your father refuses to ask for directions even when he&#39;s clearly lost, you are more likely to adopt that specific quality and assume asking for help is not a very manly thing. 
&nbsp;

Therefore, a good way to address toxic masculinity is to revisit the models of behaviors set in the past and redefine man&#39;s role in society. 
&nbsp;

A father&#39;s role in a family is often limited to being the financial provider. However, over the years, this role has evolved to fathers becoming more involved in the lives of their children. A UK cohort study found that early father involvement in the form of creative play and quality time lowers the risk of subsequent behavior problems in both boys and girls<a href="#accordion">[6]</a>. According to research, altering the social role of fathers to a more nurturing and involved role can help change harmful gender stereotypes<a href="#accordion">[7]</a>.&nbsp; 
&nbsp;

This involvement can begin as early as at the time of birth. Skin-to-skin contact between the father and the neonate not only benefits the child&#39;s physiological health but also helps men ease into fatherhood<a href="#accordion">[8].</a>

&nbsp;

&#39;Men don&#39;t cry&#39;, &#39;man up&#39;, and &#39;don&#39;t be such a girl&#39; are just some of the things men grow up hearing. These phrases teach men to suppress all emotions of sadness, fear, or pain. Thus, they grow up hiding all these feelings within themselves. This inability to express emotions or share their feelings with others leads to feelings of loneliness. As per an APA study, these gender norms act as barriers to men seeking psychological help when facing mental health issues<a href="#accordion">[9]</a>. Moreover, male victims of domestic or sexual abuse may find it even more challenging to get help. 
&nbsp;

Similarly, toxic masculinity promotes the idea of being self-reliant. Therefore, men will avoid going to a physician for any type of health care<a href="#accordion">[4].</a> Thus, identifying and addressing these behaviors can be beneficial to both your <a href="https://www.merisehat.pk/article/Mental%20Health">mental</a> and physical health.&nbsp;

&nbsp;

Conclusion

Toxic masculinity is not a problem that can be solved overnight. These traits and behaviors are ingrained in society as a whole. Therefore, a redefinition of masculinity is needed. However, everyone&rsquo;s version of masculinity or femininity is different. And one can only arrive at this definition after holding conversations with friends and family about the problematic patterns of the past. 
&nbsp;

As the newer generations move forward, it is important to keep toxic masculinity in the past. Raising awareness among the masses and educating them on the toxic nature of certain society-defined masculine traits is a great way to achieve this. Moreover, more positive male role models can greatly impact how one views masculinity. 
&nbsp;

However, many people believe that dismantling toxic masculinity is just another way to emasculate men or make them more feminine. In reality, the whole concept actually centers around breaking down the boxes society has placed around genders.&nbsp;&nbsp; 
&nbsp;

The bottom line is you can be masculine without being toxic. Remember, you define your own identity.&nbsp;

&nbsp;

Key Points

<ul>
	<li>Toxic masculinity refers to a set of behaviors that are harmful to men and society as a whole. Traits such as physical strength, aggression, self-reliance, emotional unavailability, and dominance are often promoted as part of toxic masculinity.</li>
	<li>Toxic masculinity can lead to depression, high-risk behaviors, feeling of loneliness, relationship issues, and mental health problems among men. Moreover, toxic guys are more likely to act out of aggression and engage in acts of bullying and sexual harassment.&nbsp;</li>
	<li>A father&#39;s role in the life of a child can play an important part in changing harmful gender stereotypes. A more nurturing and involved role is beneficial to both the father and child.&nbsp;</li>
	<li>Identifying toxic masculine traits and seeking help are significant steps in eliminating toxic masculinity.&nbsp;</li>
</ul>

&nbsp;

[1] Kupers, T. A., 2005. Toxic masculinity as a barrier to mental health treatment in prison. Journal of Clinical Psychology, 61(6), pp. 713-724.

[2] Ingram, K. M. et al., 2019. Longitudinal associations between features of toxic masculinity and bystander willingness to intervene in bullying among middle school boys. Journal of School Psychology, Volume 77, pp. 139-151.

[3] Iwamoto, D. K., Brady, J. & Park, A., 2018. Masculinity and Depression: A Longitudinal Investigation of Multidimensional Masculine Norms Among College Men. American Journal of Men's Health, 12(6), pp. 1873-1881.

[4] Mahalik, J. R., Burns, S. M. & Syzdek, M., 2007. Masculinity and perceived normative health behaviors as predictors of men's health behaviors. Social Science & Medicine, 64(11), pp. 2201-2209.

[5]  American Psychological Association, 2018. APA GUIDELINES for Psychological Practice with Boys and Men.

[6] Kroll, M. E., Carson, C., Redshaw, M. & Quigley, M. A., 2016. Early Father Involvement and Subsequent Child Behaviour at Ages 3, 5 and 7 Years: Prospective Analysis of the UK Millennium Cohort Study. PLOS One, 11(9).

[7]  Park, B. and Banchefsky, S. (2018) ‘Leveraging the Social Role of Dad to Change Gender Stereotypes of Men’, Personality and Social Psychology Bulletin, 44(9), pp. 1380–1394. doi: 10.1177/0146167218768794.

[8] Chen, Er-Mei et al. “Effects of Father-Neonate Skin-to-Skin Contact on Attachment: A Randomized Controlled Trial.” Nursing research and practice vol. 2017 (2017): 8612024. doi:10.1155/2017/8612024

[9] Yousaf, O., Popat, A., & Hunter, M. S. (2015). An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. Psychology of Men & Masculinity, 16(2), 234–237

Nimrah H. Sattar

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

Everything You Need To Know About Restless Leg Syndrome

In restless leg syndrome (RLS), you may experience the need to move your legs constantly. This impulse is usually triggered when you feel uncomfortable. According to the National Institute of Neurological Disorders and Stroke, it affects roughly 10% of Americans. 5-10% of adults in North America and Europe have RLS<a href="#accordion">[1]</a>. 
&nbsp;

The fact that it frequently occurs or worsens while you&#39;re sleeping, doctors classify RLS as a sleep disorder. You also experience this sleeping-associated problem when you sit for a long time without stretching your legs, like in a movie theater or a car.&nbsp; 
&nbsp;

If you don&#39;t receive treatment, then it gets worse. Over time, sleep deprivation can lead to issues at work or home. 
&nbsp;

While anyone can experience RLS, women and middle-aged individuals are more likely to experience severe symptoms. Doctors occasionally fail to diagnose restless leg syndrome, mainly because the signs are minor or infrequent. But once diagnosed, it can be treated. 
&nbsp;

Understanding Restless Leg Syndrome(RLS)

A neural system disease called restless legs syndrome results in an excited impulse to move your legs. It is also called Willis-Ekbom illness. 35% of RLS patients reported having symptoms before the age of 20<a href="#accordion">[2]</a>. By age 10, 1 in 10 children exhibit symptoms. With time, these symptoms typically get worse.&nbsp; 
&nbsp;

While the impulse to move your legs is the main symptom, RLS can be characterized by the following: 
&nbsp;

<h5>Leg Aches Causing Discomfort</h5>

<ul>
	<li>A strong feeling that makes you move your legs. Not only is the feeling uncomfortable, it can also be painful.</li>
	<li>There are many ways to describe the experience - aches, pulls, creepy crawling sensations, etc.</li>
	<li>This need or impulse to move the legs will be the primary cause of your discomfort.</li>
	<li>Although the entire leg from the thigh to the ankle will be affected, these sensations will typically occur in your calf area.</li>
	<li>Both of your legs could be impacted or it could be just one. There&rsquo;s a possibility that you feel the sensations in your arms as well. 
	&nbsp;</li>
</ul>

<h5>It&rsquo;s Worse At Night</h5>

<ul>
	<li>Symptoms may appear only after your bedtime or when you&rsquo;re trying to sit for any length of time in the evening.</li>
	<li>You may experience symptoms all day long, but you can notice them getting worse at night and occasionally in the morning. 
	&nbsp;</li>
</ul>

<h5>It Leads To Sleep Issues</h5>

<ul>
	<li>The sensations are likely to appear whether one is attempting to lie quietly before bed or sitting during a long flight during the day.</li>
	<li>The symptoms become intolerable, whether trying to sit through a movie or calmly reading a book to enjoy some moments.</li>
	<li>You are unable to relax or calm down.</li>
	<li>Due to difficulty falling asleep, RLS frequently results in sleep issues. 
	&nbsp;</li>
</ul>

<h5>Moving Helps Relieve The Symptoms</h5>

<ul>
	<li>If you have RLS, you&rsquo;ll quickly discover that getting up and moving around immediately alleviates the pain.</li>
	<li>The symptoms typically reappear as soon as you return to a relaxed condition.</li>
	<li>Usually, any leg movement will provide some instant relief even though it would be short-lived.</li>
	<li>The legs might bounce on their own if you do not move.</li>
	<li>A fleeting feeling may precede the involuntary leg motions.</li>
	<li>Most of the time, it&rsquo;s moving your legs in a repetitive or semi-rhythmic manner when you are asleep.</li>
	<li>Your bed partner would know about this, even if you don&rsquo;t.</li>
	<li>RLS is named for the way the sufferer&#39;s legs move constantly in an effort to stave off the discomfort, giving the impression that they are restless. 
	&nbsp;</li>
</ul>

The sensations are typically felt inside the limb as opposed to on the skin, and they are described as: 
&nbsp;

<ul>
	<li>Crawling</li>
	<li>Creeping</li>
	<li>Pulling</li>
	<li>Throbbing</li>
	<li>Electric</li>
	<li>Aching</li>
	<li>Itching 
	&nbsp;</li>
</ul>

Sometimes it&#39;s challenging to convey the sensations. You cannot assume you have RLS every time you experience numbness or a muscle cramp. However, there would be this constant urge to move their legs that should be taken seriously. The degree of symptoms changes often; sometimes, symptoms go away for a while before returning. 
&nbsp;

Genetics play an important role; nearly half of the people with RLS have it because it runs in the family<a href="#accordion">[3]</a>. It could also be connected to: 
&nbsp;

<ul>
	<li>Chronic Illnesses&nbsp;</li>
	<li>It can be a symptom of several chronic medical diseases, such as: 
	&nbsp;</li>
</ul>

1.<a href="https://www.merisehat.pk/disease/iron-deficiency-anemia-64"> Iron deficiency</a>

2. Renal disease

3. Parkinson&#39;s disease

4. <a href="https://www.merisehat.pk/disease/diabetes-type-1-and-2">Diabetes </a>and peripheral neuropathy 
&nbsp;

<ul>
	<li>
	<h5>Medications</h5>
	</li>
</ul>

Some medications can potentially exacerbate symptoms. For example:&nbsp; 
&nbsp;

1. Antipsychotics

2. Antidepressants

3. Antihistamine-containing cold and allergy remedies 
&nbsp;

<ul>
	<li>
	<h5>Pregnancy</h5>
	</li>
</ul>

&nbsp;Some pregnant women might develop it, especially in their third trimester. After delivery, symptoms typically disappear within a month. 
&nbsp;

<ul>
	<li>
	<h5>Lifestyle</h5>
	</li>
</ul>

A sleep condition, like apnea, or lack of sleep can cause or exacerbate symptoms. Same is the case with smoking and consuming coffee/alcohol. 
&nbsp;

Medical testing does not exist for RLS. Your doctor might want to discuss their observations with your partner. 
&nbsp;

The following 4 factors are necessary to diagnose RLS: 
&nbsp;

1. A strong impulse to get up, especially when coupled with unsettling or strange emotions.

2. A need to move legs that appears or intensifies when you&#39;re at rest.

3. A pressure that subsides when you move, either entirely or partially.

4. A desire to move your legs that either begins or worsens in the evening in the absence of other symptoms such as muscle pains, leg cramps. 
&nbsp;

Your doctor may use lab testing to rule out other conditions. A neurological examination might look for issues with blood vessels or nerve damage. If you have any additional sleep problems that could be causing your restless legs syndrome, a sleep test called polysomnography can reveal this. 
&nbsp;

Although therapies can help control RLS and you can enjoy a decent night&#39;s sleep, there is no particular cure and treatment for the condition itself. The first step of treatment planning involves managing any underlying conditions if any. 
&nbsp;

Regardless, the focus of the treatment is centered around providing symptomatic relief. If your condition is mild or moderate, making a few minor lifestyle adjustments could be beneficial. These include obtaining regular exercise, maintaining a typical sleep pattern, and abstaining from caffeine, alcohol, and tobacco. 
&nbsp;

Some people benefit from medications. However, a drug that reduces symptoms in one person may make them worse in another, and a medication that has been effective for a while may stop working in future. 
&nbsp;

RLS medications include: 
&nbsp;

<ul>
	<li>Drugs known as dopaminergic affect the brain&#39;s dopamine neurotransmitter. For moderate to severe restless legs syndrome, the FDA has approved ropinirole (Requip), pramipexole (Mirapex), and rotigotine (Neupro).</li>
	<li>Occasionally, doctors prescribe Parkinson&#39;s disease medications: carbidopa/levodopa (Sinemet).</li>
	<li>A sedative called benzodiazepines may aid with sleep but can also make you tired during the day.</li>
	<li>Narcotic analgesics can also help alleviate symptoms.</li>
	<li>Pregabalin, carbamazepine (Tegretol), gabapentin (Neurontin), gabapentin enacarbil (Horizant), and other anticonvulsant or seizure medications (Lyrica) are appropriate treatments, too. 
	&nbsp;</li>
</ul>

A lifelong ailment, RLS may worsen with age. However, some patients experience remission and go months to years without symptoms.&nbsp; 
&nbsp;

The important point is to keep your doctor informed of your progress. They could advise alternative lifestyle modifications or different drugs if your symptoms appear to be worsening.

Pregnancy-associated RLS symptoms typically emerge in the third trimester. According to data, the risk of RLS is 2-3 times higher in pregnant women. 
&nbsp;

Unfortunately, the exact cause of RLS remains to be elucidated. However, a few potential causes such as deficiencies in vitamins or minerals, hormonal imbalances, or nerve compression have been studied. 
&nbsp;

Since leg pains and trouble sleeping are also side effects of pregnancy, it is a challenge to discriminate between these symptoms and RLS. Consult your doctor if you suffer from restless leg syndrome symptoms during pregnancy. Testing for iron deficiency or other deficiencies may be necessary. You can also test out a few of these at-home care methods: 
&nbsp;

<ul>
	<li>Don&#39;t spend too much time sitting stationary, especially in the evening.</li>
	<li>Even a short walk in the afternoon will count as some exercise.</li>
	<li>Before going to bed, massage your legs or do some leg stretches.</li>
	<li>When your legs bother you, try applying a heat or cold pack to them.</li>
	<li>Maintain a consistent sleeping routine.</li>
	<li>Steer clear of alcohol, coffee, smoking, and antihistamines.</li>
	<li>Make sure your diet or prenatal supplements have all the nutrients you require. 
	&nbsp;</li>
</ul>

Some drugs prescribed to treat RLS should not be taken during pregnancy. Besides, it typically goes away on its own after delivery. Consult your doctor about alternative treatments if it doesn&#39;t, especially if you are nursing. 
&nbsp;

Speaking with others who understand what you&#39;re going through, like a family member with restless leg syndrome or a support group, is always helpful.&nbsp; 
&nbsp;

Here are some exercise tips and lifestyle changes that can help 
&nbsp;

<ul>
	<li>
	<h5>Exercises</h5>
	</li>
</ul>

1. Exercise at lunch; walk to the park or around the block while carrying your sandwich.

2. Boost your circulation by doing some stationary jogging.

3. Make sure to stand up, stretch, and move about for five minutes after every hour or so, if RLS is troubling you at work.

4. Stretch your legs at the beginning and the end of the day for symptomatic relief.

5. Don&rsquo;t sit in one position for a long time during a long road trip. Passengers and drivers both should take frequent breaks to stretch out and switch places.

6. Indulge in a relaxing leg massage, calm the body and mind as well as your restless legs.

7. Opt for an aisle seat when flying. Increase your circulation by getting up often.

8. Skip the coffee and spend five minutes stretching your legs if you wake up at 3 am in the morning due to RLS. 
&nbsp;

<ul>
	<li>
	<h5>Lifestyle&nbsp;</h5>
	</li>
</ul>

1. Massage your legs gently while attending a conference call or observing TV.

2. Take a hot bath to relax.&nbsp;

3. Use ice packs to soothe restless legs.

4. Consult your physician on how you can increase your iron levels.&nbsp;

5. Limit your alcohol intake as it may exacerbate RLS symptoms.

6. Avoid taking large meals before bed to reduce symptoms and achieve a better night&#39;s sleep. On the same note try to also reduce your intake of junk food.&nbsp;

7. Try relaxation methods, like progressive muscle relaxation or meditation.

8. Only take prescription drugs and herbal therapies that are prescribed by your doctor. 
&nbsp;

<ul>
	<li>
	<h5>Nighttime Strategies&nbsp;</h5>
	</li>
</ul>

1. Go for a stroll with your children, pet, or friend. You might sleep better if you exercise often. Moderate exercise can help with RLS symptoms, but be careful not to overdo it, as that can worsen the condition.

2. Use a heated pad before you go to bed.

3. Breathe!&nbsp;

4. Eliminate alcohol, caffeine and nicotine from your evening routine to improve your sleep quality.

5. Try to maintain a regular sleep pattern and avoid day napping.&nbsp;

6. Think positive thoughts while in bed to reduce any anxiety.&nbsp; 
&nbsp;

<h5>Diet Recommendations&nbsp;</h5>

There are no particular dietary recommendations. However, it&#39;s wise to evaluate your diet to ensure you&#39;re getting all the necessary vitamins and nutrients. It will also help reduce your intake of processed foods that have high calories but little to no nutritional value.

Sometimes, restless leg syndrome is due to a deficiency in specific vitamins and minerals. You can alter your diet or use dietary supplements if that is the case.&nbsp; 
&nbsp;

Try increasing your intake of these iron-rich foods if you suffer from an iron deficiency:

<ul>
	<li>Dark green leafy vegetables</li>
	<li>Dried fruit</li>
	<li>Beans</li>
	<li>Poultry and seafood</li>
	<li>Peas</li>
	<li>Iron-fortified foods, such as certain cereals, pasta, and bread 
	&nbsp;</li>
</ul>

You may also wish to combine iron-rich products with these supplies of vitamin C since vitamin C aids in the body&#39;s absorption of iron:

<ul>
	<li>Citrus juices</li>
	<li>Grapefruit, oranges, tangerines</li>
	<li>Strawberries</li>
	<li>Kiwi&nbsp;</li>
	<li>Melons</li>
	<li>Tomatoes</li>
	<li>Peppers</li>
	<li>Broccoli and leafy greens| 
	&nbsp;</li>
</ul>

The role of caffeine is not clear. It triggers symptoms of RLS in some people, whereas others find it beneficial. Checking to see if caffeine affects your symptoms is worth a try. However, alcohol is definitely known to disturb sleep; avoid it at all costs, especially at night. 
&nbsp;

Restless leg syndrome results in uncomfortable feelings and a strong impulse to move the legs. This compulsive desire is usually stronger when you are resting or attempting to fall asleep. The biggest worry, thus, is that RLS interferes with sleep and you are left feeling tired and exhausted during the day.&nbsp; 
&nbsp;

If RLS and sleep deprivation are not treated, you may develop additional health issues, such as depression. Although there is no known cure for restless leg syndrome, medicines can help moderate symptoms. Primary care physicians now have more tools than ever to diagnose and treat restless leg syndrome patients, thanks to improvements in diagnostic criteria, treatment plans, and revised recommendations. Continued investigation of pharmaceutical long-term therapy results is necessary for future advancement in drug therapy guidelines. 
&nbsp;

<ul><li>A neural system disease called restless legs syndrome results in an excited impulse to move your legs.</li><li>There are no specific symptoms of the syndrome and it can occasionally be misdiagnosed as another illness.</li><li>Pregnant women are more prone to developing RLS , especially in the third trimester.</li><li>Restless legs syndrome cannot be cured, but it’s possible to manage its symptoms to a certain extent by making lifestyle adjustments.&nbsp;</li></ul>

[1] Kwatra V, Khan MA, Quadri SA, Cook TS. Differential Diagnosis and Treatment of Restless Legs Syndrome: A Literature  Review. Cureus. 2018 Sep;10(9):e3297.

[2] Bassetti CL, Mauerhofer D, Gugger M, Mathis J, Hess CW. Restless legs syndrome: a clinical study of 55 patients. Eur Neurol. 2001;45(2):67–74.

[3] Ekbom K, Ulfberg J. Restless legs syndrome. J Intern Med. 2009;266(5):419–31.

Neelam Asad

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

Pregnant? Avoid The TORCH

Pregnancy is a highly complex period in a woman&rsquo;s life. Hormonal changes, weight gain, stress about the future, and the fear of upcoming life changes are just the tip of the iceberg. And all of this is just related to the woman herself; add to it the fact that her choices are going to affect the fetus, and this long list becomes a plethora of advice (maintained through years of cultural wisdom and/or medical evidence) of all the things she must or mustn&rsquo;t do for her and her baby&rsquo;s health.&nbsp;

&nbsp;

One point that&rsquo;s flagged and is considered of utmost importance is staying clear of certain infections to avoid any adverse fetal outcomes. This is because multiple infections can pass from the mother to the baby in the womb and cause birth defects, miscarriages, and several developmental problems. One of these infections is called the TORCH syndrome. 
&nbsp;

Understanding TORCH Syndrome During Pregnancy & Postpartum

TORCH syndrome represents a group of infectious diseases that can be passed to the fetus during pregnancy, delivery, or after birth. The word TORCH is an acronym for Toxoplasmosis, <a href="https://merisehat.pk/disease/congenital-rubella-syndrome">Rubella</a>, Cytomegalovirus, and <a href="https://merisehat.pk/disease/genital-herpes">Herpes </a>Simplex.&nbsp;

&nbsp;

Other diseases such as <a href="https://merisehat.pk/disease/hiv-61">HIV</a>, fifth disease, varicella-zoster virus, Zika, and syphilis are also included in TORCH syndrome.&nbsp;

&nbsp;

A study conducted in Peshawar, Pakistan, revealed the frequency of TORCH infection during pregnancy as approximately 7%<a href="#accordion">[1]</a>. These infections account for 10-15% of abortions<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

According to research, 2-3% of all congenital anomalies can be linked to congenital TORCH infections<a href="#accordion">[3]</a>. Cytomegalovirus (CMV) is the most common virus transmitted during pregnancy, and is the most common fetal infection, affecting 0.5-2% of all live births<a href="#accordion">[3]</a>. Maternal toxoplasmosis and CMV have an incidence of 2-10 per 1,000 births<a href="#accordion">[4]</a>. In comparison, herpes simplex virus (HSV) infections are uncommon and occur in 1 out of every 3,200 births in the United States<a href="#accordion">[5]</a>. However, 90% of women with genital herpes are asymptomatic and underdiagnosed<a href="#accordion">[3]</a>. Therefore, there&#39;s a high risk of transmission to the fetus during delivery, or via close contact.&nbsp;

&nbsp;

These infections are generally transmitted prenatally, perinatally, and postnatally via the placenta, contact with blood and vaginal secretions, or from exposure to breast milk<a href="#accordion">[3]</a>. Even during delivery, the infant can catch pathogens (e.g., HSV-2) while passing through the birth canal.&nbsp;

&nbsp;

Women can contract viruses, such as HIV, syphilis, and <a href="https://merisehat.pk/disease/hepatitis-b-113">hepatitis B</a>, via sexual contact. Infected women may be asymptomatic. However, when they give birth, the infection typically presents itself in newborns at the time of delivery or in infants later in life. Preterm birth, miscarriage, restricted fetal growth, stillbirth, birth defects, and chronic postnatal infections are common sequelae of TORCH syndrome.&nbsp; 
&nbsp;

Infection during the first trimester is the most detrimental to the fetus&rsquo; health. Maternal risk factors include<a href="#accordion">[4]</a>:

<ul>
	<li>Missed vaccinations</li>
	<li>Animal exposure during pregnancy (e.g., toxoplasmosis via cat feces)&nbsp;</li>
	<li>Ingestion of uncooked meat or unpasteurized milk products&nbsp;</li>
	<li>Sexually transmitted infections (e.g., HIV, syphilis, and herpes simplex) 
	&nbsp;</li>
</ul>

Symptoms vary depending on the pathogen, but they usually overlap. The common signs and symptoms of TORCH syndrome are:

<ul>
	<li>Petechial, maculopapular rash (blueberry muffin rash)</li>
	<li>Difficulty feeding</li>
	<li>Low birth weight</li>
	<li>Lethargy&nbsp;</li>
	<li>Microcephaly</li>
	<li>Sensorineural hearing loss&nbsp;</li>
	<li>Chorioretinitis&nbsp;</li>
	<li>Hepatosplenomegaly</li>
	<li>Cardiac abnormalities</li>
	<li>Hydrops fetalis</li>
	<li>Developmental delay</li>
	<li>Seizure 
	&nbsp;</li>
</ul>

There are currently no maternal or neonatal screening tests for the identification of TORCH infections. Doctors typically recommend the TORCH titer test to check for titers of the pathogens in females before pregnancy.&nbsp;

&nbsp;

A negative result indicates the absence of antibodies against the pathogens, proving that there was no recent or past infection in the body. On the other hand, a positive result can mean either of the two things: (a) the person&rsquo;s been vaccinated against the disease before or (b) they&rsquo;ve had the infection earlier.&nbsp; 
&nbsp;

The following prevention strategies help reduce maternal and infant morbidity and mortality:

<ul>
	<li>Rubella and varicella-zoster vaccinations for mothers before pregnancy</li>
	<li>Cesarean delivery in women with active HSV lesions</li>
	<li>Antibiotics for mothers diagnosed with toxoplasmosis or syphilis early in the pregnancy</li>
	<li>Avoiding contact with cat&rsquo;s feces or cleaning litter boxes during pregnancy</li>
	<li>Practice regular hand washing&nbsp;</li>
	<li>Avoid sharing utensils or drinks with other people</li>
	<li>Avoid ingesting deli meats or unpasteurized dairy products</li>
	<li>Avoid contact with people who are ill</li>
	<li>Practice safe sex 
	&nbsp;</li>
</ul>

Rubella infection can result in congenital rubella syndrome, which has no cure. According to the World Health Organization (WHO), approximately 100,000 congenital rubella syndrome cases are recorded every year<a href="#accordion">[2]</a>. Therefore, it&rsquo;s recommended to get the MMR vaccine at least 28 days before conceiving.&nbsp; 
&nbsp;

Early recognition of TORCH infections and appropriate management will not only reduce maternal morbidity, but also fetal mortality and morbidity. Therefore, there is a need for better in-utero diagnostic tools. Moreover, all women should ensure that their vaccinations are up to date before and during pregnancy. Inform the healthcare professional of any illness immediately in case symptoms of an infection such as fever or rash crop up during pregnancy.&nbsp;

<ul><li>TORCH syndrome represents a group of infectious diseases that can be passed to the fetus during pregnancy, delivery, or after birth. TORCH stands for Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes Simplex. Other diseases, such as HIV, fifth disease, varicella-zoster virus, Zika, and syphilis, are also included in the TORCH syndrome.</li><li>These infections are generally transmitted prenatally, perinatally, and postnatally via the placenta, contact with blood and vaginal secretions, or from exposure to breast milk.</li><li>Preterm birth, restricted fetal growth, stillbirth, miscarriage, birth defects, and chronic postnatal infections are common sequelae of TORCH syndrome.&nbsp;</li><li>Maternal risk factors include missed vaccinations, animal exposure during pregnancy, ingestion of uncooked meat or unpasteurized milk products, and sexually transmitted infections (e.g., HIV, syphilis, and herpes simplex).</li><li>The common signs and symptoms of TORCH syndrome are petechial, maculopapular rash (blueberry muffin rash), difficulty feeding, microcephaly, sensorineural hearing loss, chorioretinitis, hepatosplenomegaly, and hydrops fetalis.&nbsp;</li><li>Doctors typically recommend the TORCH titer test to check for titers of the pathogens in females before pregnancy.</li><li>Early recognition of TORCH infections and appropriate management will not only reduce maternal morbidity, but also fetal mortality and morbidity.&nbsp;</li></ul>

[1] Zeb MA, Jamal SF, Mir A, Khan AA, Ullah A. Frequency of Torch Infections during Pregnancy in Peshawar, Pakistan. Advances in Applied Science Research. 2018;9(1).

[2] Zhang L, Wang X, Liu M, et al. The epidemiology and disease burden of congenital torch infections among hospitalized children in China: A national cross-sectional study. PLOS Neglected Tropical Diseases. 2022;16(10). doi:10.1371/journal.pntd.0010861

[3] Batra P, Batra M, Singh S. Epidemiology of torch infections and understanding the serology in their diagnosis. Journal of Fetal Medicine. 2020;7(1):25-29. doi:10.1007/s40556-019-00232-8

[4] Jaan A, Rajnik M. TORCH Complex. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

[5] Liu Y, Wu Y, Wang F, et al. The Association Between Previous TORCH Infections and Pregnancy and Neonatal Outcomes in IVF/ICSI-ET: A Retrospective Cohort Study. Front Endocrinol (Lausanne). 2020;11:466. Published 2020 Aug 5. doi:10.3389/fendo.2020.00466

Madeeha Syed

How A Sedentary Lifestyle Is Toxic For Your Health

Overview

Over six percent of all deaths in the world can be attributed to being physically inactive. This statistic includes people of all age groups.

Research has observed that, even though previously, physical activity was high in toddlers and younger people as compared to the older generation, with the advent of the newest gadgets and iPads, there has been a sharp decline in that as well. 
&nbsp;

The modern capitalist world we live in requires most of us to be sedentary for long periods of time. Whether it is through our daily eight-hour desk job, the long commute to anywhere in the city or the need to catch up on the latest series on streaming platforms (preferably in one night), we are all just sitting or lying down all the time.
<quillbot-extension-portal></quillbot-extension-portal>

Sitting For Long Hours

But why is sitting for long hours bad for you? Here are some of the reasons: 
&nbsp;

<ul>
	<li>Sitting burns fewer calories than standing or walking and people who live a sedentary lifestyle are more prone to obesity and a number of other health-related issues. 
	&nbsp;</li>
	<li>It increases your chances of developing metabolic syndrome which includes high blood pressure, impaired fasting glucose predisposing one to diabetes, increased body fat especially around the waist area (also known as central <a href="https://merisehat.pk/disease/obesity">obesity</a>), raised cholesterol and triglyceride levels and lower levels of HDL (the good cholesterol). 
	&nbsp;</li>
	<li>Multiple studies have reached the conclusion that the risk of death from sitting for long periods is the same as the risk of death from smoking or obesity. It has even been called the &lsquo;new smoking&rsquo; as that is how hazardous to your health it really is. 
	&nbsp;</li>
	<li>It can lead to insulin resistance which means your body won&rsquo;t be efficiently processing carbs and sugars anymore. 
	&nbsp;</li>
	<li>It also predisposes you to cardiovascular disease. Research has shown that people who sit for longer periods of time are more likely to die of heart attacks and strokes. 
	&nbsp;</li>
	<li>Surprisingly enough it can raise one&rsquo;s chances of getting certain cancers such as lung, uterine and colon cancer. However, more research is needed to trace the pathophysiology of this. 
	&nbsp;</li>
	<li>It also bad for your bowel function as we have observed that people who are bedridden or sedentary for too long start having slower bowel movements. This can lead to chronic constipation which in turn can cause hemorrhoids, fecal impaction, rectal prolapse and bowel incontinence. 
	&nbsp;</li>
	<li>Walking around helps the veins in your legs to perform their function properly which is to return the blood down there to the heart. Sitting for too long means theres no pressure or compression on your veins and this leads to pooling of the blood. This is how varicose veins develop. Apart from the aesthetic concerns this raises, it poses a risk of thrombosis and other more serious issues in the long term. 
	&nbsp;</li>
	<li>It can also lead to the development of a Deep Vein Thrombosis (DVT) which is a clot in your leg veins. This blood clot can break off and travel to your lungs, blocking major vessels, leading to pulmonary embolism which is a life-threatening condition. Even something as routine as a long flight can lead to the development of a DVT in those who are already at high risk. 
	&nbsp; </li>
	<li>It&rsquo;s not good for the health of your bones either since they need to be bearing weight for their optimal growth and maintenance. It raises your chances of developing osteoporosis which means you end up with porous and weak bones. 
	&nbsp;</li>
	<li>Similarly, your leg muscles and glutes can undergo wasting if not utilised enough. 
	&nbsp;</li>
	<li>The muscles in your back and hip flexors are also affected and cannot work efficiently enough for stabilising and supporting you. 
	&nbsp;</li>
	<li>Your neck and shoulder muscles end up suffering as well and this can lead to neck stiffness. 
	&nbsp;</li>
	<li>Most of us retain a poor posture while sitting, especially when we have been sitting for too long and it&rsquo;s impossible to stay upright. This can lead to poor spine health as well and can cause disk degeneration which in turn will lead to nerve impingement and can be very painful and debilitating. 
	&nbsp;</li>
	<li>Positive effects of an active lifestyle include a good mood and stable mental health. Sitting does the opposite of this and can lead to depression and anxiety. 
	&nbsp;</li>
	<li>It also increases your risk of developing dementia. 
	&nbsp;</li>
</ul>

Tips To Relax

Most of us can&rsquo;t choose to quit our desk job or do much about our sedentary existence. But research has also found that we can still counter the effects of too much sitting. Moderate physical activity every day for 60 to 75 minutes can help you do this. Another interesting finding was that people who were more active while sitting had fewer side effects from sitting for too long as well. 
&nbsp;

Some other steps you can take are:

<ul>
	<li>If you can, walk or cycle to your workplace or nearby shops. </li>
	<li>If you take the bus to work, get off one stop early and walk the rest of the way. </li>
	<li>If none of these are an option then park farther away from where you are going to get more of a walk in. </li>
	<li>Get up from your desk and take a walk whenever you can. </li>
	<li>Try to take a break from sitting every 30 minutes.</li>
	<li>Stand or walk while you watch TV or better yet do some squats or a wall sit. </li>
	<li>Try a standing desk or place your laptop on a treadmill while you work or attend meetings </li>
	<li>Opt for stairs instead of elevators. </li>
	<li>Look into a sport that you enjoy that requires you to be active such as tennis or football and try to go every week. </li>
	<li>Add weight bearing exercises to your routine for ensuring good bone and muscle health. </li>
	<li>Develop better sitting posture and invest in an ergonomic chair and a desk to protect your spine. Make sure your laptop or computer is placed at your eye level. </li>
	<li>Don&rsquo;t cross your legs while sitting. </li>
	<li>Switch your sitting position often and try to be active while sitting for example by doing sitting calf raises. </li>
	<li>Get up and stretch ever so often to get your blood flowing. 
	&nbsp;</li>
</ul>

The modern world is rigged to ensure an unhealthy lifestyle but there are ways we can overcome this. Physical activity is good for your overall health and that includes your mental health as well. None of us want to develop chronic health conditions at any point in our lives and its better if we start being cautious about these things as early as possible. &nbsp; 
&nbsp;

Dr. Safia Mehmood

What Is Toxic Masculinity? How To Deal With It?

<a href="https://merisehat.pk/article/overcoming-the-stigma-around-self-care-for-men-breaking-the-barriers-of-toxic-masculinity">Toxic masculinity</a> is a term that has gained increasing recognition in recent years. It refers to societal expectations and norms that pressure men to conform to certain rigid and harmful behaviors, emphasizing dominance, emotional suppression and aggressive behavior. Let&rsquo;s delve into the concept of toxic masculinity, explain its effects on individuals and society, and provide insights into how to overcome and challenge this harmful phenomenon. 
&nbsp;

Toxic masculinity is a set of cultural norms and beliefs that promote a narrow and harmful understanding of what it means to be a man. It enforces stereotypes that discourage emotional expression, prioritize dominance and aggression and marginalize traits deemed &quot;feminine.&quot; Understanding toxic masculinity involves recognizing the negative impact it has on men, women and gender non-conforming individuals. 
&nbsp;

Toxic masculinity is deeply embedded in cultural expectations and socialization. From a young age, boys are often taught to suppress their emotions and prioritize physical strength over emotional intelligence. This can lead to a lack of empathy and an inability to effectively communicate feelings. 
&nbsp;

Effects Of Toxic Masculinity

<ul>
	<li>Emotional Suppression &ndash; Toxic masculinity fosters emotional suppression, causing men to bury their feelings and avoid vulnerability. This emotional detachment can lead to mental health issues, such as depression and anxiety.</li>
	<li>Aggression And Violence &ndash; Toxic masculinity glorifies aggression and dominance, which can manifest in abusive behaviors, both physically and emotionally. This contributes to a culture of violence and harmful relationships.</li>
	<li>Stifling Individuality &ndash; Men conforming to toxic masculinity often stifle their true selves to fit into societal expectations. This stifling of individuality can lead to feelings of inadequacy and disconnection from their authentic selves. 
	&nbsp;</li>
</ul>

Overcoming Toxic Masculinity

<ul>
	<li>Promoting Emotional Intelligence &ndash; Challenging toxic masculinity involves promoting emotional intelligence in men. Encouraging the understanding and expression of emotions can lead to healthier relationships and self-awareness.</li>
	<li>Questioning Traditional Gender Roles &ndash; Rigid gender roles perpetuate toxic masculinity. By questioning and challenging these roles, we can create space for more diverse and inclusive expressions of gender.</li>
	<li>Encouraging Open Communication &ndash; Open communication is essential for overcoming toxic masculinity. Creating safe spaces where men can express their feelings without judgment is crucial for emotional growth and development.</li>
	<li>Supporting Men&#39;s Mental Health &ndash; Men facing the effects of toxic masculinity may struggle with mental health issues. It&#39;s essential to provide support and resources for men to seek help and address their emotional well-being.</li>
	<li>Redefining Masculinity &ndash; Redefining masculinity involves celebrating traits such as empathy, compassion and vulnerability. By dismantling the notion that vulnerability is a sign of weakness, we can foster a healthier understanding of masculinity.</li>
	<li>Education And Awareness &ndash; Educating society about toxic masculinity&#39;s harmful effects is vital for creating positive change. Awareness campaigns and discussions can challenge societal norms and promote inclusivity.</li>
	<li>Seeking Professional Help &ndash; Men who have internalized toxic masculinity may need professional help to unlearn harmful behaviors and beliefs. Therapy can provide a safe and supportive environment to explore and address these issues.</li>
	<li>Role Of Media And Representation &ndash; Media plays a significant role in perpetuating toxic masculinity. Encouraging diverse and positive representations of men in media can challenge harmful stereotypes and influence societal perceptions.</li>
	<li>Cultivating Empathy And Respect &ndash; Promoting empathy and respect towards all individuals, regardless of gender, is essential for dismantling toxic masculinity. By creating a culture of empathy, we can foster healthier relationships and a more inclusive society. 
	&nbsp;</li>
</ul>

Bottom Line

Toxic masculinity is a harmful and pervasive societal issue that enforces harmful stereotypes and stifles individuality and emotional expression. Understanding the effects of toxic masculinity is crucial for challenging and overcoming this harmful phenomenon. Many younger individuals are now actively fighting against this insidious phenomenon and have been able to cultivate healthier and more balanced lives as a result of it. We must foster an environment where these efforts are appreciated and encouraged. Redefining masculinity and providing support for men&#39;s mental health are essential steps towards dismantling toxic masculinity and fostering healthier relationships and communities.

How Your Office Is Making You Sick, And How To Fix It

We all immediately said OMG YES in our heads the moment we read the title. Our offices do make us <a href="https://merisehat.pk/article/too-sick-to-move">sick mentally</a> but this article targets more of the physical aspect of sickness.

Seems weird but it is a thing. Your office building may just be the reason behind your illness. 
&nbsp;

Sick Building Syndrome

Sick Building Syndrome (SBS) is a term used to describe a set of symptoms experienced by people who spend time in a building or enclosed space, such as an office or school, and experience health and comfort issues that are associated with the time spent in that building. Symptoms of SBS may include headaches, dizziness, nausea, fatigue, respiratory problems, and skin irritation, among others.

SBS is believed to be caused by a combination of factors related to the building environment, including poor indoor air quality, inadequate ventilation, and chemical or biological contaminants. Some of the specific causes of SBS may include: 
&nbsp;

<ul>
	<li>Poor Indoor Air Quality: This can be caused by a range of factors, such as inadequate ventilation, the presence of volatile organic compounds (VOCs) from building materials or furnishings, or the accumulation of indoor air pollutants such as dust and mold.</li>
	<li>Inadequate Ventilation: Poor ventilation can result in a build-up of pollutants and humidity, which can lead to respiratory and other health problems.</li>
	<li>Chemical Contaminants: Chemical contaminants can come from a range of sources, such as cleaning products, pesticides, or building materials, and can have negative effects on human health.</li>
	<li>Biological Contaminants: Biological contaminants, such as mold and bacteria, can thrive in indoor environments that are damp or poorly ventilated, and can cause respiratory and other health problems.</li>
	<li>Indoor Temperature And Humidity: Indoor temperature and humidity levels can affect human comfort and well-being, and inadequate heating or cooling systems can lead to discomfort and health issues. 
	&nbsp;</li>
</ul>

SBS can have negative impacts on individual health and well-being, as well as productivity and performance in the workplace or school. Additionally, it can lead to increased absenteeism and healthcare costs for employers and organizations.

&nbsp;

Fix ing SBS

The treatment or solution for Sick Building Syndrome (SBS) typically depends on the underlying causes of the symptoms. Here are some steps that can be taken to treat or fix SBS: 
&nbsp;

<ul>
	<li>Identify And Remove Sources Of Pollutants: Conduct an indoor air quality assessment to identify the sources of pollutants in the building. This may include removing or reducing the use of products or materials that emit chemicals, such as cleaning products, carpets, or furniture.</li>
	<li>Increase Ventilation: Increase the amount of fresh air circulation in the building by improving ventilation systems, opening windows or doors, or using air purifiers or filters.</li>
	<li>Regulate Indoor Temperature&nbsp; And&nbsp; Humidity: Maintain appropriate indoor temperature and humidity levels to prevent the growth of mold or other biological contaminants, and to ensure that occupants are comfortable.</li>
	<li>Educate Building Occupants: Provide education and training to building occupants on ways to reduce indoor air pollution and improve indoor air quality. This may include promoting good hygiene practices, such as washing hands regularly, and avoiding smoking indoors.</li>
	<li>Address Individual Health Issues: For individuals who experience persistent symptoms, medical treatment may be necessary to manage or alleviate their symptoms.</li>
	<li>Implement Building Design Changes: In some cases, building design changes may be necessary to improve indoor air quality, such as installing new ventilation systems or modifying building materials or furnishings.</li>
</ul>

Overall, the treatment or solution for SBS requires a holistic approach that addresses the underlying causes of poor indoor air quality and promotes a healthy and comfortable indoor environment for building occupants. 
&nbsp;

Umna Salah

Safia Mehmood

Imposter Syndrome: Are You Really A Fraud, Or Is It Just Your Brain Playing Tricks?

Have you ever achieved something great but felt like you don&#39;t truly deserve it? Do you often attribute your success to luck or think &quot;anyone could have done it&quot;? If these thoughts sound familiar, then my friend, you might be experiencing Imposter Syndrome. But what is imposter syndrome exactly, and why does it feel like your brain is hosting a never-ending &lsquo;fraud fest&rsquo;? 
&nbsp;

strategies to shatter Impostor Syndrome

Imposter Syndrome isn&#39;t just a fancy buzzword; it&#39;s a psychological pattern where people doubt their accomplishments and fear being exposed as a &quot;fraud.&quot; It&rsquo;s like having an internal critic, constantly nagging that you&rsquo;re just winging it, and soon everyone will find out.

Dr. Pauline Clance and Dr. Suzanne Imes coined the term in their seminal 1978 study, noting its prevalence among high-achieving women who felt like frauds despite evident success. However, Impostor Syndrome doesn&#39;t discriminate. It casts its shadow across genders, cultures, and professions.

At its core, IS is a psychological pattern where individuals doubt their accomplishments, attributing success to luck or error rather than ability. This self-doubt often accompanies <a href="https://merisehat.pk/disease/anxiety">anxiety</a> and depression, as discussed in a 2011 study in the Journal of Behavioral Science. Think of Imposter Syndrome as a chameleon, changing colors according to the situation. Whether you&#39;re a student, a professional, or even a new parent, it sneaks up, whispering doubts and undermining your confidence. 
&nbsp;

<h5>The Mechanics Of Doubt</h5>

Why does Impostor Syndrome take hold? Cognitive-behavioural theory provides some insight. Our beliefs shape our reality. If we harbor a core belief that we&#39;re inadequate, we&#39;re prone to dismissing evidence that contradicts this belief. In a 2020 Nature article, researchers posit that such internal narratives are self-sabotaging prophecies. 
&nbsp;

<h5>Triggers Of The Impostor Phenomenon</h5>

<ol>
	<li>Novelty: Transitioning to new roles can trigger IS. A study in the International Journal of Behavioral Science suggests the unfamiliarity of new responsibilities can magnify self-doubt. 
	&nbsp;</li>
	<li>Cultural Stereotypes: Certain cultural backgrounds that place immense value on achievement can heighten the risk of IS. The Asian American Journal of Psychology has explored how societal expectations influence self-perception, particularly in minority groups. 
	&nbsp;</li>
	<li>Upbringing: Family dynamics play a crucial role. Overly critical or protective parents might inadvertently set the stage for IS, as outlined in Developmental Psychology. 
	&nbsp;</li>
</ol>

How do we dismantle the intricate masquerade of Impostor Syndrome? Science points us to several strategies:

<ol>
	<li>Identification And Mindfulness: Recognizing the moments when IS speaks is key. Mindfulness-based approaches, as described in a 2019 study in the Journal of Clinical Psychology, teach us to observe our thoughts without judgment, reducing their power. 
	&nbsp;</li>
	<li>Cognitive Behavioural Change: Challenging the impostor narrative requires restructuring thoughts. Cognitive-behavioural therapy (CBT) has been shown to help, as per the American Psychological Association. Replacing &quot;I must not fail&quot; with &quot;I will do my best&quot; can reshape our thought patterns. 
	&nbsp;</li>
	<li>Keep A&nbsp;Success Journal: Documenting achievements helps solidify them in your memory, combating the impostor narrative. This technique aligns with positive psychology interventions aimed at enhancing well-being. 
	&nbsp;</li>
	<li>Talking About It: Disclosure lessens the impostor phenomenon&#39;s grip. According to a study in the Journal of Multicultural Counseling and Development, sharing feelings of fraudulence diminishes their intensity. 
	&nbsp;</li>
	<li>Mentorship And Networking: Connecting with mentors can be invaluable. Mentorship provides a reality check and external validation, as noted in a study in the Academy of Management Learning &amp; Education. 
	&nbsp;</li>
</ol>

<h5>Spotting The Symptoms: Is It Imposter Syndrome Or Just A Bad Day?</h5>

Imposter syndrome symptoms include:

<ul>
	<li>Chronic self-doubt.</li>
	<li>Attributing success to external factors (like luck).</li>
	<li>Fear of not meeting expectations.</li>
	<li>Overachieving and then feeling burnt out. 
	&nbsp;</li>
</ul>

<h5>Why Me? Understanding The Roots</h5>

So, why do some of us feel like imposters? It&rsquo;s often a mix of personality traits (like perfectionism), family expectations, and societal pressure. In Pakistan, where there&rsquo;s a strong emphasis on academic and professional success, imposter syndrome can hit hard. You might have grown up hearing, &quot;Beta, you need to top your class!&quot; or &quot;You must be the best in your field!&quot; No pressure, right? 
&nbsp;

<h5>Expert Insights</h5>

&quot;Overcoming impostor syndrome is about rewiring our thinking,&quot; says Dr. Carol Dweck, renowned psychologist and author. &quot;When we understand that abilities can be developed, success becomes a reflection of growth, not a confirmation of innate talent.&quot; 
&nbsp;

As we conclude, remember this: Feeling like an imposter doesn&rsquo;t make you one. It&rsquo;s a sign that you&rsquo;re pushing your boundaries and stepping out of your comfort zone. So, next time your brain starts its &lsquo;fraud fest&rsquo;, take a deep breath, remember your achievements, and wear your successes like a badge of honor. You&rsquo;ve earned it, and no imposter thoughts can take that away!

With actionable strategies grounded in robust research, expert insights, and the inspiration from those who have walked this path, you&#39;re now equipped to conquer the imposter syndrome and unlock your full potential. The journey to self-acknowledgement may be challenging, but as you continue to combat IS with evidence-based tools, the narrative of self-doubt loses its grip, allowing your true capabilities and successes to shine through.

What Is An Energy Vampire And How To Protect Yourself

Have you ever found yourself feeling drained after spending time with a particular person? Maybe you can&#39;t quite put your finger on it, but being around them leaves you feeling not just frustrated but depleted and exhausted. Ever wonder why this only happens with some people and not all the time? Turns out, you may have encountered an &lsquo;energy vampire&rsquo;. 
&nbsp;

Types of Energy Vampires

Yes, you read that right. An &lsquo;energy vampire&rsquo; is someone who feeds off of other people&#39;s energy, draining them of their vitality and leaving them feeling depleted. Now this is not always done intentionally and most of them aren&rsquo;t even aware of their impact and the extent of &ldquo;bad vibes&rdquo; they bring into your life. What&rsquo;s more is that these energy vampires can be found in all areas of life. You can find yourself stuck in this dynamic in both your personal and professional relationships and its often very hard to get out of. There are several types of energy vampires, each with their own tactics for sapping your energy.&nbsp;

&nbsp;

<ul>
	<li>The first type is the victim. This person is constantly complaining and looking for sympathy but never seems to take any action to improve their situation. They will come and sit with you, tell you everything that&rsquo;s been going wrong with their life, you will invest your precious time and energy in listening and advising them for the next course of action and the very next day find yourself going through these same motions all over again. Because they aren&rsquo;t really looking to change or improve their circumstances, all they are looking for is sympathy and attention. One can easily imagine how draining this can get over time.&nbsp; 
	&nbsp;</li>
	<li>The second type of energy vampire is the drama queen. This person thrives on drama and chaos, and will do whatever it takes to create it. They may gossip, spread rumors or start arguments just for the thrill of it. Being around them can be exhausting as well because you never know what they will do next.&nbsp; 
	&nbsp;</li>
	<li>The third type of energy vampire is the narcissist. This person is obsessed with themselves and their own needs and will do whatever it takes to get what they want. They are extremely charming, charismatic and have a knack for making everyone like them. What most of us fail to realize is that all this is a means to an end and this is how they make sure they get everything they want. Being around this kind of energy vampire can be especially draining because they will demand not just your attention but are also constantly looking for high praise and admiration.&nbsp;</li>
</ul>

&nbsp;

Protection from Energy Vampires

So how do we protect ourselves from energy vampires? The first step is to be able to acknowledge that you&rsquo;re in the presence of one. Next time you start to feel exhausted in the presence of a particular person, take a step back and evaluate the situation. Are you being asked to pour into an insatiable black hole? Have you been here before and nothing seems to have changed? Once you achieve this basic task, you can now move on to the next step.&nbsp;

&nbsp;

<ul>
	<li>The only way to protect yourself from energy vampires is to establish clear boundaries. Let them know what you are and aren&rsquo;t willing to tolerate in your relationship and stick to those boundaries. When we think of boundaries we believe they start and end at the &ldquo;talk&rdquo; you&rsquo;re supposed to have. But the most crucial step is actually following through. It&rsquo;s also a promise your make to yourself to keep yourself safe. So if your boundary is that &lsquo;if x does y then I won&rsquo;t allow them to be a part of my life anymore or limit our interaction&rsquo; then make sure you&rsquo;re sticking by it.&nbsp; 
	&nbsp;</li>
	<li>Another way to protect yourself from energy vampires is to practice <a href="https://merisehat.pk/article/embracing-self-care-unveiling-the-importance-of-self-care-for-men">self-care</a>. This is especially for those who can&rsquo;t actually move away from the toxic person in their life for example if you&rsquo;re the child of such a parent or are married to one. You can take time to do things that bring you joy and replenish your energy, such as exercising, meditating or spending time in nature. When you prioritize your own well-being, you will be better equipped to deal with the hefty demands of this particular dynamic. 
	&nbsp;</li>
	<li>It is also important to surround yourself with positive, uplifting people. Seek out friends and family members who support you and encourage you to be your best self. When you are around people who lift you up, you will be less susceptible to the influence of energy vampires.</li>
</ul>

&nbsp;

It is important to remember that you are not responsible for other people&#39;s energy. However, you are responsible for safeguarding yourself from negative energies. While it is important to be kind and compassionate, you cannot allow others to drain you.&nbsp;

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Toxic shock syndrome (TSS) is a combination of symptoms that affects numerous bodily systems. Some bacterial infections cause the release of toxins into circulation, which are then distributed to the body&#39;s organs and lead to serious disease and impairment. Approximately, 70% of women who tested positive for TSS in Canada, the United States, and a majority of Western Europe have been observed to use tampons during menstruation<a href="#accordion">[1]</a>.&nbsp;

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TSS was explained in 1978 for the first time when occurrences of illness fitting the TSS case definition (e.g., appearance of fever, low blood pressure, rash, skin peeling, and multiorgan system involvement) had begun to emerge in large numbers<a href="#accordion">[3][5]</a>. By 1980-81, it was considered in the United States.&nbsp;

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Dr. Schlievert, who was the first person to identify TSS toxin-1, the primary cause of TSS, stressed that tampons had a direct connection to TSS. While it&rsquo;s not the only reason, it was considered a major risk factor since those young women, who were otherwise healthy individuals, had one thing in common &ndash; they were using super-absorbent tampons<a href="#accordion">[4][8]</a>.&nbsp; 
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Understanding FAQs About Toxic Shock Syndrome

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<h5>Is Toxic Shock Syndrome Rare? 
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Yes, TSS is a rare multisystem disease characterized by a wide range of symptoms. While little research has been done in this regard, results indicate that it influences approximately 3 women of reproductive age in every 100,000 in the United States annually<a href="#accordion">[6]</a>. 
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<h5>Which Bacteria is Responsible for Toxic Shock Syndrome? 
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Staphylococcus aureus (S. aureus) is a common bacterium that triggers TSS. It generally lives on the skin of about 20% of healthy individuals&nbsp;and in the nose (30%), groin, armpit, or vagina without causing harm<a href="#accordion">[7][15]</a>. In rare occurrences, specific strains of these bacteria form toxins that trigger TSS. 
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<h5>When does Toxic Shock Syndrome occur? 
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<a name="_heading=h.1fob9te"></a>TSS develops after a skin cut or burn, a recent surgery, or using contraceptive sponges, diaphragms, superabsorbent tampons, or menstrual cups. In most cases, TSS symptoms appear as early as 12 hours following a surgery<a href="#accordion">[8]</a>. 
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<h5>Do Seasons Influence the Incidence of Toxic Shock Syndrome? 
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Yes, they do. The number of cases is higher particularly in the winter and spring season<a href="#accordion">[9]</a>. 
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<h5>Why do Tampons cause Toxic Shock Syndrome? 
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Tampons induce TSS because they become a breeding ground for bacteria, especially if they are not changed frequently enough. Moreover, tampons can adhere to the walls of the vagina, particularly when blood flow is low, causing small scrapes when removed. It&rsquo;s easy for the bacteria to enter the uterus through the cervix.

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It&rsquo;s recommended to remove the tampons after approximately 4-6 hours (or earlier in case of heavy bleeding) to reduce the risk of TSS<a href="#accordion">[9]</a>. On the other hand, this does not imply that females will automatically acquire TSS if they leave a tampon in the vagina for more than 4 hours. 
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<h5>Will using Organic Tampons Lower the Risk of Developing TSS?</h5>

No. The risk of developing TSS is the same whether the woman uses organic or non-organic tampons. The only difference that can elevate the risk of TSS is the tampons&#39; absorbency. A tampon with a higher absorbency can increase the risk of TSS, whereas a tampon with a lower absorbance has a lowered risk of TSS. That is why, whether organic or conventional, it&rsquo;s best to always use the lowest permeability tampon that will manage the flow. 
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<h5>Do Sanitary Pads have the Potential to Trigger Toxic Shock Syndrome? 
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Yes; the usage of pads makes the female vulnerable to TSS. It&#39;s uncommon, but it can occur. It&rsquo;s not the tampons themselves, but the environment, which is ideal for bacterial growth, that trigger the syndrome. 
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<h5>Is it Possible to get TSS from Wearing A Pad for an Extended Time? 
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The risk of getting TSS is linked to using tampons and other menstrual products, such as discs and menstrual cups, which are inserted into the vaginas for an extended time. With pads, this risk is low; however, not practicing proper period hygiene (e.g., wearing a pad for an extended time) can lead to other infections such as a yeast infection<a href="#accordion">[10]</a>. 
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<h5>Who can Acquire Toxic Shock Syndrome? 
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It&rsquo;s not just the women; anybody can acquire TSS and that includes men and children, too! While half of all reported occurrences of TSS are linked to females who use tampons, the other half are caused by localized infections, such as those induced by burns, boils, insect bites, or surgery.

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Evidence suggests that the risk of TSS is higher in children and teenagers because adults are more likely to have the required antibodies to safeguard them from the toxin that triggers TSS. 
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<h5>Is Toxic Shock Syndrome Transmissible? 
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TSS is an infectious disease that itself cannot be transmitted to other people. However, S. aureus, the bacteria that trigger infections and cause TSS, can be passed from one individual to the other through one-to-one contact<a href="#accordion">[5]</a>.

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<h5>Is Toxic Shock Syndrome Curable? 
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It is a serious condition, but most individuals get better completely if it&rsquo;s diagnosed and, consequently, treated early. 
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<h5>Is it Possible for Toxic Shock Syndrome to Resolve on its Own? 
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No; TSS will not resolve on its own. Immediate treatment is required to avoid possibly fatal outcomes.

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<h5>Is Toxic Shock Syndrome Capable of Causing Sepsis? 
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The release of toxins into the body by specific bacteria triggers TSS. Although group A streptococcus (strep) bacteria can cause TSS, S. aureus (staph) bacteria are more commonly responsible. They can cause sepsis and septic shock<a href="#accordion">[11]</a>. 
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<h5>Is there a Difference Between Septic Shock and Toxic Shock? 
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Bacterial infections can cause septic shock and TSS in children. An overpowering immune reaction to the infection triggers septic shock, whereas toxic shock results from bacterial exotoxins<a href="#accordion">[3][12]</a>. 
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<h5>Is Toxic Shock Syndrome Capable of Triggering Seizures? 
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TSS can indeed trigger seizures. Any individual, adult or child, who exhibits symptoms of TSS should seek immediate medical attention. The infection has the potential to spread speedily throughout the body.

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<h5>Is Toxic Shock Syndrome always Deadly? 
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<a name="_heading=h.3dy6vkm"></a>TSS is a possibly fatal condition that occurs suddenly. It does not always result in death, and most people are able to recover completely if they are diagnosed and treated early.

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<h5>Does Toxic Shock Syndrome have Long-Term Consequences?</h5>

 
Most patients recover completely, but since TSS is uncommon, there is less data about the long-term consequences. There have been reports of long-term muscle weakness, though, as well as psychological effects like trouble concentrating, memory loss, and emotional changes<a href="#accordion">[13]</a>. 
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<h5>Why does Toxic Shock Syndrome Necessitate Amputation? 
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The body becomes severely ill as a result of bacterial toxins which is why patients are advised amputations of toes, fingers, or even limbs<a href="#accordion">[5]</a>.

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<h5>Is it Possible to Acquire Toxic Shock Syndrome Multiple Times? 
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Sadly, yes<a href="#accordion">[14]</a>. Anyone who has previously experienced TSS due to tampons especially should talk to their medical professional before using tampons in future. Many specialists prohibit tampons if a patient has a history of TSS.&nbsp; 
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The disease known as toxic shock syndrome or TSS is severe. It is caused by toxins that release germs. Tampon use is frequently linked to TSS. However, it can also occur as a result of childbirth, burns, skin diseases, or surgical incisions. TSS's initial symptoms include a sudden, high temperature and a rash that resembles sunburn.

<ul><li>A rare but potentially fatal condition known as toxic shock syndrome (TSS) is believed to be triggered by bacterial infection.</li><li>TSS is brought on by toxins that have been released by bacteria in the body.</li><li>TSS requires hospitalization and intravenous antibiotic therapy.</li></ul>

[1] Parsonnet J, Hansmann MA, Delaney ML, Modern PA, DuBois AM, Wieland-Alter W, et al. Prevalence of toxic shock syndrome toxin 1-producing Staphylococcus aureus and the presence of antibodies to this superantigen in menstruating women. J Clin Microbiol. 2005;43(9):4628–34.

[2] Nelson E, Jordan M. Seeking new markets for tampons, Procter \& Gamble tries “bonding sessions” and school slide shows to win sales in Mexico. Wall Str J. 2000;

[3] Poudel B, Zhang Q, Trongtorsak A, Pyakuryal B, Egoryan G, Sous M, et al. An overlooked cause of septic shock: Staphylococcal Toxic Shock Syndrome secondary to an axillary abscess. IDCases. 2021;23:e01039.

[4] Toxic shock syndrome (TSS). Toxic Shock Syndrome (TSS) | Johns Hopkins Medicine.

[5] Toxic shock syndrome. NORD (National Organization for Rare Disorders).

[6] Stanley CN UHAA. Prevalence and antibiotic susceptibility of Staphylococcus aureus and other staphylococcal infections in pregnant women attending antenatal clinic in a tertiary hospital in Port Harcourt, Nigeria. OMICS International.