AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

Morning sickness is quite common in the first trimester of pregnancy. Morning sickness in pregnancy may cause nausea and vomiting till up to 14 weeks of conception.

Your Morning Sickness Guide

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

Madeeha Syed

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

Beat The Heat: What Happens When Heat, Sweat And Skin Collide

Overview

The summer months can be a fun time for outdoor activities and spending time with friends. But if you&rsquo;re prone to chafing or rashes, they may not be so enjoyable.&nbsp; 
&nbsp;

effect of heat on skin

Chafing and rashes are a common problem, especially during the summer months. The main cause of these annoying conditions is sweat. When your skin gets wet and rubs against itself or another surface, it can become inflamed and tender to the touch.

When you put on clothes that are too tight or made with synthetic materials like lycra, they can act like a glue trap for sweat, which contributes to chafing and rashes by trapping moisture between your skin and clothing. Sweat can also irritate sensitive skin as it evaporates off of your body &mdash; this is why you should always wear breathable fabrics such as cotton when exercising outdoors or in an air-conditioned room on hot days. 
&nbsp;

Sweat is the main cause of chafing, but it&rsquo;s not the only one. Friction is also a major factor in causing irritation and soreness that can make you unable to enjoy your day-to-day activities. 
&nbsp;

There&rsquo;s a rash for every occasion:

<ul>
	<li>Boob Rash: It&rsquo;s the bane of many a lady&rsquo;s existence, especially during sweaty summers and strenuous workouts. The friction of your bra rubbing against your skin causes irritation, which leads to red bumps and rashes.</li>
	<li>Thigh Chafing: Similar to boob rash but on your legs instead of chest, thigh chafing is caused by the constant rubbing of clothing against bare skin as you walk or run around all day long &mdash; especially if you&rsquo;re wearing shorts or skirts!</li>
	<li>Nipple Chafing: This is one particular type of nipple rash that can happen during pregnancy or breastfeeding when there&rsquo;s excess fluid flowing through those delicate glands in addition to sweat from exercise! 
	&nbsp;</li>
</ul>

Sweat itself doesn&rsquo;t cause chafing, but it can make things worse. If your skin is already sensitive to friction or susceptible to rashes and blisters, then sweat will make it even more sensitive.

&nbsp;

When you&rsquo;re trying to keep cool in the summer heat, it&rsquo;s easy to over-hydrate and end up with a gush of liquid dripping down your back as you walk around. When that happens, you might start thinking that all this sweat must be causing me some discomfort &mdash; but in reality, we just need a little bit more salt!

&nbsp;

These rashes could cause serious health problems if left untreated

Cuts and scrapes can lead to infections. Chafing can lead to blisters, and, in turn, those blisters can become infected.

Infections in the skin can cause damage that leaves you vulnerable to infection by other germs and even viruses like <a href="https://merisehat.pk/disease/hepatitis-b-113">Hepatitis B</a> and C or <a href="https://merisehat.pk/disease/hiv-61">HIV</a>, which can be fatal if left untreated.

To avoid these rashes in the first place, you need to keep the skin dry, reduce friction and stop rubbing your skin raw.

A rash is an uncomfortable, and sometimes painful, skin condition that can occur due to a variety of reasons. The most common cause of rashes is sweat and friction. To avoid these rashes in the first place, you need to keep the skin dry, reduce friction and stop rubbing your skin raw. 
&nbsp;

Avoiding Sweat And Friction: Using a lubricant between two surfaces that rub together without causing much wear (skin against fabric) will help prevent chafing and blisters caused by sweating under heavy loads or tight-fitting clothing like cycling jerseys or hiking shorts. Silicone-based lubricants work well because they stay slick longer than water-based lubricants; however, they&rsquo;re not as safe for use around water because silicone doesn&rsquo;t absorb into fabrics so it can be slippery when wet!

Keeping Skin Dry: You should apply sunscreen before you go outside since sun exposure makes you more susceptible to getting burned &mdash; especially if there isn&rsquo;t any breeze to cool down your body temperature during long runs outdoors (or even short ones). 
A good rule of thumb is that if it&rsquo;s hot outside but feels less humid than usual then put on sunscreen anyway just in case because humid conditions make it harder for sweat from evaporating off our bodies which means we need more frequent hydration breaks during long workouts outside in summer heat waves! 
Don&rsquo;t forget about protecting yourself against UV rays too because even though clouds may block direct sunlight from reaching us directly down here on earth&rsquo;s surface &mdash; they don&rsquo;t block UV rays which come through holes in them called &ldquo;glare points.&rdquo; These glares points are responsible for generating many different kinds of reflections including glare reflection off surfaces such as pavements when walking along city streets. 
&nbsp;

The first rule of treating any skin condition is not to try to rub it off. The rubbing can make it worse, and you may introduce bacteria into the area, which could cause inflammation and infection. The best thing to do is keep the area dry by using talcum powder or a non-oily moisturizer with a high water-content like Vaseline or Petroleum Jelly. 
&nbsp;

<h4>&quot;Most rashes will clear up within a few days after you adopt prevention techniques that keep your skin dry and limit friction&quot; 
&nbsp;</h4>

If you&rsquo;re at risk of developing a rash, it&rsquo;s best to take the following precautions:

<ul>
	<li>Use a towel to dry off immediately after swimming or sweating.</li>
	<li>Apply a moisturizer with an SPF of at least 30 every morning and reapply in the afternoon if you plan on being outside for longer than an hour.</li>
	<li>If you are wearing clothes that rub against your skin, use an anti-chafing product such as zinc oxide paste until your rash clears up and then switch to a heavier formula like dimethicone which will protect against future rashes. You may also want to try tea tree oil or aloe vera gel if those options appeal more strongly than using medication prescribed by a healthcare professional. 
	&nbsp;</li>
</ul>

The best way to prevent chafing while running is to take steps before your run. You can start with a good exfoliating shower and apply some body lotion or cream to dry areas. Then, wear the right clothes. Make sure they fit you well and aren&rsquo;t too tight or too loose where it counts &mdash; the thighs and crotch area are particularly susceptible to chafing.

Lastly, you should use products like Vaseline on dry spots before you hit the road. These products will help protect against rubbing and chafing during exercise so that when it&rsquo;s time for your next long run, all of those miles won&#39;t be spent dealing with embarrassing rashes instead of crossing finish lines! However, this is not just limited to the girlies who are active. Even when you are going on with your daily life, you can always incorporate these hacks to make summers more comfortable for you. 
&nbsp;

Bottom Line

We know that dealing with these rashes can be frustrating. We want you to know that there is hope, though! They are all preventable, and it&rsquo;s not just about following the rules of hygiene either. You need to keep your skin dry and limit friction by wearing loose clothing and changing out of sweaty clothes as soon as possible after an activity ends. If you find yourself with a rash or chafing, don&rsquo;t try rubbing it off&mdash;that will only make things worse! Instead let your body heal naturally by keeping the affected area clean and dry until the symptoms subside on their own.

Umna Salah

What Is Cupping And Do You Need It?

Have you noticed those small, circular marks that celebrities flaunt these days? In malls, on red carpets, they&rsquo;re everywhere. What is it? Is it a cause for concern?&nbsp;

Well, they are a result of cupping therapy.&nbsp;

Cupping is a form of complementary therapy. It is believed that the suction it creates would enhance your body&#39;s energy flow and promote healing. 
&nbsp;

Cupping Treatment

Historical text referring to cupping therapy dates back to 1550 B.C. It has been a part of many ancient healing systems &ndash; Chinese, Tibetan, Korean, and Unani. Even the &ldquo;father of medicine&rdquo;, Hippocrates, wrote and compiled extensively on cupping procedures.&nbsp;

Nowadays, traditional Chinese medicine practitioners are known for using cupping therapy as a form of treatment. 
&nbsp;

The Chinese word for life force is Qi. Proponents of cupping believe the therapy is helpful in regulating the flow of Qi in the body. A lot of people also believe it balances out the negative and positive energy flow within the body. This balance is necessary to fight pathogens (illness causing microorganisms), increase blood flow, and <a href="https://merisehat.pk/article/natural-remedies-for-pain">reduce the level of pain</a>. 
&nbsp;

The process of cupping improves blood flow to the area where the cups are applied. This eases muscular tension, which, in turn, promotes cell repair and enhances general blood flow.&nbsp;

Additionally, cupping might support the development of new blood vessels and connective tissues.

Cups are frequently placed on the back, chest, abdomen, or legs. The most common site is back, though. For facial cupping, as the name suggests, the cups are placed on the face. 
&nbsp;

People use cupping as a supplementary type of treatment for a variety of symptoms and ailments:

<ul>
	<li>Neck and back pain</li>
	<li>Lowering cholesterol levels</li>
	<li>Knee and joint pains</li>
	<li>Improving immune system performance</li>
	<li>Chronic headaches 
	&nbsp;</li>
</ul>

The question here is how exactly cupping helps in treating these conditions? It is still unclear how sucking and drawing of blood under the skin could be this beneficial.&nbsp;

One study describes cupping as a complementary treatment and draws attention to how it deals with any disease-causing factors by simply restoring the body&rsquo;s energy flow and eventually improving blood circulation.

Actually, the cup is first heated with the herbs, alcohol, and paper placed within it. The heated cup is then placed on the skin upside down. The air inside the heated cup cools down. This creates a vacuum that pulls the skin and muscles up into the cup. As a result, changes in blood pressure causes the skin to turn red. 
&nbsp;

Unfortunately, despite the fact so much research has been carried out on cupping, no one seems to have come up with solid evidence to prove whether it actually works.&nbsp;

Back in 2015, an evaluation of the evidence discovered that cupping might help relieve chronic neck or back discomfort to some extent. Unfortunately, the quality of the research was insufficient to make definite conclusions.&nbsp;

In 2017, according to a study, cupping could increase the blood flow and stretch the underlying tissue.

Despite many competing theories, however, the effectiveness of cupping remains dubious. 
&nbsp;

Cupping might be a useful supplemental treatment for a number of symptoms and illnesses, according to a growing body of research. However, more credible research is required to confirm the benefits of cupping.

Namwer Rao

Online Consultation

Iqra Mazhar

Is Keto Diet Safe For People With Diabetes?

Introduction

In recent years, there has been a significant surge of interest in exploring different weight loss regimes, specifically following high-protein diets. One such high-protein diet is the <a href="https://www.merisehat.pk/article/what-is-the-ketogenic-diet">ketogenic diet</a>, or simply the keto diet, which is a diet rich in proteins and fats. Initially, the ketogenic diet was primarily proposed to reduce the frequency of epileptic seizures in children, but it has since gained popularity for weight loss. While there is evidence of short-term results with the keto diet, the verdict on its long-term benefits is still inconclusive. However, unlike other low-carb diets that center around protein, the ketogenic diet focuses mainly on fat.

&nbsp;

Understanding The Advantages Of Keto Diet In Diabetes

In 2008, researchers conducted a 24-week study to determine the effects of a low-carbohydrate diet on people with diabetes type 2 and obesity. The study concluded that people who followed the ketogenic diet saw a significant improvement in the glycemic index compared to those following a low-glycemic diet<a href="#accordion">[1]</a>. Patients following a ketogenic diet also saw a significant reduction in the use of medication. Another study conducted in 2013 reported that participants on a ketogenic diet showed improvements in their blood sugar levels and were also able to taper off insulin requirements compared to other diets<a href="#accordion">[2]</a>. Similarly, the ketogenic diet outperformed a low-fat diabetes diet, and the participants showed better weight loss and control of HbA1c in another study<a href="#accordion">[3]</a>.&nbsp;

Although it may seem unlikely that a high-fat diet focuses on weight loss, the ketogenic diet is different and can potentially change the way your body stores and uses energy. The ketogenic diet is high in fat and low in carbs. Instead of sugar, your body converts fat into energy in the keto diet. As mentioned earlier, the diet was initially considered for the treatment of epilepsy in the 1920s, but the effects were later also studied for type 2 diabetes<a href="#accordion">[4]</a>. The ketogenic diet improves blood sugar levels and reduces the need for insulin. However, as with any other diet, there are risks associated with the keto diet as well. Thus, it is important to discuss the possibility of starting the keto diet with your doctor before making any drastic changes to your current diet plan.&nbsp;

&nbsp;

Diabetes is of 2 types: diabetes type 1 and diabetes type 2.&nbsp;

<ul>
	<li>In type 1 diabetes, the body is incapable of producing insulin, and the patient has to rely on medication for life. This condition is less common and is typically diagnosed during childhood.&nbsp;</li>
	<li>In diabetes type 2, which has a more common presentation of the two, the body either does not produce enough insulin to meet the body&rsquo;s needs, or the insulin produced does not work effectively in lowering blood glucose levels.&nbsp;</li>
	<li>Pre-diabetic people have higher than normal blood sugar levels&nbsp;and are at a higher risk of developing diabetes type 2 if they do not take precautionary lifestyle and dietary measures.&nbsp;</li>
	<li>Gestational diabetes is described as diabetes that develops when you are pregnant. This type of diabetes generally resolves after giving birth. Though, it places you at a higher risk of developing type 2 diabetes.&nbsp;</li>
</ul>

&nbsp;

<h4>"Good diabetes control can increase your heart rate variability. Head on over to the <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> and get your reading now!"</h4><h4> </h4>

Unlike other low-carb diets, the keto diet aims to force your body to use a different type of fuel. And instead of relying on sugar that comes from carbohydrates, for example, fruits, vegetables, legumes, and grains, the diet relies on ketone bodies. This is a type of fuel that the liver produces using stored fat. While burning fat sounds like an ideal way to lose weight, getting the liver to make ketone bodies is a tricky process.&nbsp;

<ul>
	<li>The diet requires that you restrict your intake of carbohydrates to 20 to 25 grams per day.&nbsp;</li>
	<li>Typically, reaching the state of ketosis takes a few days.&nbsp;</li>
	<li>If your diet is too high in protein, it can also interfere with ketosis.&nbsp;</li>
</ul>

In many cases, people with type 2 diabetes are overweight and a high-fat diet may seem unhelpful. The goal of a ketogenic diet is to train the body into using fat instead of carbohydrates or glucose. On the ketogenic diet, most of the energy comes from fat and only a small amount comes from carbohydrates. However, there are some ground rules. A diet high in fats doesn&rsquo;t mean that you should load up on saturated fats. It is recommended that your diet is rich in heart-healthy fats to maintain overall health. Some healthy foods that you can eat on a ketogenic diet include:&nbsp;

<ul>
	<li>Eggs&nbsp;</li>
	<li>Fish&nbsp;</li>
	<li>Cottage cheese&nbsp;</li>
	<li>Avocado&nbsp;</li>
	<li>Olives&nbsp;</li>
	<li>Nuts&nbsp;</li>
	<li>Seeds</li>
	<li>Olive oil&nbsp;</li>
	<li>Nut butter&nbsp;</li>
</ul>

&nbsp;

Foods To Be Eaten In Moderation

<ul>
	<li>Berries -&nbsp;1 cup or less</li>
	<li>Plain, Greek yogurt -&nbsp;1 cup or less</li>
	<li>Cottage cheese -&nbsp;1/2 cup or less</li>
	<li>Nuts and peanuts -&nbsp;1&ndash;2 ounces&nbsp;or 30&ndash;60 grams</li>
	<li>Flaxseeds or chia seeds -&nbsp;2 tablespoons</li>
	<li>Dark chocolate (at least 85% cocoa) -&nbsp;30 grams or less</li>
</ul>

&nbsp;

Foods To Avoid

<ul>
	<li>Bread&nbsp;</li>
	<li>Pasta&nbsp;</li>
	<li>Cereal&nbsp;</li>
	<li>Corn and other grains&nbsp;</li>
	<li>Potatoes, sweet potatoes</li>
	<li>Milk&nbsp;</li>
	<li>Fruits excluding berries&nbsp;</li>
	<li>Juices, sodas, and sweetened teas</li>
	<li>Desserts, candies, ice cream, and other baked goods</li>
</ul>

&nbsp;

When you eat carbs, your body&rsquo;s digestive system breaks down the carbohydrates and turns them into sugars that enter your bloodstream. The more sugar there is in your bloodstream, the more insulin your body needs to break down the sugar for energy. Insulin signals the cells to use the sugar for energy and energy storage. Moreover, the pancreas releases glucagon when the cells of your body begin to use the blood sugar. The two hormones, insulin, and glucagon work together to ensure that you have enough energy. If you have diabetes, then this means that your body is not using the insulin properly or cannot make or is not making enough insulin.

Hence, for people with diabetes type 2, it is recommended to control carbohydrate intake because it turns to sugar, and having it in large quantities can cause spikes in blood sugar levels. However, the ketogenic diet has the potential to decrease the levels of blood glucose. Your doctor will determine the number of carbs you should have based on your needs, current BMI, etc. Studies have shown that some people experience reduced blood sugar by switching to a diet high in fat.

Diabetes affects about 10 percent of the American population. Whereas in Pakistan, 17.1% of the population is estimated to be living with diabetes. This makes a total of 19 million adults in Pakistan who are at risk of the life-threatening complications of diabetes making it a pertinent public health issue<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Other than the standard keto diet, there are 3 other variations of the diet: the cyclical ketogenic diet, the targeted ketogenic diet, and the very low-carb diet.&nbsp;

<ul>
	<li>On the cyclical ketogenic diet, you can eat 100 to 150 grams of clean carbs once or twice a week.</li>
	<li>With the targeted ketogenic diet, you can follow the same rules as a regular keto diet but the time you eat carbs is fixed. It is suggested to consume carbs before or after a workout.&nbsp;</li>
	<li>The very low-carb diet, as the name suggests, allows you to eat very small quantities of carbs, high fat, and moderate protein. However, compared to the standard keto diet that allows only 50 grams of carbs a day, this diet allows you to eat 100 to 150 grams of carbs daily. However, this may not help you reach a state of ketosis.&nbsp;</li>
</ul>

&nbsp;

Conclusion

After reading this article, you may be wondering how a diet that focuses on fat makes it good for you. Especially, considering the fact that many people with diabetes also have obesity. While this question is completely reasonable, the keto diet is about redefining our understanding of fat. For years, people have focused on low-fat foods, milk, and yogurt thinking that fats are the root cause of all our health concerns, including obesity. However, the situation is more complex.&nbsp;

A recent study indicates that focusing on reducing total fats leads to harmful habits such as increased consumption of refined carbohydrates and added sugars. Moreover, it also leads to avoiding nutrient-dense foods, such as nuts, seeds, vegetable oils, and avocados. We all need fat to keep ourselves healthy and only recently researchers have started shifting from anti-fat foods to encouraging high-fat foods. In simpler words, fat is an important source of energy. It helps our bodies absorb essential vitamins and minerals, helps our muscles move, and enables blood to clot. Thus, science shows that a diet high in fat can be healthy, whereas eating low-fat diets can actually be harmful in the long run because of overconsumption of carbs and processed foods.&nbsp;

&nbsp;

Key Points

<ul>
	<li>It is important that you speak with your doctor before you start a keto diet. Speaking with your doctor is a rule that should be followed before starting any diet.&nbsp;</li>
	<li>A keto diet can be helpful for diabetics who want to lose weight and lessen the need for medications. However, for others, it might even make diabetes worse. The diet isn&rsquo;t a magic weight loss pill, and there is currently limited information on the long-term effects of a keto diet.&nbsp;</li>
	<li>Moreover, be cautious when transitioning from the keto diet to adding carbs back to your diet. Sudden high consumption of carbs can cause your blood sugar levels to spike, and cause you to gain weight.</li>
</ul>

&nbsp;

[1] Westman, E.C., Yancy, W.S., Mavropoulos, J.C., Marquart, M. and McDuffie, J.R., 2008. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & metabolism, 5(1), pp.1-9.

[2] Paoli, A., Rubini, A., Volek, J.S. and Grimaldi, K.A., 2013. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition, 67(8), pp.789-796.

[3] Saslow, L.R., Mason, A.E., Kim, S., Goldman, V., Ploutz-Snyder, R., Bayandorian, H., Daubenmier, J., Hecht, F.M. and Moskowitz, J.T., 2017. An online intervention comparing a very low-carbohydrate ketogenic diet and lifestyle recommendations versus a plate method diet in overweight individuals with type 2 diabetes: a randomized controlled trial. Journal of medical Internet research, 19(2), p.e5806.

[4] Meira, I.A., Romão, T.T., do Prado, H.P., Krüger, L.T., Pires, M.E.P. and da Conceição, P.O., 2019. Ketogenic diet and epilepsy: What we know so far, Front. Neurosci-Switz.(13), 5.

[5] Akhtar, S., Nasir, J.A., Abbas, T. and Sarwar, A., 2019. Diabetes in Pakistan: a systematic review and meta-analysis. Pakistan journal of medical sciences, 35(4), p.1173.Akhtar, S., Nasir, J.A., Abbas, T. and Sarwar, A., 2019. Diabetes in Pakistan: a systematic review and meta-analysis. Pakistan journal of medical sciences, 35(4), p.1173.

Staff Writer

How To Heal From Grief?

Grief is a natural reaction to any kind of loss. It&rsquo;s something we all experience, but the way it manifests itself varies from person to person. Some people are able to move on quickly, while others find it harder to heal. In this article I&rsquo;ll explain how the stages of grief work and give some tips on how you can help yourself or a loved one through their grieving process. 
&nbsp;

Tips to Heal From Grief

Denial is a defense mechanism. It&rsquo;s a way to protect yourself from the pain of loss, or at least postpone facing it. You may have heard of denial as something that happens during the grieving process, but this isn&rsquo;t quite accurate. Denial doesn&rsquo;t necessarily kick in once someone has died; it can also be an immediate coping mechanism for people who aren&rsquo;t yet ready to admit their loved one is gone.

Denial helps shield you from the <a href="https://merisehat.pk/article/natural-remedies-for-pain">pain</a> of grief by avoiding reality and hiding from feelings you&rsquo;d rather not experience (such as anger and sadness). 
&nbsp;

Anger is a natural and healthy reaction to loss. Anger can help you express your feelings, release negative emotions and show others that you are upset or hurt by what happened.

However, while it is normal to feel angry after the loss of someone or something close to you, there are some things that should be avoided when expressing anger:

Don&rsquo;t direct your anger at anyone else. You may have some pent-up frustrations with people associated with the loss (e.g., family members or friends), but directing your rage toward them will only make things worse for everyone involved.&nbsp;

Directing your anger inward instead by staying home from work or school can also be harmful because it could prevent you from accomplishing goals (such as getting back into college).&nbsp;

It&rsquo;s best not to let anger boil over into lashing out at others unnecessarily; instead, find other outlets for releasing negative emotion such as yoga classes or therapy sessions with a counsellor who specialises in grief counselling. 
&nbsp;

When you are bargaining, you are essentially trying to make the best of an intolerable situation. You may start thinking that there is something you could have done differently or something that will help save your loved one&rsquo;s life. You might even try to bargain with God or a higher power in order to get them back again.

For example, you might think, &ldquo;If only I had spent more time with my husband before he died!&rdquo;, &ldquo;If only I hadn&rsquo;t taken so long buying groceries!&rdquo; or &ldquo;If only I had remembered to call him earlier!&rdquo;&nbsp;

While these thoughts and feelings aren&rsquo;t necessarily accurate (the reality is that death or breakups happens when they happen), they can still be helpful if they allow you some peace of mind and perspective during this difficult time of grieving. 
&nbsp;

Bargaining can also manifest itself as guilt &mdash; for instance, if someone close dies from an illness but another person survives the same illness, there may be some sense that it should&rsquo;ve been the other way around, even though there&rsquo;s no real reason for this feeling beyond just being human (and overthinking things).&nbsp;

If this sounds like how you&rsquo;re feeling right now &mdash; like maybe there was something else r someone else who could&rsquo;ve helped prevent their death (for example) &mdash; it might be helpful for friends and family members who care about your well-being (or just want their own questions answered) not dismiss these thoughts or feelings outright by saying things like, &ldquo;It wasn&rsquo;t your fault&rdquo; or &ldquo;Of course everything would have been different if only...&rdquo;&nbsp;

Instead, they could take those questions seriously while acknowledging how hard they must be on whoever lost their loved ones without belittling them at all &mdash; because sometimes just recognising how painful it must feel helps us move forward without letting ourselves stay stuck in grief forever.&rdquo; 
&nbsp;

The final stage of grief is sadness and acceptance. The loss of someone leaves you feeling helpless. There will be times when you are too distracted by the world and work to think about it but at times, it is common to have a depressive episode and completely lose your pace or focus.&nbsp;

People who are unable to cope and accept tend to go into depression at this stage and numb themselves towards the outside world. The only way to avoid suffering from this illness is to deal with your loss and come to terms with it mentally. This requires your maximum input as your experience life without the person, the need for acceptance and doing things differently now. The only way is the way forward.&nbsp; 
&nbsp;

The stages of grief are not a checklist, nor are they rules to follow. They aren&rsquo;t even in the same order for everyone.

The five stages &mdash; denial, anger, bargaining, sadness and acceptance &mdash; are merely a general guide to help you understand what your loved one might be experiencing during their time of grieving. However, everyone grieves differently and no two people will go through all five stages at the same time or in the same way. It&rsquo;s important to remember that every person needs different kinds of support during times like these: some may need lots of love and affection as they work through their feelings; others will want space from others so they can take care of themselves first before reaching out for support later on. 
&nbsp;

The most important thing that needs to be acknowledged is that there is no shortcut to coping with grief. You cannot skip the stages. However, you can make it easy for yourself to handle your grief and speed up the process. Following are the steps that are age-old practices employed by people to help them cope:

<ul>
	<li>There are people around you who care about you, lean on them. Share your feelings with your friends and family. Hangout with them more to keep yourself distracted.</li>
	<li>Be acceptable for whatever support you are getting. Not many people know what to say or how to act around someone grieving, appreciate their efforts. They are doing it because they care.</li>
	<li>Religion has been a very strong catalyst for people struggling with grief. If you believe in one, resort to your faith. Praying can be very relaxing for the mind.</li>
	<li>A support group or therapy. Both allows you to talk about your experience, how it has affected you without getting a biased answer from the other side.&nbsp; 
	&nbsp;</li>
</ul>

Grief is a normal part of life and it can be hard to deal with. But remember, there are ways to cope with your feelings and move on from them. If you&rsquo;re struggling with grief or have lost someone close to you, remember that you&rsquo;re not alone. Reach out for help if needed, but don&rsquo;t forget that it may take time before things feel better again!

Your Body After Giving Birth

Post-pregnancy or postpartum is a crucial period. It&rsquo;s also known as the fourth trimester. This is when your body is <a href="https://merisehat.pk/disease/chronic-fatigue-syndrome">recovering from the fatigue</a> of pregnancy.

During pregnancy, the body goes through a lot of changes to accommodate your baby. The body eventually goes back to normal, but this can take a while.&nbsp;

Continue reading to find out more about some common changes that take place in your body, after you give birth. 
&nbsp;

Post-pregnancy or postpartum

During pregnancy, hair growth gets better and the texture of hair gets thicker. This is all thanks to the hormones that are active during that phase. However, post-delivery, this phase settles down and enters into a resting phase for about one to five months. Normal hair growth pattern usually returns six to 15 months after delivery. 
&nbsp;

Shoe surprise is pretty common after pregnancy. It is not just the midsection that gets affected. After a baby is born, your shoe size changes permanently. That is because during pregnancy women gain an average of 25-35 pounds which puts extra pressure on the feet. This pressure flattens out the arch in your feet which is the reason for extra inches in your feet. 
&nbsp;

Belly bulge is common after pregnancy. A lot of women expect that the belly will return to its normal size after birth. The upper portion of the uterus is at the level of your navel. Post-pregnancy belly returns to its normal size in about six to eight weeks. A good diet and exercise are the key to toning down your belly. Workouts focused on the core can show quick results. 
&nbsp;

A common expectation of most women is that the breast size will go up after giving birth and breastfeeding. Once you stop breastfeeding, however, the size goes back to what it was. In fact, in some cases, it goes a cup down. The main reason for the size to increase is that fat tissue in the breast is replaced by functional tissue. Once a woman stops breastfeeding, functional tissue depletes as it is no longer needed. 
&nbsp;

The first six months of the post-partum period are the recovery period. No matter how easy or smooth your pregnancy is, your body has gone through a lot of stress and trauma. It needs time to recuperate. Remember that every mom goes through a different experience and symptoms; hence, the recovery rate also changes.

Most of the symptoms, like sore nipples, backache, pain in the thigh area, etc., continue for more than a week. Other symptoms, like leaky breasts, can linger on for months.

In vaginal delivery, recovery timelines vary depending upon the kind of delivery. The soreness and perennial pain go away in three weeks. However, in the case of vaginal tear or episiotomy (incision made on the vagina to ease the delivery process), recovery can take up to six weeks.

If you have been delivered through c-section, it will take around three to four days in the hospital to recover. In about four to six weeks you can recover completely. 
&nbsp;

For the first 24 hours after birth, ice your perineum region. Sit in warm baths for 20 minutes to ease pain and avoid long periods of standing or sitting.

Ease pain and aches by taking hot showers and massages.

Do your Kegel exercises, to strengthen your pelvic muscles.

Keep up with your doctor appointments. It will help you stay on track. Your doctor can also notify you about your emotional well-being and help you with your new journey.

Ask your doctor regarding your workout plan. They can guide you about how and when can you exercise. It is a good idea to start by walking into your house and then gradually into the neighbourhood. Walking helps in recovery by improving blood circulation and toning muscles. 
&nbsp;

Your diet after pregnancy shouldn&rsquo;t be very different from what you eat during pregnancy. Avoid processed foods. Focus on eating whole grains, high fibre foods, Omega-3 fatty acid-rich food, nuts, and fish.&nbsp;

<ul>
	<li>Lean Meat: Milk, cheese, and yogurt are all crucial components of a breastfeeding mother&#39;s diet. Your infant receives calcium from breastmilk for the formation of bones. Consume foods high in calcium to replenish the calcium your body has lost. Include three cups of dairy in your diet each day.</li>
	<li>Pulses: These are a good source of protein and fibre. You can cook them with different seasonings to make them tasty and easy to eat. Pulses also prevent fat from accumulating in the body.</li>
	<li>Vegetables:&nbsp;These are low-calorie healthy food. They are rich in antioxidants and aid in losing weight. Spinach and broccoli are good sources of Vitamin A which is healthy for you and your baby.</li>
</ul>

Once the baby is born, you can resume most of the food you avoided during pregnancy. Include nutrient-rich foods like legumes, proteins, fibre, citrus fruits, and vegetables. Don&rsquo;t forget to keep yourself hydrated. You may consult a dietician and your doctor in designing your diet plan.

What Anti-Vaxxers Get Wrong About the Polio Vaccine

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

Anti-Vaxxers  About  Polio Vaccine

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

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

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

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

Vaccines Are Safe

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

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

How An Over-Prescription Of Antibiotics Affects Your Immune System

The ground-breaking discovery of the first antibiotic penicillin changed the fate of medical science forever. The diseases people were losing their lives over were now only a minor setback. Back then, however, we could not have imagined that our very own invention could turn on us.&nbsp; 
&nbsp;

Effect of Antibiotics

There are many kinds of microbes (bacteria, fungi, viruses etc.) that attack the human body and can be eradicated by using antimicrobial agents. Antibiotics are antimicrobial agents prescribed for bacterial infections, the most common ones being Urinary Tract Infections (UTIs), strep throat, <a href="https://merisehat.pk/disease/pneumonia">pneumonia</a>, tuberculosis, cholera etc.

Antibiotics can be naturally occurring (made by other microorganisms) such as penicilin or synthetic such as sulfonamides. Much of the progress medical science has made, surgeries for instance, can be traced back to our ability to control infections and their deleterious impact. Infections went from being the top three causes of mortality back in the 1900s to being something we now take for granted.&nbsp; 
&nbsp;

Many doctors, especially in the third-world countries, don&rsquo;t think twice before writing you a quick prescription of metronidazole, a common antibiotic given for many ordinary infections, mostly for an ailment as little as an upset stomach.&nbsp;

Some stats report that around 47 million doctors worldwide prescribe antibiotics for absolutely no reason.&nbsp;

On the other hand, these maladies are so common and the drugs so easily available and effective that some people don&rsquo;t even bother going to the doctor for an opinion and will end up taking the antibiotic prescribed by the internet at home. This casual consumption of antibiotics has led to the development of antibiotic resistance.&nbsp;

The use of antibiotics doesn&rsquo;t extend to just medical illnesses, but they are also used in agriculture and livestock. 
&nbsp;

This is when the bacteria evolve to resist the impact of antibiotics. Once that happens, patients then need stronger antibiotics and eventually even those stop working.&nbsp;

There are several reasons behind this, some of which are:&nbsp;

<ul>
	<li>The over-prescription of antibiotics. This includes both misuse and overuse of the drugs.&nbsp;</li>
	<li>Patients not completing their antibiotic course as soon as get some see relief in their symptoms.&nbsp;</li>
	<li>Excessive usage in livestock and farming.&nbsp;</li>
	<li>Lack of infection control in hospitals.&nbsp;</li>
	<li>Poor hygiene and sanitation efforts.</li>
</ul>

No wonder then that antibiotic resistance has been called &ldquo;the greatest public health challenge of our time&rdquo; by several healthcare regulatory bodies such as WHO and the CDC.&nbsp; 
&nbsp;

A study published in the Lancet way back in 2013 claimed that we were already, &ldquo;at the dawn of a post-antibiotic era&rdquo;. This is a threat to food security as well. We are at a point where common diseases such as tuberculosis and salmonella etc. are harder to treat than before. This has also added burden to the healthcare system given that we now have longer hospital stays, higher costs of treatment and increased mortality.&nbsp; 
&nbsp;

Think of our immune system as the security guards of our body. It not only destroys any foreign body or pathogen that might harm us but also memorises these invaders and will recognise and destroy them if they detect them. The function of antibiotics is to provide support to our immune system.&nbsp;

Antibiotics enter the body and coordinate with our immune system in order to control infections. What ends up happening many times, however, is that they will indiscriminately kill any bacteria they see since they can&rsquo;t distinguish between healthy and harmful bacteria. This way even helpful microbes in our body are eliminated that actually can help us fight some of the more harmful infections such as fungal infections.&nbsp; 
&nbsp;

These antibiotics also destroy the healthy gut microbes that help in running the machinery of our digestion smoothly. Once lost, our digestive system suffers immensely, our metabolism is ruined and even our mental health eventually suffers. There are also immune cells present in our gut that can&rsquo;t function normally anymore. This effect on our gut microbiome due to antibiotic consumption can also be irreversible.&nbsp;

Studies conducted in mice have shown that antibiotics were able to completely alter the natural biochemistry of their cells. Instead of helping the cells kill these bacteria, they were making the cells protect them.&nbsp; 
&nbsp;

One study found that the immune cells of these mice suffered at the hands of the antibiotics to an extent where they couldn&rsquo;t perform their normal function of killing the pathogens &mdash; which can be anything from bacteria to virus or fungi and protozoans.&nbsp;

This goes on to show that antibiotic drugs have the ability to adjust immune responses by directly acting on the cells of our immune system and overhauling the metabolic microenvironment of our body. In the absence of an appropriate protective response, all kinds of invaders can wreak havoc on the body, even the ones that would be least harmful under normal conditions.&nbsp;&nbsp; 
&nbsp;

The impact of the over-prescription of antibiotics is all kinds of new, more powerful diseases become an insurmountable issue for mankind to resolve. We have all been exposed to overuse of antibiotics in some way shape or form.

If you do end up with symptoms where the cause could be viral or bacterial and you aren&rsquo;t sure about it, schedule an appointment with your doctor and go through the necessary tests to confirm the cause. If and when prescribed antibiotics, make sure you complete the full course. Don&rsquo;t stop midway just because your symptoms have been alleviated. Maintaining better hygiene, vaccinating when needed and not demanding that your doctor prescribe you an antibiotic are some other measures you can take to protect your immune system.&nbsp;

Add probiotics to your food. These are foods such as curd, cheese, kombucha, cocoa, bananas, lentils, nuts, whole grains, beans, broccoli, peas, and berries are all great options to help restore gut bacteria.&nbsp;

Dr. Safia Mehmood

Ismail Munir

To Meat Or Not To Meat?

Research over the years has shown that a strict vegetarian diet excluding all animal fats can lead to vitamin B12 deficiency. Thus, increasing the risk of developing anemia. Newer research also suggests that a more lenient diet puts people at risk of developing <a href="https://www.merisehat.pk/disease/anemia">anemia </a>and heart disease.

There are various reasons behind people giving up eating meat and animal products (milk, cheese, and eggs). However, doing so might increase their risk of anemia, which is a potentially serious condition in which the body does not make enough red blood cells. For vegetarians, vitamin B12 deficiency anemia is typically caused because of eliminating meat from their diet. Similarly, for vegans, giving up all animal products including dairy, eggs, and even honey increases the risk of developing anemia.&nbsp; 
&nbsp;

Understanding Ways To Diversify Iron Sources In Vegetarian And Vegan Diets

A lack of vitamin B12 in your diet can cause pernicious anemia. The body needs vitamin B12 from foods such as meat, poultry, fish and eggs to make red blood cells. Pernicious anemia is a rare type of anemia in which the body is unable to absorb vitamin B12. The vitamin is only available in meat and animal products. While vegetarians who eat dairy and eggs are getting enough vitamin B12 through these sources, vegans must find other ways to include it in their diets, for example, through vitamin B12 supplements. 
&nbsp;

Vitamin B12 deficiency can boost the levels of homocysteine in the blood, a common amino acid that is associated with a higher risk of heart disease. Studies also suggest that the level of this amino acid can over time cause blockages in arteries and lead to heart disease or stroke. Vitamin B12, unlike B vitamins, is not found in any plant derived foods and fortified cereals. However, many types of meat and fish are abundant in vitamin B12. Thus, making it difficult for people following a strict vegetarian diet to get the necessary amount of vitamin B12. The answer is to eat a well-balanced diet and get the needed B12 from other sources, such as vitamin B12 supplementation, to prevent anemia.&nbsp; 
&nbsp;

Look for foods fortified with vitamin B12. Read the nutrition label on packaged foods. Some examples of processed foods that contain vitamin B12 are:&nbsp;

<ul>
	<li>Fortified rice&nbsp;</li>
	<li>Soy milk&nbsp;</li>
	<li>Grain products and cereal&nbsp;</li>
	<li>Meat substitutes</li>
	<li>Dietary supplements containing B complex&nbsp;</li>
	<li>Nutritional yeast&nbsp; 
	&nbsp;</li>
</ul>

Whether you are on a vegan or vegetarian diet, you need to create a healthy and balanced diet that includes enough vitamin B12 to prevent anemia. While fortified cereals are a good choice because of their good bioavailability, meaning it doesn&rsquo;t need to break down before the body absorbs them, vegetarians should consume the following foods on a regular basis:&nbsp;

<ul>
	<li>8 ounces (oz) of yogurt contains about 1.1 mcg of vitamin B12</li>
	<li>1 cup of low-fat milk can provide 1.2 mcg of vitamin B12</li>
	<li>1 oz of Swiss cheese can contain 0.95 mcg of vitamin B12</li>
	<li>1 large egg contains 0.6 mcg of vitamin B12</li>
</ul>

Nutritional yeast is also popular among vegetarians because of its rich, cheesy, and nutty flavor. The yeast can either be added to cooked meals or sprinkled on foods and snacks.

<div>
Since vegans avoid all animal-derived products, they may rely on vitamin B12 fortified breakfast cereals and nutritional yeast, as an alternative source of vitamin B12. For example, fortified non-dairy milk, meat substitutes, breakfast cereals, nutritional yeast, and vegan spreads. However, it is essential to read the labels of the foods as some may not be fortified in vitamin B12.&nbsp;

For those who are deficient in vitamin B12, supplemental vitamins in the form of capsules may be required.&nbsp; 
&nbsp;
</div>

<h4>"All that meat is great for your anemia. But can it also be affecting the heart rate? Get your reading with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!" </h4>

If you decide on taking a dietary supplement, there are some ground rules. A healthy body does not readily absorb all the vitamin B12 in a supplement. Food supplements should never be used as a substitute for a balanced diet and healthy lifestyle. Therefore, it is essential that you talk to your doctor or nutritionist to know the amount of vitamin B12 supplement that is right for you.&nbsp; 
&nbsp;

<ul>
	<li>Vegetarians and vegans need to take steps to make sure that they are including an adequate amount of vitamin B12 in their diet. Not maintaining proper levels of vitamin B12 increases the risk of developing anemia.</li>
	<li>Similarly, since there are no plant-derived foods that contain vitamin B12, it is essential to look into alternative sources, for example, fortified foods and vitamin B12 supplements.</li>
	<li>Speak with a healthcare provider for advice on how much you need to take and where to find sources of vitamin B12.</li>
</ul>

[1] Pawlak, R., Parrott, S.J., Raj, S., Cullum-Dugan, D. and Lucus, D., 2013. How prevalent is vitamin B12 deficiency among vegetarians? Nutrition reviews, 71(2), pp.110-117.

[2] Walsh, S., Appleby, P., Baron, L., Dallas-Chapman, G., Davis, B. and Harris, W., 2001. What every vegan should know about vitamin B12. Birmingham: Vegan Society.

[3] Watanabe, F., Yabuta, Y., Bito, T. and Teng, F., 2014. Vitamin B12-containing plant food sources for vegetarians. Nutrients, 6(5), pp.1861-1873.

How Do I Boost My Iron Levels?

Iron is an essential mineral that your body uses to make hemoglobin. Iron is also an essential mineral for growth and development. There are two types of iron in food: animal-derived and plant-derived. While there is enough iron available in our food sources, it can also be taken as a supplement.

Understanding Ways To Treat Iron Deficiency Anemia

Studies have shown that the average amount of iron is 8.7 milligrams per day for men and 14.8 milligrams per day for women. The requirement for iron in vegetarians and vegans is 1.8 times more than in people who eat meat.&nbsp;

&nbsp;

You need iron to function properly. A lack of iron in your diet will lead to iron deficiency. Iron plays an important role in different bodily functions; it is an essential nutrient needed to form hemoglobin and carry oxygen in your blood to organs and tissues. This is important for optimal heart health, immune function, and respiratory functions.

&nbsp;

<a href="https://www.merisehat.pk/disease/anemia">Anemia</a> occurs when the body does not have enough red blood cells to carry oxygen to the body&rsquo;s organs and tissues. There are different types of anemia, but iron-deficiency anemia is the most common type of anemia in developing countries. According to the World Health Organization, 1.62 billion people are estimated to be affected by anemia worldwide.&nbsp;

&nbsp;

Low levels of iron can further lead to iron deficiency anemia. The symptoms of anemia include:&nbsp;

<ul>
	<li>Fatigue&nbsp;</li>
	<li>Weakness&nbsp;</li>
	<li>Pale and yellow skin&nbsp;</li>
	<li>Shortness of breath&nbsp;</li>
	<li>Lightheadedness&nbsp;</li>
	<li>Chest pain&nbsp;</li>
	<li>Cold hands and feet&nbsp;</li>
	<li>Headaches&nbsp;</li>
</ul>

&nbsp;

There are some types of anemia that are inherited and cannot be prevented, for example, sickle cell anemia, hemolytic anemia, and aplastic anemia.&nbsp;

However, anemia caused because of iron deficiency, vitamin B12, and vitamin B9 deficiency, can be prevented by eating well. This includes eating foods that provide enough iron and vitamins, in addition to vitamin C food sources, because it helps with the absorption of iron. Studies have also shown that drinking enough water helps keep hemoglobin levels up.

Moreover, daily iron supplementation may increase hemoglobin levels, and decrease the risk of anemia in infants, school-aged children, and pregnant and non-pregnant women. Foods fortified with iron and improving overall diet also have benefits in reducing the risk of developing iron-deficiency anemia.

There are some types of anemia that are short-term and mild. However, others can affect you throughout your life. There are several ways to manage anemia, including:

<ul>
	<li><a href="https://www.merisehat.pk/article/anemia-best-meals-for-boosting-iron">A healthy, well-balanced diet</a></li>
	<li>Stay hydrated</li>
	<li>Regular exercise</li>
	<li>Avoid&nbsp;exposure to chemicals that trigger anemia</li>
	<li>Visiting the dentist regularly because anemia increases the risk of tooth decay and gum disease</li>
	<li>Keep track of your symptoms and talk to your doctor about any changing symptoms</li>
</ul>

&nbsp;

If you have anemia, it is important to make good food choices. For example, avoid junk foods because it means adding calories to your diet without getting any essential nutrients. In addition, some foods impair the absorption of iron. Therefore, it is important to make the right food choices.

Here are some foods you should avoid:&nbsp;

<ul>
	<li>Coffee, tea, and other tannin-containing products, such as some spices</li>
	<li>Egg whites</li>
	<li>Fiber, but not all of it because some iron supplements may cause constipation</li>
	<li>Soy protein</li>
	<li>You should not be taking calcium with iron supplements because it impairs its absorption</li>
</ul>

&nbsp;

Here are some foods you should eat:

<ul>
	<li>Whether you eat meat or not, you should generally eat iron-rich foods, such as lentils, spinach, and pistachios.&nbsp;</li>
	<li>You can also get protein from different kinds of meat, like lean beef and turkey. There are some iron-fortified foods also available for vegans and vegetarians.&nbsp;</li>
	<li>It is also important to incorporate citrus fruits, berries, and other vitamin C-containing foods such as peppers and tomatoes in your diet to improve iron consumption.</li>
</ul>

&nbsp;

Consult with a healthcare provider to help with your iron intake, and do what works best for you.&nbsp;

&nbsp;

Can't Go To Sleep? Here’s Why And How To Fix It

You&rsquo;re lying in bed, trying to fall asleep. You&rsquo;ve tried everything: reading a book, taking a bath, meditating, nothing seems to work. If this sounds like you, don&rsquo;t worry, I&rsquo;m here to help. In this article, we&rsquo;ll explore some of the most common reasons why people can&rsquo;t fall asleep and what you can do about them. 
&nbsp;

trick your body into sleeping

It&rsquo;s hard to shut down the mind, but if you can allow yourself to be free of all thoughts, worries and overthinking, it&rsquo;s easier to get a good night&rsquo;s sleep. This is why meditation has become so popular as a way to relax and clear your mind.

If you are having trouble going to sleep at night because you have too much on your mind, try focusing on relaxing exercises, such as taking deep breaths for 10 minutes or listening to calming music before bedtime.

If you feel like there is simply too much for your mind to process before bedtime, try not to think about anything at all until after midnight (or whenever you plan on falling asleep). That means no worrying about things that happened earlier in the day or what needs doing tomorrow morning&mdash;just let everything go until it&#39;s time for bed!

&nbsp;

Your environment can also influence the quality of your sleep. If you are sharing a bed with a partner who snores, or have pets that are noisy at night, this can affect your ability to get into REM and deep sleep stages of sleep. If you suffer from these problems, try to keep your pets out during night time.

&nbsp;

If you nap during the day, this can make it harder to fall asleep at night. This is because napping reduces your total sleep time and delays your internal circadian rhythm. In other words, it makes for a long period of time with reduced sleep quality and quantity, which makes falling asleep at night even more difficult.

Napping during the day also makes you feel groggy when it&rsquo;s time to go to bed. It&rsquo;s like drinking coffee in the morning. Once the caffeine has worn off, you may find yourself struggling to stay awake until lunchtime, instead of the usual 3pm!

If you want an afternoon nap but don&rsquo;t want these side effects on your nighttime slumber, consider power naps (naps lasting between 15 minutes and 1 hour), instead of full-on snoozing sessions (which can last longer than 90 minutes). Naps are great if they help improve alertness or performance, however, they shouldn&#39;t be used as a substitute for nighttime sleep if that&rsquo;s what you need most!

&nbsp;

You may have heard that it&#39;s important to go to bed at the same time every night and wake up at the same time every morning. This is true, but even more important is your schedule on weekends and weekdays. If you get enough sleep every night, then it doesn&rsquo;t matter if you sleep in on Saturdays or stay up late on Sundays, your body will adjust to these changes when they happen.&nbsp;

However, if you&rsquo;re not getting enough sleep overall, especially if it&rsquo;s because of inconsistent nighttime habits, then your body might have trouble adjusting to irregular schedules.

&nbsp;

Imagine this scenario: you go to bed at 10pm as usual, but you&rsquo;re not tired. You try and get comfortable, but you can&rsquo;t stop thinking about all of the things that happened during the day &mdash; the conversations you had with colleagues, how much work is left to do tomorrow, or what your friends are doing right now. You start worrying about them and then feel guilty because they don&rsquo;t have time for a phone call when they could be sleeping.&nbsp;

Then another thought pops into your head: did I switch off my iron? Should I check? Now we all know that checking whether an appliance is turned off isn&rsquo;t going to help us sleep any better than worrying if our friends are safe (unless there&rsquo;s a fire nearby somewhere), but this process repeats itself over and over again until suddenly, it&rsquo;s 2am, and there&rsquo;s no hope for rest tonight either!

So how can we avoid these situations? The key is finding something else, anything else, to occupy our minds instead of keeping track of every single little thing that crosses our minds throughout the day.

&nbsp;

Pillow size is another important consideration. Your pillow should be firm enough to support your head and neck, but soft enough to mold around your head and neck as you sleep. A proper pillow will also allow you to keep your spine in alignment while sleeping on either side or on your back, which helps with good posture.

If you have been using the same old pillows for years, it may be time for an upgrade. If a new pillow doesn&rsquo;t work right away, try adjusting its height (keep adding or removing stuffing) until you find one that works for you 
&nbsp;

Don&rsquo;t forget about the other side of the bed - do not share a bed with someone if that person snores heavily. Snoring can really affect quality of life. If a partner snores loudly enough at night that it keeps other people awake or keeps them from getting enough sleep themselves, then this could lead to fights between couples over who gets up earlier so they don&rsquo;t disturb their spouse&#39;s slumber. This problem can be resolved by setting up separate bedrooms for each person or getting rid of noisy beds altogether by buying two twin mattresses instead!

&nbsp;

If you can&rsquo;t get to sleep, it could be for any number of reasons. There are a lot of things that can keep you from drifting off into blissful slumber.

<ul>
	<li>You have too much going on. If there&rsquo;s something weighing on your mind, or if you&rsquo;re in an environment that&rsquo;s too stimulating (like a loud restaurant or party), try taking a moment to reflect on everything that&rsquo;s stressing you out and how it might affect your sleep quality. Try jotting down some notes and setting aside time tomorrow to talk over those issues with someone else so they&rsquo;re not still bothering you when it&rsquo;s bedtime.</li>
	<li>You napped during the day or had too much caffeine/food/alcohol before bedtime. When we nap during the day, we tend to wake up feeling more alert than usual, and while this can be helpful if we have somewhere important to go after work and need the extra boost, it can also hinder our ability to fall asleep at night when all we want is rest.</li>
	<li>Your sleep schedule is off-kilter or irregularly shifted throughout the week due to travel changes etcetera. This will make it harder for us humans whose bodies are programmed over thousands of years by evolution just like all animals&rsquo; bodies, except ours has evolved way faster so now sometimes ours needs work done on them sometimes too. Thus, needing proper rest does matter, so here are some tips. 
	&nbsp;</li>
</ul>

If you are listening to music, watching TV, or playing video games, shut it off! Your brain may be losing focus and this makes it hard for you to sleep.

If you can&rsquo;t sleep, get up and do something else before going back to bed. The more time spent lying awake in bed the more difficult it becomes to fall asleep again.

&nbsp;

On a personal note, I have always <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle" target="_blank">struggled with sleeping</a>. When I was younger, I had to have my mom read me bedtime stories to help me fall asleep and would still be up way past midnight reading under my covers. These days, it&rsquo;s not as bad but there are still nights where my mind won&rsquo;t shut off and I find myself lying awake for hours. Sometimes it&rsquo;s because of something that happened earlier in the day or week; other times it&#39;s just a matter of getting enough rest.

As you can imagine, this can be frustrating when you want nothing more than to turn off your brain and go to sleep! But there are ways you can get better at falling asleep faster, and even staying asleep all night long if you want.

&nbsp;

If you have tried all of these tricks and still can&rsquo;t sleep, there&rsquo;s nothing left to do but wait it out! Just remember, sometimes things happen in life that are out of our control. If you are lying there tossing and turning, just try to breathe deeply and stay calm. It may take some time for us humans to get back into a <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">regular sleeping cycle</a> again, so don&rsquo;t be discouraged if you&rsquo;re stuck in bed all day without any hope of going anywhere else anytime soon!

Morning sickness affects roughly half to two-thirds of all pregnant women, especially in the first trimester. The most common signs are nausea and vomiting. Morning sickness occurs mostly early in the day, hence the name, but it can occur at any time of day or night.

&nbsp;

Morning sickness usually starts during the 4th week of pregnancy and lasts until weeks 12-14. However, 1 in every 5 women experiences morning sickness throughout their second trimester and a small fraction of unfortunate women suffer from nausea and vomiting throughout their pregnancy. In the west, the incidence of vomiting and nausea during pregnancy is about 50-80%<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

In most situations, morning sickness doesn&rsquo;t affect the pregnant woman or the unborn child. However, severe morning sickness, which involves weight loss and dehydration, requires immediate medical care and assistance.&nbsp; 
&nbsp;

Understanding Morning Sickness in Pregnancy

Morning sickness can cause a variety of signs and symptoms, including:

<ul>
	<li>Nausea and sickness</li>
	<li>Loss of appetite, which can lead to <a href="https://merisehat.pk/disease/anorexia-nervosa">anorexia&nbsp;</a></li>
	<li>Vomiting</li>
	<li>Psychological and mental effects, which include <a href="https://merisehat.pk/disease/depression">depression </a>and <a href="https://merisehat.pk/disease/anxiety">anxiety&nbsp;</a> 
	&nbsp;</li>
</ul>

The reason for morning sickness is unknown. However, it is believed that a combination of physical and metabolic factors plays a significant role. This includes:

<ul>
	<li>Hormonal imbalance, particularly high levels of estroge</li>
	<li>Changes in blood pressure, particularly low blood pressure</li>
	<li>Changes in the metabolism of carbohydrates</li>
	<li>Physiological changes that pregnancy provokes 
	&nbsp;</li>
</ul>

Early in pregnancy, the thyroid gland is activated, perhaps by hCG (human chorionic gonadotropin) or a similar chemical that may cause gestational emesis. Increased free T4 and hCG and decreased TSH are all linked with the intensity of morning sickness, and, according to a study, these changes are more pronounced in participants who also experienced nausea and vomiting<a href="#accordion">[2]</a>.

&nbsp;

<h5>Is Morning Sickness Harmful to Baby?</h5>

Some mothers are worried that the action of vomiting may harm their unborn child. The physical mechanics of vomiting and retching do not harm the unborn child, but it may strain the abdominal muscles and cause localized pain, discomfort, and soreness. Nevertheless, the fetus remains well-cushioned and protected within its amniotic fluid sac. Several studies have found that mild morning sickness is associated with a lower chance of miscarriage.&nbsp;

&nbsp;

On the other hand, prolonged vomiting that leads to dehydration and weight loss can deprive the fetus of sufficient nourishment and increase the risk of the baby being underweight at birth. 
&nbsp;

Hyperemesis gravidarum (HG), which is also known as severe morning sickness, affects approximately 1 in every 1000 pregnant women<a href="#accordion">[3]</a>. The signs and symptoms of HG are frequent vomiting, weight loss, and dehydration. Hospitalization and the administration of intravenous fluid and nourishment is necessary to treat it.

&nbsp;

Untreated hyperemesis gravidarum may lead to the following possible complications:

<ul>
	<li>Electrolyte imbalances</li>
	<li>Severe anxiety, sadness, and despair</li>
	<li>Malnourishment of the fetus</li>
	<li>Severe stress on essential organs, such as the liver, heart, kidneys, and brain 
	&nbsp;</li>
</ul>

Doctors usually recommend vitamin B-6 supplements (pyridoxine), ginger, and over-the-counter medications, like doxylamine (Unisom), for management. If nausea and other symptoms of morning sickness persist, they may prescribe anti-nausea medicine. 
&nbsp;

<h5>Does Morning Sickness Cause Electrolyte Imbalance?</h5>

Mild to severe pregnancy related nausea and vomiting can usually cause dehydration and electrolyte (e.g., sodium or potassium) imbalance. For mild to severe morning sickness, more fluids and prescription drugs are suggested.

&nbsp;

A healthcare provider will discuss it with the expecting mother how frequently they have experienced nausea, the number of times they vomited, their ability to keep fluids down, and whether they tried any home remedies. For nausea and vomiting, there are a number of prescription drugs that are safe to take during pregnancy, but it all depends on the severity of the symptoms exhibited.

&nbsp;

It&#39;s best to consult with a doctor before taking any over-the-counter drugs or supplements during pregnancy. Especially if it&rsquo;s a case of hyperemesis gravidarum, which requires close monitoring and treatment with intravenous (IV) fluids and anti-nausea medications at a hospital. 
&nbsp;

To help ease symptoms of morning sickness:

&nbsp;

<ul>
	<li>Select Foods Carefully</li>
</ul>

Avoid oily, spicy, and fatty foods. Instead, opt for foods that are high in protein, low in fat, and easy to digest. Bananas, rice, applesauce, bread, and other bland foods are relatively easy to digest. Adding some ginger to your food can be beneficial at times. For some pregnant women, herbal ginger supplements appear to ease morning sickness. The majority of evidence suggests that ginger can be consumed safely during pregnancy, but there is some risk that ginger may interfere with fetal sex hormones.

&nbsp;

<ul>
	<li>Snack Frequently</li>
</ul>

Eat a couple of soda crackers or a piece of dry toast before getting out of bed in the morning. Instead of eating three large meals, snack throughout the day; this helps keep the stomach from becoming too full or empty, either of which may worsen nausea.

&nbsp;

<ul>
	<li>Drink Plenty Of Liquids&nbsp;</li>
</ul>

Drink some water or ginger ale. Every day, consume 6-8 glasses of non-caffeinated beverages to stay hydrated.

&nbsp;

<ul>
	<li>Steer Clear Of Nausea Triggers</li>
</ul>

Keep an eye out for foods or odors that seem to worsen nausea. Having a backup plan, like carrying snacks or essential oils (aromatherapy), is helpful in case of social gatherings to avoid nausea.&nbsp; &nbsp;

&nbsp;

<ul>
	<li>Inhale Fresh Air</li>
</ul>

If the weather permits, open the windows at home or workplace. Take a walk outside every day. It&rsquo;s soothing for the senses and can, therefore, act as a remedy for morning sickness.

&nbsp;

<ul>
	<li>Follow Prenatal Vitamins Guidelines</li>
</ul>

If the nausea hits after taking the prenatal vitamins, take them with a snack or right before bed. If these steps don&#39;t work, consult a doctor about alternate ways to get the iron and vitamins needed for a healthy pregnancy.

&nbsp;

<ul>
	<li>Rinse With Water After Vomiting</li>
</ul>

The acid from the stomach can erode tooth enamel. If possible, rinse with a cup of water mixed with a teaspoon of baking soda. This will help in the neutralization of the acid and protect teeth as well. 
&nbsp;

Several alternative therapies for morning sickness have been suggested, including:

&nbsp;

<ul>
	<li>Acupressure</li>
</ul>

Acupressure wristbands are accessible in most pharmacies without a prescription. Acupressure wristband studies have shown different results, but some women claim to find the wristbands beneficial.

&nbsp;

<ul>
	<li>Acupuncture</li>
</ul>

A qualified practitioner inserts hair-thin needles into the skin for acupuncture. Although it seems to help some women, acupuncture isn&#39;t a proven treatment for morning sickness.

&nbsp;

<ul>
	<li>Hypnosis</li>
</ul>

Despite the lack of study on the subject, some women have experienced relief from morning sickness through hypnosis.

&nbsp;

<ul>
	<li>Aromatherapy</li>
</ul>

Although there is limited study on the subject, particular aromas typically made using essential oils can help some women deal with morning sickness.

&nbsp;

NOTE:&nbsp;Some women are tempted to use marijuana as a way to relieve sickness and nausea if they reside in a place where it&#39;s legal. However, the American College of Obstetricians and Gynecologists advises pregnant women not to consume marijuana because the drug&#39;s effects on the mother and fetus have not been well researched. Additionally, chronic marijuana usage may also cause nausea and vomiting syndrome, which is also known as cannabinoid hyperemesis syndrome.

&nbsp;

Consult a doctor before taking any herbal remedies or alternative treatments to ease the symptoms of morning sickness.&nbsp; 
&nbsp;

Moderate nausea and vomiting during pregnancy are unlikely to cause any difficulties for the mother or the fetus.

&nbsp;

If left untreated, however, severe nausea and vomiting can lead to dehydration, an electrolyte imbalance, decreased urination, and hospitalization. The research on whether hyperemesis gravidarum affects poor weight gain in the fetus is unclear. 
&nbsp;

<h4>How To Prevent Morning Sickness?</h4>

Morning sickness cannot be totally prevented. However, avoiding triggers such as strong scents, severe fatigue, spicy foods, and sugary foods helps. 
&nbsp;

Morning sickness can affect any pregnant woman, although it may be more frequent if the expecting mother has:

<ul>
	<li>Experienced nausea or vomiting due to motion sickness, migraines, particular scents or tastes, or estrogen exposure (for example, in birth control pills) prior to the pregnancy</li>
	<li>Experienced morning sickness in their previous pregnancy</li>
	<li>A pregnancy with twins or other multiples 
	&nbsp;</li>
</ul>

They are more likely to develop hyperemesis gravidarum if:

<ul>
	<li>They are pregnant with a girl</li>
	<li>They have a family history of hyperemesis gravidarum</li>
	<li>They have already experienced hyperemesis gravidarum during a previous pregnancy&nbsp; 
	&nbsp;</li>
</ul>

<h5>Is A Doctor Consultation Necessary?</h5>

Always consult a doctor if the morning sickness feels really bad, if there&rsquo;s a sudden and extreme decrease in body weight, or if there&rsquo;s an unexplained sense of sadness or anxiety. They can prescribe a medication that will not harm your or your developing baby. 
&nbsp;

<h5>1.&nbsp;Morning Sickness Only Occurs in the Morning</h5>

It&rsquo;s a wrong concept. Morning sickness can occur at any time throughout the day. Morning sickness is named after the fact that most women feel nausea and vomiting in the morning. However, nothing guarantees that they won&#39;t feel sick at other times of the day or be sick all day and all night.

&nbsp;

<h5>2. Nausea and Vomiting are The Only Signs of Morning Sickness</h5>

Wrong again. While they are the most frequent signs and symptoms, other symptoms of morning sickness include dizziness, lightheadedness, motion sickness, and excessive salivation. None of these symptoms is pleasant and some of them, such as motion sickness, can cause nausea and vomiting.

&nbsp;

<h5>3. Don&rsquo;t Try to Eat Anything</h5>

This is bad advice. Contrary to belief, eating can occasionally help with morning sickness. Eating small meals throughout the day and a light snack before bed helps to control the blood sugar and keep morning sickness symptoms at bay. Simply avoid foods that can upset the stomach.

&nbsp;

<h5>4. Every Woman Experiences Morning Sickness</h5>

This is not true. Some women never suffer from morning sickness, no matter how many children they have. No signs of morning sickness should not be a matter of concern. Just breathe a sigh of relief.

&nbsp;

<h5>5. Morning Sickness Causes Malnutrition in the Developing Baby</h5>

It may appear that vomiting is depriving the unborn baby of essential nutrients, but this is not the case. They will get enough nutrition to develop and grow if the mother&rsquo;s consuming small meals throughout the day. It&#39;s best to consult your OB/GYN and nutritionist to create a meal plan suitable for you. 
&nbsp;

Everyone has an opinion and a solution for morning sickness. The issue is that morning sickness is not a one-size-fits-all problem with a single treatment. Every woman is unique. In fact, some women may suffer from morning sickness during one pregnancy but not in their next pregnancy! Morning sickness can be unpleasant and can have a negative impact on the daily life of the expecting mother. However, it normally clears itself by weeks 16-20 of a pregnancy and generally poses no harm to the fetus. However, in rare cases like hyperemesis gravidarum, hospitalization is a must.&nbsp;

<ul><li>Morning sickness is characterized by nausea and vomiting during pregnancy. Even though it is known as morning sickness, it can occur at any time of the day.</li><li>Morning sickness typically begins at 6 weeks of pregnancy and ends in the second trimester.</li><li>Hormone imbalances, blood pressure irregularities, and alterations in carbohydrate metabolism are all possible causes.</li><li>Hyperemesis gravidarum is characterized by severe nausea and vomiting that demands medical attention (typically in a hospital) to help the individual recover.</li><li>The signs and symptoms of morning sickness can be eased by eating a few dry crackers before getting out of bed, avoiding foods and scents that make the person nauseous, drinking enough liquids, and eating high-carbohydrate and high-protein foods.</li></ul>

[1] STRONG Jr TH. Alternative therapies of morning sickness. Clin Obstet Gynecol. 2001;44(4):653–60.

[2] Mori M, Amino N, Tamaki H, Miyai K, Tanizawa O. Morning sickness and thyroid function in normal pregnancy. Obstet Gynecol [Internet]. 1988 Sep;72(3 Pt 1):355—359.

[3] Fejzo MS, Trovik J, Grooten IJ, Sridharan K, Roseboom TJ, Vikanes Å, et al. Nausea and vomiting of pregnancy and hyperemesis gravidarum. Nat Rev Dis Prim. 2019;5(1):1–17.