A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

اس سے پہلے کہ ہوں شدید بیمار،  چیک اپ سے رکھیں  صحت کا شمار ۔

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

Madeeha Syed

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

The Bald Truth

The bald truth is that hair loss in men can happen easily and quickly, and usually it&#39;s out of their control. While the reasons why hair loss occurs in men are somewhat murky, there are some things that can exacerbate the effects of natural balding. The good news is there are things you can do about it. We&#39;ve compiled a list of several ways for you to deal with baldness if it hits you or your loved ones. 
&nbsp;

Understanding the causes of hair loss

To start off with, lets first understand what causes hair loss in men. These include: 
&nbsp;

<ul>
	<li>Family History: A big chunk of the diseases or the disorders a person face is because of their family medical history. If your family has a history of male pattern baldness, there is a very slim chance for you to escape it.&nbsp;</li>
	<li>Hormones: We know you might feel like every other issue is now blamed on hormones but they have a crucial impact on our bodies. These <a href="https://merisehat.pk/article/what-is-hormonal-acne">hormones</a> are often imbalanced due to some medical condition or medicines that are taken for it that may lead you to lose your hair.</li>
	<li>Stress: This is another culprit of many issues in our body. However, losing hair due to stress is relatively temporary and is reversed in most cases.</li>
	<li>Hairstyles And Treatments: Too much product, styles that pull your hair, etc., may cause traction alopecia and causes your hairline to go backwards. This type of hair loss is permanent in many cases. 
	&nbsp;</li>
</ul>

Options For delay the process

If we are being blunt, there is no cure or a reversal of baldness or extreme hair loss. However, there are several options out there that may either delay the process or provide you with other options to copy with the issue.&nbsp;

&nbsp;

<ul>
	<li>Minoxidil: Originally created to treat high blood pressure, the side effect of the medicine included excessive hair growth with made the experts reconsider the use of the drug and target it towards treating baldness. The results are best shown in people who are 40 or under.&nbsp;</li>
	<li>Finasteride: Finasteride is a drug that can help fight male pattern baldness. It is available in both oral and topical forms, and works by decreasing the amount of DHT in the scalp. DHT seems to cause hair follicles to become thinner, so reducing DHT may help promote hair regrowth and slow hair loss. Unlike minoxidil, finasteride does not affect hair growth on other parts of your body.</li>
	<li>Surgery: If you&#39;re experiencing hair loss, the good news is there&#39;s a treatment for it. The bad news is that it requires surgery. Hair transplantation works for men with male pattern baldness. A hair transplant involves removing hair follicles from the back of the head, where they are resistant to DHT, and placing them on the scalp. As with any surgery, hair transplants carry the risk of complications. The American Society of Plastic Surgeons states that the risks include excessive bleeding and wide scars. Additionally, there is a chance the skin plugs may die, which requires further surgery to fix.</li>
	<li>Laser Combs: Laser combs are a newer form of hair loss treatment. Advocates claim these devices promote hair growth by using concentrated light to stimulate hair follicles. This treatment has mixed results and may work best when combines with other forms of treatment. 
	&nbsp;</li>
</ul>

Hair loss affects all ages, races, and sexes and literally has no boundaries. No one is immune from this epidemic and will eventually witness, if not experience it for themselves. It is an unavoidable fact of life that sometimes the best laid plans, the most fervent prayers or the strongest medications cannot eradicate. While some men see their hair grow back in after years of balding, for others their hair loss is a life long battle. This makes it even more important to live a healthy lifestyle and take active measures to ensure that you are doing everything possible to prevent hair loss.&nbsp; 
&nbsp;

Common Symptoms

Some common symptoms of male-pattern baldness include thinning or receding hairline, excessive hair on the side of the head, slow hair growth and even complete baldness at the top of the head over time. All men may benefit by getting more regular exercise and increasing activity during their free time. It is also recommended to have a balanced diet that includes vegetables, fruits and protein as well as staying away from fast food. Another natural remedy that can contribute to hair re-growth is using coconut oil regularly.

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Saad Ullah Siddiqui

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Time For Men To Share The Burden Of Pregnancy

Introduction

A fast-growing population is one of the greatest challenges currently faced by Pakistan. Increasing poverty, food shortage, health challenges, depletion of natural resources, and overcrowding are just some of the problems associated with overpopulation. According to the 2017 Census of Pakistan, with a population of more than 207 million, the country is the fifth most populated country in the world<a href="#accordion">[1]</a>. Therefore, effective birth control methods are a need of the hour to prevent the risks associated with overpopulation.

However, the use of contraception is largely stigmatized in Pakistan due to various reasons. As per the Pakistan Demographic and Health Survey (PDHS), the current contraceptive prevalence rate (CPR) is only 34%<a href="#accordion">[2]</a>. Moreover, the use of contraceptive methods among men is extremely low. Thus, resulting in the burden of pregnancy and contraception lying largely with women. This could probably be due to a lack of awareness among men regarding various contraceptive methods that are readily available. Raising awareness about these methods is the first step in ensuring that the financial and emotional burden of <a href="https://merisehat.pk/article/how-to-practice-safe-sex">safe sex</a> is shared among both partners in a couple.&nbsp;

Almost 200 years ago, humans invented the world&#39;s first condom, and for a long time that was the greatest discovery in the world of contraception. However, scientists soon discovered methods specifically designed for women that could aid further in population control. Several female contraceptive options ranging from hormonal pills to invasive tubal ligation were introduced. However, each of the proposed methods comes with its side effects. Contraception methods have been widely politicized and various speculations exist regarding the reasons behind the disparity among male and female contraceptives. However, it is important to mention that male contraceptive methods are generally safer than their female counterparts, which is why in recent years significant work has been done to search for effective male contraceptive options. This shift in tide is also perpetuated in part by the increasing awareness among men and their willingness to use contraceptives.&nbsp;&nbsp;

&nbsp;

Understanding Male Contraceptives

Currently, two widely acceptable male contraceptive methods exist: condoms and the invasive vasectomy.

&nbsp;

<h5 dir="ltr">Condoms</h5>

These are a form of barrier method and stop the sperm from entering and fertilizing the egg. Along with being an effective and inexpensive birth control, condoms also prevent sexually transmitted infections (STIs). However, incorrect use is associated with a high failure rate, and they can easily break or get damaged. In Pakistan, condoms are the most used form of contraceptive method, with a frequency of 65.5%<a href="#accordion">[3]</a>.&nbsp;

In recent years, the Pakistani government has stepped up its social media campaigns in a bid to educate the public regarding the use of condoms and other effective family planning methods. This is aimed at controlling the growing population by promoting birth spacing and awareness of women&#39;s fertility. Doorstep availability and affordable prices have significantly increased the use of condoms among the general population.&nbsp;

Unfortunately, misconceptions about condoms and other family planning methods still need to be overcome.&nbsp;

&nbsp;

<h5 dir="ltr">Vasectomy</h5>

Also called male sterilization, the surgical procedure has been in use since the 1970s. The procedure involves cutting or blocking the vas deferens that carry sperm to the urethra. As a result, the semen is devoid of sperm and the egg cannot be fertilized. It is not easily reversed; therefore, it is mostly advised to men who are sure of not wanting children or who believe their family is complete.&nbsp;

With a success rate of 99.85%, it is the most reliable contraceptive option. Moreover, compared to tubal ligation in women, it is less invasive, has fewer risks, and has a quicker recovery time. However, only 2.4% of men around the world have undergone the procedure<a href="#accordion">[4]</a>. In Pakistan, the prevalence is only 0.4%<a href="#accordion">[3]</a>.&nbsp;

The lack of knowledge regarding vasectomy plays a major role in its low acceptance. Moreover, a majority of men hold the view that it leads to impotency or reduces sex drive. However, a recent study has found that men in Pakistan are becoming more accepting of vasectomy and recognizing their role in sharing the responsibility of family planning<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

While female birth control pills have been around for more than 50 years, researchers have only recently started looking into pills for men.&nbsp;

In 2019, a team of scientists conducted a clinical trial for a male birth control pill among 82 healthy men<a href="#accordion">[6]</a>.&nbsp;They administered dimethandrolone undecanoate (DMAU) in varying doses over a period of 28 days. The two active hormones, progestin, and modified testosterone, helped suppress levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the study participants. Thus, suppressing sperm production without causing symptoms of low testosterone levels.&nbsp;

Although the study did not measure sperm count, the pill was found to be safe, even in high dosages. The team is currently conducting a longer trial to assess the drug&#39;s effect on sperm production and any long-term effects on the body.&nbsp;

However, men are often hesitant to use hormonal options due to the presence of adverse effects. Therefore, a team at the University of Minnesota have developed a non-hormonal male contraceptive pill. According to early results from a trial in mice, the contraceptive was 99% effective at preventing pregnancy<a href="#accordion">[7]</a>. Moreover, it had no obvious side effects in the mice.

Called YCT529, the non-hormonal pill works by targeting a protein called the retinoic acid receptor alpha (RAR-&alpha;). Through inhibition of this receptor, the retinoic acid in the body is unable to cause cell growth and differentiation, both of which contribute to sperm formation. As a result, the contraceptive helped cause reversible sterility in male mice.&nbsp;

Researchers now plan to conduct human trials for the compound. However, it is too early to tell whether the results in mice will also translate to humans.&nbsp;

&nbsp;

Conclusion

Pakistan faces several challenges to the acceptability of various family planning methods. These range from religious and cultural beliefs, low literacy levels, misconceptions about side effects, lack of knowledge regarding various options for men and women, and reluctance to adopt a method. According to a study from Karachi, fear of side effects was the most common reason for low prevalence among users<a href="#accordion">[8]</a>.&nbsp;

Several trials are currently underway to look for safe and effective male contraceptive pills. However, it can take years till a pill is available in store. Even then, its availability will not matter until there is a change in beliefs regarding family planning.

Despite the safety and availability of male contraception, men are reluctant to use the contraception methods due to various reasons ranging from misconceptions about side effects to a lack of knowledge about safe sexual practices.&nbsp;

Therefore, there is a need for campaigns aimed at educating men about the importance of adopting contraception methods.&nbsp;

&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>A growing population poses several challenges to a country&#39;s health and economic stability.</li>
	<li>Effective implementation of family planning measures can help control overpopulation.</li>
	<li>In Pakistan, use of contraceptives is highly stigmatized due to various reasons.</li>
	<li>While several advances have been made in the search for female contraception, men have only been presented with two options: condoms and vasectomy.</li>
	<li>Condoms are the most commonly used form of contraception; however, there is a need to raise awareness on its correct usage.</li>
	<li>Vasectomy is the most effective male contraceptive method, but the lack of education and widespread myths regarding its side effects has resulted in a low frequency (0.4%) of the procedure in Pakistan.</li>
	<li>Recently, scientists have begun testing various hormonal and non-hormonal compounds as male contraceptive pills.&nbsp;</li>
	<li>In 2019, a team of scientists tested varying doses of dimethandrolone undecanoate (DMAU) among healthy males and found it was well-tolerated. They are now planning long-term clinical trials to test the compound&#39;s effect on sperm production.</li>
	<li>Recently, a team at the University of Minnesota developed a non-hormonal contraceptive pill. They tested the compound in mice and found it to be 99% effective, with no observable side effects. The team now plans to conduct human trials of the compound.</li>
	<li>The development of male contraceptive pills can help men share some of the burden of contraception and pregnancy.</li>
</ul>

&nbsp;

[1] Statistics, P. B. o., 2021. Brief on Census - 2017. [Online].

[2] Meherali, S., Ali, A., Khaliq, A. & Lassi, Z. S., 2021. Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018. F1000 Research, Volume 10.

[3] Shattuck, D., Perry, B., Packer, C. & Quee, D. C., 2016. A Review of 10 Years of Vasectomy Programming and Research in Low-Resource Settings. Global Health, Science and Practice, 4(4), pp. 647-660.

[4] Siddiqui, M. et al., 2020. Prevalence and Predictors of Contraception Usage in Karachi, Pakistan. Cureus, 12(10).

[5] Hatesh, H., Maheshwari, B. K., Shah, S. Q. & Kumar, D., 2020. Males’ perception and motivation for Vasectomy. Pakistan Journal of Public Health, 10(4).

[6] Thirumalai, A. et al., 2019. Effects of 28 Days of Oral Dimethandrolone Undecanoate in Healthy Men: A Prototype Male Pill. The Journal of Clinical Endocrinology & Metabolism, 104(2).

[7] Society, A. C., 2022. A non-hormonal pill could soon expand men’s birth control options. [Online].

[8] Bibi, S., Memon, A., Memon, Z. & Bibi, M., 2008. Contraceptive knowledge and practices in two districts of Sindh, Pakistan: A hospital based study. Journal of the Pakistan Medical Associatio, 58(5).

Nimrah H. Sattar

Getting Back To Working Out After Giving Birth

The weeks after one&rsquo;s delivery can be as stressful as they are joyous. Newborn babies need constant attention and it&rsquo;s difficult to take out time to care for oneself. When the baby is down for a nap, it&rsquo;s our chance to get some sleep too or catch up on chores. Naturally, there&rsquo;s very little time or mental space for fitness and physical activity. Plus, there&rsquo;s the physical exhaustion that comes with long nights and breastfeeding. 
However, taking care of our bodies is essential to recovering quickly from pregnancy and childbirth. Taking time out for fitness enables us to better manage the stressors that come with a newborn baby, both physically and emotionally. This, in turn, ensures that we are able to enjoy the joys of new motherhood as well.

<div>&nbsp;</div>

time to recover body

As a new mother, it&rsquo;s important to ensure that you are consuming all of the nutrients that are essential to your health and recovery. If you are breastfeeding, it is even more important that you consume a nutritious diet.&nbsp;

Try to include a good amount of protein in your diet, as well as good fats and essential fatty acids. Eating a sufficient amount of carbs will give you the energy you need to keep up with your baby. Make sure to include fruits and nutrients in your diet as they are an important source of <a href="https://merisehat.pk/article/a-guide-to-essential-vitamins-and-micronutrients-and-should-you-be-taking-them">micronutrients and fibre</a>.&nbsp;

If you have a straightforward vaginal delivery, you can start with gentle movement in the form of short walks as soon as the day you deliver; however, you will have to wait till your epidural has been taken out. If you delivered via a caesarean or faced postpartum complications, you may have to wait a few extra days to give your body time to recover.&nbsp; 
&nbsp;

<h5>Moderate Walking</h5>

Easy to moderate walking is the best way to start moving after childbirth. You can start with just 20 minutes a day and gently build up to half an hour over the course of four to six weeks. Consider breaking up your walks into several walks a day to avoid tiring yourself out and being able to fit them in more easily into your newborn&rsquo;s routine. You could start with two 10-minute walks a day, build that up to two 12-minute walks after a few days and so on. Walking burns calories, while also strengthening muscles and joints, and improving blood circulation. 
&nbsp;

<h5>Postpartum Exercises</h5>

Incorporate gentle postpartum exercises and stretches into your routine in the first few weeks after a delivery. There is a lot of information online about safe postpartum exercises. You can look some up and aim to do them for five minutes a day. YouTube videos focused on postpartum exercises can also be easy to follow along, and if you&rsquo;d like the opportunity to get out of the house, a postpartum exercise or yoga class might just be the thing for you. As with walking, start with just a few minutes a day and slowly build up as your body adjusts.

Your pelvic floor and core tend to be particularly weak after childbirth. Before you move onto high-impact exercises, it is important to build some strength in these parts of the body. You can start doing gentle pelvic exercises, like kegels and pelvic tilts in the first week after your delivery. Aim to do them for about five minutes at a time, up to three times a day. Again, there&rsquo;s no need to do long sessions and tire yourself out. Fitting in smaller movement sessions throughout the day will ensure that you are able to be consistent and don&rsquo;t end up pushing yourself too much.

About a month after childbirth, you can start exercising core exercises into your routine. Again, this also depends on what kind of delivery you&rsquo;ve had and whether you faced any complications during or after. Once again, incorporate a few minutes of core work into your daily movement sessions and break it up into two to three sessions a day.&nbsp; 
&nbsp;

<h5>As A Rule Of Thumb</h5>

You should wait at least six weeks after childbirth to get into high-impact exercises. It&rsquo;s important to prepare your body in the preceding weeks and to also take it slow when you do start with higher impact movement. Make sure to consult your doctor and get their okay beforehand. Even at this stage, start slowly and listen to your body. There&rsquo;s no need to push forward from the get go. What&rsquo;s important is that you maintain consistency and build up in a manner that is doable for you. 
&nbsp;

It&rsquo;s easy to forget to take care of ourselves in the first few months after childbirth. But we need to remember that we need as much love and care as our newborn babies do. Being kind to yourself and patient with your body is especially important after a delivery. Remember, the healthier you feel, the better you&rsquo;ll be able to enjoy the time you get with your newborn!

Ayesha Binte Rashid

Humza Khizer

How Can I Better Support A Breast Cancer Survivor?

In 2020, <a href="https://merisehat.pk/disease/breast-cancer">breast cancer</a> accounted for 28.7% of new cancer cases in Pakistani women of all ages<a href="#accordion">[1]</a>. With the highest incidence in Asia, the country continues to struggle with increasing morbidity and mortality rates, especially among young females<a href="#accordion">[2]</a>.&nbsp;

As per a Pakistani study, 89% of breast cancer patients are diagnosed at a later stage while 59% present at an advanced stage<a href="#accordion">[3]</a>. This delay in diagnosis can reduce survival rates and cause an increased mortality rate among patients. Researchers believe that a lack of awareness and a combination of sociocultural and personal factors contribute to the delay. Furthermore, a delayed diagnosis also translates into a poor prognosis and the need for more aggressive treatments.&nbsp;

Treatments such as chemotherapy, radiation, and mastectomy can affect an individual&#39;s physical and mental health. The fear of side effects of chemotherapy such as loss of hair and eyebrows often causes women to delay seeking help. Moreover, mastectomy is often associated with body image issues that can be extremely challenging in a world where a woman&#39;s attractiveness is solely based on her physical appearance.&nbsp;

However, <a href="https://www.merisehat.pk/disease/breast-cancer">breast cancer</a> can have an implication on the lives of both survivors and their friends and family. Thus, it is important to identify the challenges they face and effectively address them to improve their overall quality of life.&nbsp;

&nbsp;

Understanding How To Support A Breast Cancer Survivor

A UK study looked at more than 50,000 breast cancer survivors and a control group consisting of over 200,000 women with no history of cancer. The results revealed a higher risk of anxiety, depression, fatigue, pain, and sexual dysfunction among the survivors<a href="#accordion">[4]</a>. This is similar to the results of a Pakistani study in which 74% of survivors reported feeling varying levels of anxiety. Moreover, 83% complained of fatigue, 75% of body pain or headache, 77% had reduced appetite, 63% had weight loss, and 77% reported sleep disturbances<a href="#accordion">[5]</a>. The fear of the recurrence of cancer is believed to further add to the anxiety. Thus, breast cancer can take a physical and psychological toll on the survivors.

In a society where physical beauty is often given preference over everything else, it is no surprise that breast surgery can elicit depression and anxiety in breast cancer patients. Across all cultures and countries, including Pakistan, a woman&#39;s breasts are considered a symbol of femininity, sexual beauty, and motherhood. Thus, the physical change associated with breast surgery or mastectomy can significantly lower a woman&#39;s self-esteem<a href="#accordion">[5]</a>. They may develop a negative image of their bodies, leading to lowered self-confidence and mental health problems. Furthermore, hairlessness, loss of eyelashes and eyebrows, and skin discoloration associated with cancer treatment also take a toll on the person&#39;s mental health.&nbsp;

The combination of all these factors may lead to the survivors feeling stigmatized. This can lead to many women never seeking help or talking about their concerns and self-isolation in some cases.&nbsp;

&nbsp;

The following are some of the ways one can help breast cancer survivors with their physical and mental health:

<ul>
	<li>
	<h5>Breast Reconstructive Surgery </h5>
	</li>
</ul>

Many women opt for reconstructive surgery following mastectomy or lumpectomy. A plastic surgeon may use an implant, a flap tissue from another part of the patient&#39;s body, or both to create a breast shape. However, if you don&#39;t want to go for reconstructive surgery, there are other options such as a breast form or prosthesis that one can wear under the bra.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Wigs And Accessories</h5>
	</li>
</ul>

​​​​​​​Women dealing with hair loss can wear a wig, hat, or scarves while they wait for the hair to grow back. Or you may feel comfortable flaunting the baldness which is just a reminder of the challenges you&#39;ve overcome as a survivor.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Cognitive Behavioral Therapy (CBT) </h5>
	</li>
</ul>

​​​​​​​CBT can prove beneficial in treating mental disorders among breast cancer survivors. It can also help them deal with the fear of recurrence.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Acceptance And Commitment Therapy (ACT)</h5>
	</li>
</ul>

​​​​​​​Unlike CBT which aims to change one&#39;s unhealthy thoughts and feelings, ACT teaches skills that help people accept their realities and live with them.

&nbsp;

<ul>
	<li>
	<h5>Mindfulness-Based Therapy</h5>
	</li>
</ul>

​​​​​​​Mindfulness meditation helps people become aware and accepting of their thoughts and feelings, without any judgment. In breast cancer survivors, it can help improve fatigue, stress, and symptoms of depression and anxiety.

&nbsp;

<ul>
	<li>
	<h5>Medication</h5>
	</li>
</ul>

​​​​​​​Some patients may also benefit from anti-anxiety pills and anti-depressants. However, professional help should be sought before starting any medication.

&nbsp;

<h4>"Supporting cancer survivors can lower their stress levels. Head on over to the <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> to monitor your stress level today!" </h4>

While cancer is a challenging time for the patient, it also takes a toll on one&#39;s family and friends who are helping them through the disease. Moreover, it can often put a strain on people&#39;s relationships with their partners. According to research, anxiety, and depression more commonly affects long-term cancer survivors and their spouses compared to healthy controls<a href="#accordion">[6]</a>.&nbsp;

If a friend or family member is a breast cancer survivor, the following can help you deal with the emotional and psychological toll:

<ul>
	<li>Support Groups - Online or in-person support groups can help people realize that they are not alone. It allows you to talk about your feelings in a safe space and trade advice with others going through similar experiences. There are also many support groups for family members of survivors on social media.&nbsp;</li>
	<li>Couples Therapy - Cancer can often affect one&#39;s personal relationships. Many partners may benefit from couple&rsquo;s therapy to improve their family and marriage relationships.&nbsp;</li>
</ul>

&nbsp;

While a cancer diagnosis and going through treatment is emotionally and physically exhausting, the post-cancer period is often what really tests the person. Both cancer survivors and their family members go through a period of psychological distress. Therefore, there is a need for programs and interventions that target both patients and their caretakers and family. Moreover, early screening breast cancer patients for mental health disorders can also help provide timely intervention and reduce the disease burden.

<ul>
	<li>A combination of physical, cultural, and social factors contributes to a delayed diagnosis of breast cancer among women. This leads to a poor prognosis and the use of aggressive treatments.</li>
	<li>Breast cancer survivors often report fatigue, pain, sleep disturbances, <a href="https://merisehat.pk/disease/depression">depression</a>, and <a href="https://merisehat.pk/disease/anxiety">anxiety</a>. Moreover, post-mastectomy or breast surgery, women report lower self-esteem and body image issues as breasts are considered a symbol of femininity, beauty, and womanhood.&nbsp;</li>
	<li>Breast reconstructive surgery, cognitive behavioral&nbsp;therapy, mindfulness meditation, acceptance and commitment therapy, and medications can help breast cancer survivors improve their overall quality of life.</li>
	<li>Partners of breast cancer survivors also report similar levels of anxiety and depression as them. Therefore, there is a need for effective programs that target both survivors and their families to help provide them timely support.&nbsp;</li>
</ul>

&nbsp;

[1] International Agency for Research on Cancer, 2021. Pakistan Globocan 2020. [Online]

[2] Sohail, S. & Alam, S. N., 2007. Breast cancer in pakistan - awareness and early detection. Journal of the College of Physicians and Surgeons Pakistan, 17(12), pp. 711-2.

[3] Gulzar, F. et al., 2019. Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital. Cancer management and research, Volume 11, pp. 1087-1096.

[4] Carreira, H. et al., 2021. Associations between breast cancer survivorship and adverse mental health outcomes: A matched population-based cohort study in the United Kingdom. PLOS Medicine, 18(1).

[5] Azam, M. et al., 2021. An empirical study on quality of life and related factors of Pakistani breast cancer survivors. Scientific Reports, Volume 11.

[6] Mitchell, A. J. et al., 2013. Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. The Lancet Oncology, 14(8), pp. 721-732.

Ismail Munir

Boys Can Wear Pink Too!

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;

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;

<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

Check Yourself Before You Wreck Yourself

&ldquo;A checkup can tell your inside story&rdquo; is something we have seemed to have forgotten over time. Sometimes it is due to a family commitment, and sometimes it is because of a work commitment. We have reached a point when we won&rsquo;t go for a checkup even when we are not feeling well!

&nbsp;

But did you know there is a list of diseases that can be prevented, or caught on early, if proper routine <a href="https://merisehat.pk/page/sehat-scan/">health checkup</a> is done? For starters, a routine <a href="https://merisehat.pk/page/sehat-scan/">health screening</a> would allow you to track any mild symptoms that might not seem dangerous initially. It also allows your health care practitioner to look for diseases that are notoriously asymptomatic.&nbsp;

&nbsp;

People nowadays have honestly started to take their health for granted. They only visit their doctors once a disease has settled in. Some of us even want to challenge the illness and see how far we can take it before we need to get admitted!

&nbsp;

Like any other medication a healthcare practitioner may prescribe for treating the disease, a <a href="https://merisehat.pk/page/sehat-scan/">health checkup</a> is necessary for preventing it. And as many of us will agree, &ldquo;prevention is better than cure&rdquo;.&nbsp; &nbsp;&nbsp; 
&nbsp;

&nbsp;

Understanding The Importance Of Regular Medical Check Ups

It is important to understand that males and females have different types of bodies physiologically. Hence, screening is essential for a range of different diseases, and, in some cases, it is solely dependent on the gender or age.

<h5>Blood Pressure</h5>

If you are a male aged between 18 and 39, you should control your blood pressure by getting it checked once every 2 years. If during these checkups your upper pressure (systolic) is above 120 and the lower pressure (diastolic) is more than 80, the monitoring has to be on a yearly basis<a href="#accordion">[1]</a>.

&nbsp;

<h5>Cholesterol</h5>

Due to dietary and lifestyle habits, cholesterol monitoring becomes crucial, particularly for men. The recommended age for cholesterol screening is 35 for men with no known risk factors for coronary heart disease, and 20 for men with known risk factors for coronary heart disease. If there are any comorbidities involved, you should get it checked more often. However, if the results are normal, the screening could simply be repeated after a span of 5 years<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

<h5>Diabetes</h5>

Diabetes and hypertension often go hand in hand. So, if you are a known hypertensive patient, you are more likely to be screened for diabetes. HbA1c is usually tested along with the oral glucose tolerance test (OGTT).&nbsp;

&nbsp;

For OGTT, blood sugar levels between 141 mg/dL and 200 mg/dL (7.8 - 11.1 mmol/L) is considered impaired glucose tolerance, whereas a result above 200 mg/dl (11.1mmol/L) means the person is diabetic. A normal HbA1C level is below 5.7%, levels of 5.7% - 6.4% indicates pre-diabetic condition, and 6.5% or more is a strong indicator of diabetes<a href="#accordion">[2]</a>. After obtaining your medical history in detail, your healthcare practitioner will decide whether screening for certain infections, like syphilis, chlamydia, and HIV is important or not.

&nbsp;

<h5>Prostate Cancer</h5>

Regarding malignancies, there are some horrific statistics seen in men, which makes it all the more necessary for them to be screened on a routine basis. According to the American Cancer Society&rsquo;s estimates for prostate cancer in the United States, in 2022, 268,490 new cases were reported and 34,500 people lost their lives due to the disease. This is equivalent to 1 in 8 men, with increasing risk once they turn 65<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

The Prostate Cancer Early Detection Guidelines established by the National Comprehensive Cancer Network urges men above 45 years of age to get a screening done, and then plan a routine checkup according to the results.&nbsp;

&nbsp;

Prostate Specific Antigen (PSA) along with a digital rectal examination (DRE) is done to screen you for prostate cancer<a href="#accordion">[5]</a>. The PSA is a blood test to check for prostate specific chemicals, whereas the DRE is the insertion of a finger in the anus to feel the physical aspects of the prostate<a href="#accordion">[4]</a>.&nbsp;

&nbsp;

<h5>Bladder Cancer</h5>

Even though it&rsquo;s a disease of elderly, with the mean age being 73, bladder cancer is another malignant disease that is four times more prevalent in men compared to women<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Data collected by GLOBOCAN in 2018 estimated that 550,000 people were diagnosed with bladder cancer<a href="#accordion">[6]</a>. The screening method for bladder cancer is done by a basic urine detailed report and urine cytology which helps detect abnormalities.&nbsp;

&nbsp;

<h5>Colorectal Cancer</h5>

Colorectal cancer is yet another cancer which takes around 27,000 lives in the US alone each year.&nbsp;

&nbsp;

It is recommended that a colonoscopy be done as a screening method in men at the age of 45 years. A family history of malignancies makes the screening even more crucial<a href="#accordion">[5]</a>.&nbsp;&nbsp;

&nbsp;

<h5>Sexually Transmitted Infections&nbsp;</h5>

Men who have sex with women should get screening for:&nbsp;

<ul>
	<li>Chlamydia, gonorrhoea, syphilis, herpes, HIV, and hepatitis B and C&nbsp;</li>
</ul>

&nbsp;

Men who have sex with men should get screening for:&nbsp;

<ul>
	<li>Chlamydia, gonorrhoea, syphilis, herpes, HIV, HPV, anal cancer, and hepatitis B and C&nbsp;</li>
</ul>

&nbsp;

Women also need to be screened for their overall health. Reason being that a woman has to go through menstruation, pregnancies, and then post-menopause, all of which can cause multiple relevant health condition like dysmenorrhea, premature delivery, and increased risk of malignancies, respectively.&nbsp;

&nbsp;

Following are a few vitamins and minerals, and their recommended daily allowance which a woman can take to ensure optimal health<a href="#accordion">[7]</a>:

<ul>
	<li>Iron: For those aged 19-50 years, it&rsquo;s 18 mg/day whereas for those aged 51 and up, it&rsquo;s 8 mg/day</li>
	<li>Magnesium: If aged 19-30, then 310 mg/day; if aged 31 years and above, then 320 mg/day</li>
	<li>Vitamin D:&nbsp;If aged 1-70 years, 15 mcg/day (600 IU or international units)</li>
	<li>Vitamin C: 75mg/day</li>
	<li>Vitamin E: 15mg/day</li>
</ul>

&nbsp;

<h5>Lung Cancer</h5>

If you smoke one pack a day, it is necessary for you to be screened for lung cancer.&nbsp;Screening is done by a Computed Tomography (CT) and has to be done annually.&nbsp;

&nbsp;

<h5>Cervical Cancer</h5>

Cervical cancer is the 4th most common malignancy found in women worldwide. Around 604,000 new cases and 342,000 deaths were reported in 2020, with 90% of this data being sourced from low and middle income countries<a href="#accordion">[8]</a>.&nbsp;

&nbsp;

In order to screen a woman with cervical cancer, a Pap test is recommended every 3 years for women aged 21-65 years. A Pap smear test is one in which your health care practitioner takes samples from your cervix and evaluates them under a microscope.&nbsp;

&nbsp;

<h5>Breast Cancer</h5>

Another alarming malignancy in females is breast cancer. A total of 7.8 million cases, diagnosed between 2015-2020, made it the most prevalent cancer worldwide. In 2020 alone, there were 2.3 million women who were diagnosed and 685,000 deaths worldwide that occurred due to breast cancer<a href="#accordion">[9]</a>.&nbsp;

&nbsp;

Screening for breast cancer is done through mammography (an x-ray of your breast) every 2 years from the age of 50 years onwards<a href="#accordion">[10]</a>.&nbsp;

&nbsp;

<h5>Sexually Transmitted Infections&nbsp;</h5>

Women who are 24 years and older and sexually active should get screened for sexually transmitted infections like chlamydia, gonorrhoea, herpes, trichomoniasis, HIV, HPV, cervical cancer, hepatitis B, hepatitis C, and syphilis. Chlamydia screening particularly should be done every year once girls turn 24.&nbsp;

&nbsp;

Pregnant women should be screened for chlamydia, gonorrhoea, herpes, HIV, HPV, cervical cancer, hepatitis B, hepatitis C, and syphilis.&nbsp;

&nbsp;

Screening for diseases in children is another ball game and one that&rsquo;s quite important too.&nbsp;

&nbsp;

<h5>Severe Acute Malnutrition</h5>

Severe acute malnutrition (SAM), also known as severe wasting, is the most crucial form of undernutrition and has a mortality rate of 10-30%.&nbsp;

&nbsp;

Studies show that children in developing countries have a strong correlation of undernutrition and development outcomes. It should be noted that even if the child survives the undernutrition at the moment, it would have a drastic effect on adulthood, especially with regards to physical and cognitive development.&nbsp;

&nbsp;

According to the Pakistan Demographic Survey (2017&ndash;18), 37.6% of children under 5 years were stunted, with 17% severely stunted. Furthermore, 7.1% were found to be wasted, with 2% severely wasted and 23% were underweight<a href="#accordion">[11]</a>. Hence, it becomes necessary to monitor a child who is 5 years or under, to counteract any existing deficiencies .&nbsp;

&nbsp;

Developmental Screening Test II (Denver), also known as DDST II, is used to screen a child for his or her development. DDST II has 4 components: personal-social behavior development, fine motor development, language, and gross motor development.&nbsp;

&nbsp;

Apart from this, anthropometric measurements are also taken to check for physical development. Anthropometric measurements include height, weight, head circumference, body mass index (BMI), body circumferences to assess for adiposity (waist, hip, and limbs), and skinfold thickness.

&nbsp;

It can be settled from the statistics mentioned above that some diseases are silent killers and need to be identified as early as possible. Anything could happen to anyone, so the best way to look out for yourself is to give yourself a fair opportunity. Just going to your doctor reduces your risk by 50%. Some diseases like pancreatic cancers are usually symptomatic at advanced stages. However, if routine blood work is done, it can warrant for early on imaging and, hence, diagnosis. There can be a lot of examples like this, but the main question remains, “do you love yourself enough?”&nbsp;&nbsp;

<ul>
	<li>A health screening routine allows to track any mild symptoms that might not seem dangerous initially.</li>
	<li>Screening is important for different diseases and in some cases it&rsquo;s solely dependent on the gender or your age.</li>
	<li>If you are a male, aged between 18 and 39, you should keep your blood pressure in check by getting it checked once every 2 years.</li>
	<li>The recommended age for cholesterol screening is 35 for men with no known risk factors regarding coronary heart disease, and 20 for men with known risk factors for coronary heart disease.</li>
	<li>Blood sugar levels between 141 mg/dL and 200 mg/dL (7.8 to 11.1 mmol/L) is considered impaired glucose tolerance, whereas above 200 mg/dl (11.1mmol/L) is diagnostic of diabetes in an OGTT.</li>
	<li>A normal HbA1C level is below 5.7%, whereas a level of 5.7-6.4% indicates pre-diabetes. 6.5% or more is a strong indicator of diabetes.</li>
	<li>2022 studies show 268,490 new cases were reported and 34,500 people lost their lives due to prostate cancer in the US.</li>
	<li>Prostate Specific Antigen (PSA) along with a digital rectal examination (DRE) are done to screen one for prostate cancer</li>
	<li>Bladder cancer is 4 times more prevalent in men compared to women.</li>
	<li>Data collected by GLOBOCAN in 2018 estimated that 550,000 people were diagnosed with bladder cancer.</li>
	<li>The screening method for bladder cancer is a basic urine detailed report and urine cytology.</li>
	<li>Colorectal cancer is the 4th most common cancer in the US which takes around 27000 lives each year.</li>
	<li>Colonoscopy should be done to screen men around 45 years.</li>
	<li>Women need to tend to their overall health as vigilantly as possible, to ensure proper menstrual cycle and pregnancies.</li>
	<li>Lung cancer screening is done by a Computed Tomography (CT) and has to be done on an annual basis.</li>
	<li>Cervical cancer is the 4th most common malignancy found in women worldwide. Around 604,000 new cases were reported in the year 2020 and 342,000 deaths, with 90% of this data being sourced from low- and middle-income countries.</li>
	<li>Pap test is recommended every 3 years for women aged 21-65 years, for screening for cervical cancer.</li>
	<li>In 2020 alone, there were 2.3 million women diagnosed with breast cancer and 685,000 deaths globally.</li>
	<li>Screening for breast cancer is done by mammography every 2 years from the age of 50 years.</li>
	<li>Sexually active men (included males who have sex with males) and women (including pregnant women) should get screened for sexually transmitted infections.</li>
	<li>According to the Pakistan Demographic Survey (2017&ndash;18), 37.6% of children under 5 years of age were stunted, with 17% severely stunted. Furthermore, 7.1% were found to be wasted, with 2% severely wasted, and 23% were underweight.</li>
	<li>Developmental Screening Test II (Denver), also known as DDST II, and anthropometric measurements are used to screen a child for his or her development.</li>
</ul>

&nbsp;

[1] Health screenings for men ages 18 to 39: Medlineplus Medical Encyclopedia. MedlinePlus.

[2] All about your A1C. Centers for Disease Control and Prevention.

[3] Key statistics for prostate cancer: Prostate cancer facts. American Cancer Society.

[4] What is screening for prostate cancer? Centers for Disease Control and Prevention.

[5] 5 most common cancers in men. Roswell Park Comprehensive Cancer Center.

[6] Saginala K, Barsouk A, Aluru JS, Rawla P, Padala SA, Barsouk A. Epidemiology of Bladder Cancer. Med Sci (Basel). 2020;8(1):15. Published 2020 Mar 13. doi:10.3390/medsci8010015

[7] Vitamins and minerals: How much should you take? WebMD.

[8] Cervical cancer. World Health Organization.

[9] Breast cancer. World Health Organization.

[10] What is a mammogram? Centers for Disease Control and Prevention.

[11] Saleem, J., Zakar, R., Bukhari, G.M.J. et al. Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan. BMC Public Health 21, 1397 (2021).

Arbaz Ansari

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

Can Men Get Yeast Infections?

We all have heard of women getting yeast infection, but rarely do we hear anything about men getting yeast infection. Quite unfair, don&rsquo;t you think? Since this makes room for the misconception that men are immune to it. And that&rsquo;s not what you&rsquo;d want to believe. It&rsquo;s baseless and untrue; men are also susceptible to yeast infection.

&nbsp;

1 in every 25 men catch the infection at least once in their lives, with 1 in every 30 uncircumcised males and uncircumcised boys under 4 being more at risk of developing the condition<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

Understanding Yeast Infection in Men

A yeast infection is caused by a fungus called candida,&nbsp;also known as candida balanitis<a href="#accordion">[3][4]</a>. Balanitis is the inflammation in the head of the penis.&nbsp;

&nbsp;

According to research, almost 20% of women have candida in their vagina, but do not experience infections<a href="#accordion">[1]</a>. In contrast, 16-26% of men have yeast on the head of the penis out of which 37% don&rsquo;t experience any symptoms while 27% of men develop infection<a href="#accordion">[6]</a>. According to a report, men over 40 and <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetic </a>are especially prone to candida balanitis<a href="#accordion">[6]</a>.

&nbsp;

Typically, candida thrives in moist environments. It makes you restless. Often, the condition can be easily treated with common over-the-counter (OTC) drugs, given that it is attended to on time. If you maintain proper hygiene, keep the area dry, and practice safe intercourse, you can actually prevent it.&nbsp;

&nbsp;

Most people hesitate discussing this topic with their doctor because of the taboo associated with it. Especially since it questions your personal hygiene routine. Don&rsquo;t be that person; you need to seek medical help as soon as possible for a better shot at recovery. 
&nbsp;

While the main cause of yeast infection is candida, there are other conducive situations that allow it to manifest:

<ul>
	<li><a href="https://merisehat.pk/disease/obesity">Obesity</a></li>
	<li>Long term use of antibiotics or steroids&nbsp;</li>
	<li>Diabetes</li>
	<li>Weak immune system</li>
	<li>Unhygienic conditions</li>
	<li>Sex (if the partner is infected)&nbsp; 
	&nbsp;</li>
</ul>

Common symptoms of inflammation are:

<ul>
	<li>Redness</li>
	<li>Swelling of foreskin</li>
	<li>Pain or itchiness on the foreskin or tip of penis 
	&nbsp;</li>
</ul>

Other symptoms include:

<ul>
	<li>Moist feeling on the tip of penis</li>
	<li>Thick, white discharge that may have unpleasant smell</li>
	<li>Burning sensation while peeing&nbsp;</li>
	<li>Sores or white patches of skin</li>
	<li>Difficulty in having or holding erection 
	&nbsp;</li>
</ul>

When the yeast infection is left untreated for a long time, systemic symptoms appear, like<a href="#accordion">[4]</a>:

<ul>
	<li>High-grade fever</li>
	<li>Chills</li>
	<li>Headache</li>
	<li>Stomach upset</li>
	<li>Narrowing or scarring of penis&nbsp;&nbsp;</li>
	<li>Increased risk of penile cancer&nbsp;</li>
	<li>Difficulty while pulling back the foreskin of penis 
	&nbsp;</li>
</ul>

This can lead to complications, such as:

<ul>
	<li>Balanitis, which can cause fatigue and weakness and lead to swollen, painful glands</li>
	<li>Candidemia or invasion of candida in bloodstream, which further affects other parts of the body including heart, bones, and brain 
	&nbsp;</li>
</ul>

Those who have a weak immune system are susceptible to candidemia. According to the CDC, candidemia is one of the most common blood infections in the US<a href="#accordion">[2]</a>. 
&nbsp;

Your health practitioner will perform a physical exam. They may check the foreskin of your penis or they may take a swab sample to identify the pathological condition under microscope<a href="#accordion">[4]</a>.

&nbsp;

Additionally, they may order a few laboratory tests<a href="#accordion">[5]</a>:

<ul>
	<li>Serum glucose test (diabetes)</li>
	<li>STD testing (<a href="https://merisehat.pk/disease/hiv-61">HIV </a>and HPV)</li>
	<li>Bladder scan and ultrasonography (urinary obstruction in severe balanitis) 
	&nbsp;</li>
</ul>

Fungal and yeast infections are quite stubborn to get rid of. They may go away on their own or they may require treatment; it&rsquo;s different for every individual. If the infection is treated on time, it can last for a week. If it&rsquo;s moderate to severe, it takes almost 2-3 weeks to clear up<a href="#accordion">[2]</a>. However, in case of uncircumcised individuals, a frequent relapse of yeast infections is possible.&nbsp; 
&nbsp;

The first thing you should do is avoid having intercourse with your partner if they have a yeast infection. Secondly, you should also keep away from any sexual activity if you yourself are suffering from yeast infection.

&nbsp;

The follow steps are also recommended to reduce your chances of contracting yeast infections:

<ul>
	<li>Use condoms&nbsp;</li>
	<li>Adopt and Maintain good hygiene to ensure clean and dry genitalia</li>
	<li>Opt for unscented soaps</li>
	<li>Wear breathable underwear to prevent moisture 
	&nbsp;</li>
</ul>

<ul>
	<li>Any sexual contact with a person who has yeast infection.</li>
	<li>Not being circumcised&nbsp;</li>
	<li>Lack of hygiene and improper cleaning of genital</li>
	<li>Using antibiotics for long durations&nbsp;</li>
	<li>Extremely low immunity 
	&nbsp;</li>
</ul>

The earlier you begin your treatment, the more likely you are to avoid complications. Do NOT self-diagnose and begin treatment on your own; always consult a doctor!&nbsp;

&nbsp;

Mostly, topical preparation, including the following, will effectively treat an infection<a href="#accordion">[2][4]</a>:

<ul>
	<li>Corticosteroid cream containing betamethasone can be used to treat certain yeast infections in combination with clotrimazole</li>
	<li>Anti-fungals (e.g., miconazole, imidazole, clotrimazole)&nbsp; 
	&nbsp;</li>
</ul>

Oral fluconazole and hydrocortisone cream are prescribed for serious infections leading to complications like balanitis<a href="#accordion">[2]</a>.

&nbsp;

If medications don&rsquo;t help, your doctor may recommend circumcision<a href="#accordion">[4]</a>.

&nbsp;

Note:&nbsp;Betamethasone should NEVER be used as stand-alone treatment for yeast infection because it weakens the immune system and makes the infection worse<a href="#accordion">[7]</a>. 
&nbsp;

As per research, penile yeast infections mostly occur due to poor hygiene and unprotected sex. Redness, swelling, itchiness, and discomfort are common signs. If you have any of the aforementioned symptoms, it should not be neglected and treated as prescribed by your physician. Corticosteroids and anti-fungal topical preparations can be used according to the degree of infection. A decent hygiene and avoiding scented products can help protect yourself and others. 
&nbsp;

<ul><li>Penile yeast infections are caused by candida. A moist environment promotes growth of candida.</li><li>Common signs and symptoms are redness, swelling, itching. A yeast infection can lead to balanitis, which causes unpleasant smell and thick white discharge.</li><li>Doctors may perform physical and order pathological testing as well to diagnose the infection.&nbsp;</li><li>Treatment includes topical corticosteroids and anti-fungal medication; for serious illness, oral antifungals are helpful. </li></ul>

[1] Sobel JD. Vulvovaginal Candidosis. The Lancet.

[2] Roland J. Male yeast infection: Symptoms, treatment, and more. Healthline.

[3] Yeast infection in men: How can I tell if I have one? Mayo Clinic.

[4] Male yeast infection (candida balanitis): Symptoms, causes & treatment. Cleveland Clinic.

[5] Mark J Leber MD. Balanitis workup. Laboratory Studies.

[6] Men also get yeast infections. WorldHealth.

[7] Can betamethasone be used for a yeast infection? Drugs.com.

Sarah Mhowwala

Mid-Life Crisis In Men: What Does It Look Like Now?

Middle-aged individuals tend to go through a period where their identity and self-confidence suffer greatly. This is usually between the ages of 30 to 65 years, when these individuals start having to face their growing age as new physical ailments start popping up.&nbsp;

Some feel they have wasted their life so far and it&rsquo;s &lsquo;too late&rsquo; now. There can be a lot of <a href="https://merisehat.pk/disease/anxiety">anxiety</a>, remorse and sadness associated with it which tends to manifest in drastic decisions that don&rsquo;t really make sense for the kind of person they are.&nbsp;

This phenomenon is termed as midlife crisis. It was first coined in 1965 by Elliot Jacques. It tends to last between three to 10 years in men and two to five years in women. But it can even last only a few months in some individuals.&nbsp; 
&nbsp;

Even though it&rsquo;s mainly associated with ageing, there can be many precipitating factors along with ageing, such as a divorce, work troubles, children maturing and leaving the house, a death of a loved one etc.&nbsp;

This, however, is not a clinical diagnosis and is even thought to be a cultural phenomenon limited to western society. Studies have shown that it might not be as common as it was previously thought to be while there is also little evidence of it in other cultures, such as in Indian and Japanese cultures.&nbsp;

Men tend to go through their midlife crisis at the age of 40 and it is usually preceded by a feeling of inadequacy, being unaccomplished or having to face a crisis such as a parent&rsquo;s or a peer&rsquo;s death. It is also very abundantly portrayed in pop-culture where men are seen to pursue younger women, buying expensive things and being in denial about their receding hairline.&nbsp;

In real life, these clues might not always (mostly never) present.&nbsp; 
&nbsp;

Mid-life Crisis

<ul><li>They tend to turn into mopey individuals with more frequent bouts of sadness requiring alone time to process feelings of loss of control, disappointment and self-pity. Other markers of chronic sadness may also be there such as disturbed sleep, over eating or lack of motivation.&nbsp; </li><li>Other than sadness they might have turbulent moods where one minute they are down and next they are ready to party. These rapidly changing moods are usually the first time you will observe these men on an emotional roller-coaster.&nbsp; </li><li>They tend to become complainers who find fault with everything and have a largely pessimistic view of the world. They will nag everyone around them about the tiniest of things and nothing can ever make them happy. At the root of all this is a lack of satisfaction they tend to feel with their own life and self.&nbsp; </li><li>These men also tend to display poor judgement and might make impulsive decisions or purchases. This can be affected by their turbulent moods as well.&nbsp; </li><li>Some men will inevitably end up using substances to cope and deal with the crisis. This can lead to other poor choices such as gambling.&nbsp; </li><li>These men are also highly irritable in all areas of life. You can find them throwing a tantrum at the office and at home and it’s increasingly obvious that everything tends to frustrate them now.&nbsp; </li><li>Some men might also become withdrawn and give up on their relationships and goals. They stop doing the activities they usually keep themselves busy with and go into hermit mode. There is a sense of boredom with the life they have created for themselves so far and want to run away from it. &nbsp; </li><li>An acute and heightened sense of awareness and self-consciousness about their marital, work, health or economic and social status.&nbsp; </li></ul>These midlife crises usually have a peak after which they end and most people come out on the other side better and changed individuals. They tend to become more comfortable with the new normal and make their peace with it. There will be a re prioritising and refocusing of their perspective but they are ready for the challenge and the next phase of life.&nbsp; So how do these lucky ones navigate something so precarious?&nbsp;

How to Cope

<ul><li>Acknowledge that you have these feelings and they tend to be overwhelming enough to lead you into a crisis.&nbsp; </li><li>Let your partner, colleagues and friends know and reach out for help. Chances are they are also feeling the same way and might have some groundbreaking insight. If nothing, you will at least realise you're not alone in this.&nbsp; </li><li>Accept that it’s completely normal to feel this way and it’s the natural progression of life. It’s just another stage in your growth and it too shall pass.&nbsp; </li><li>Try not to make any big decisions by making sure you consult either your partner or a trusted friend/mentor beforehand. This reduces your chances of making any impulsive decisions you might come to regret later.&nbsp; </li><li>Invest in your physical and mental wellbeing. Join a gym or pick up one physical activity that you enjoy doing and stick with it. Being active also makes you feel better emotionally. Meditation and yoga can also help calm down those recurrent feelings of anxiety.&nbsp; </li><li>Embrace the oncoming changes and appreciate the effect of time on circumstance. Recognise that ageing might not be the worst thing in the world and you can still continue to enjoy life in your older age.&nbsp; </li></ul>

The process of ageing can be daunting and life can seem quite overwhelming at any point in time. Some people tend to suffer through these crises earlier in life, which is happening more and more lately thanks to social media and the impending threat of climate change, food and water shortages and the general upheaval in society.&nbsp;People feel they are not only stuck behind while their peers have progressed and achieved so much more in life, but they also think any effort is futile since the world is ending anyway. This is what we call a ‘quarter life crisis’ which looks almost the same as having a mid-life crisis but in your 20s and 30s.&nbsp;In either scenario, taking a step back and looking at the whole forest instead of the trees might help and calm you down. It’s never too late to make any changes or achieve anything.&nbsp; However, if none of these things work it is likely that you're depressed and can benefit from seeking professional help. Although a midlife crisis is not the same as depression, it can still precipitate it.Recognising that with each stage of life there needs to be a readjustment and you’re more than capable of it can be a huge task. You don’t have to accomplish it alone.&nbsp;Another interesting concept to acknowledge here is that some renowned psychologists have deemed a midlife crisis as the process that leads to self-actualisation, the last need on Maslow’s hierarchy. Integrating all your knowledge, intuition, thoughts and feelings into a newer version of you can be daunting and can rightfully lead to a state of crisis. However, there is hope on the other side of it where your identity achieves a much more solid footing.&nbsp;

Dr. Safia Mehmood

10 Essential Shirts Every Man Should Have In His Wardrobe

<ul>
	<li>Dress Shirt: A dress shirt is an elegant and simple garment that needs to be starched and crisp for a perfect look. A well-fitted dress shirt is comfortable for anyone who wears it, but the fit can vary for different men. A looser fit is suitable for larger men, while a more form-fitting cut suits thin and petite men. Dress shirts are perfect for impressing bosses at work or a lady at a nearby caf&eacute;. 
	&nbsp;</li>
</ul>

<ul>
	<li>Polo: A polo shirt is neither a t-shirt nor a dress shirt and is a must-have for both casual wear and more dressed-up occasions. It is the perfect garment for many non-formal events in life and casual events where dressing up is not necessary. Feel free to tuck or untuck depending on personal preference and the given situation. 
	&nbsp;</li>
</ul>

<ul>
	<li>Classic Short Sleeve: A classic short-sleeve t-shirt is the most &#39;bad boy&#39; thing a man can have in his wardrobe. This classic t-shirt is popular among both men and women and is perfect for all ages. These sleeves are slightly longer than cap sleeves and typically extend to the elbow or just above it. Make sure the t-shirt is plain and dark in color unless it is white. 
	&nbsp;</li>
	<li>Denim: A denim shirt is a timeless and stylish option for days when you want to feel comfortable but look cool at the same time. It is made from cotton fibers using twill weave and has diagonal ribbing that is iconic to the denim material. The denim shirt is a piece of clothing that can instantly tie an outfit together, be it a casual gathering or a smart-casual event. 
	&nbsp;</li>
	<li>Linen: Linen shirts are made from thread made from the fibers of the flax plant, making them completely natural and sustainable. Linen is known to be the strongest natural fiber on earth and is 30% thicker and stronger than cotton. It is a shirt that instantly makes you cooler and feel amazing when worn due to its expendable and breathable structure. Linen dries faster than cotton, making it a valued asset to have in your wardrobe. 
	&nbsp;</li>
	<li>Oxford: An Oxford shirt is perfect for semi-professional settings, and a pair of wingtip Oxfords is a wonderful choice for a business casual wardrobe. Oxford shirts are always made with oxford cloth, a unique type of basket weave that creates extremely soft and durable fabric with a hearty feel that is both durable and naturally resistant to wrinkles. Roll up your sleeves and get to work while looking effortlessly smart. An Oxford shirt sends a message to its wearer that it&#39;s ready for a sporting event or work. 
	&nbsp;</li>
	<li>Henley: Henley shirts are a step up from other forms of t-shirts when it comes to attraction factors. They give a casual sophistication to your daily wear and could be easily added to your wardrobe. Henley shirts fit the male figure perfectly, showing off those nice arms and a broad chest. They are usually very soft and stretchable, allowing freedom of movement, and the neckline helps your body breathe even on hot sunny days. 
	&nbsp;</li>
	<li>Chambray: A Chambray shirt is a great option if you like the look of denim but find it a bit too much. Chambray is a cotton plain-weave fabric made with a dyed warp yarn and a white filling yarn, similar to denim but much lighter in weight. Chambray shirts are versatile and can be dressed up or down, worn to a business-casual office, date night, or to the bar for a night out. A great way to dress down a suit or mix it up with your casual attire. 
	&nbsp;</li>
	<li>Hawaiian Shirt: This is a bold statement, and many people may not agree with it. But there just has to be a shirt that adds bright colors to your life and spices up your wardrobe. Contrary to what many people think, this shirt is not only useful for one hot Sunday on the beach. It&#39;s a great piece to have whether you&#39;re at parties, dinners, or just chilling at a casual barbecue. The brighter they are, the better the chances that they look good. The best thing about the Hawaiian shirt is that it doesn&#39;t need to fit perfectly, and in fact, it can be worn a little loose. 
	&nbsp;</li>
	<li>Mandarin Shirt: Mandarin shirts are very unique and are becoming increasingly popular. While the use of this collar dates back centuries, it has received a new boost in this modern era. Not only is the mandarin collar shirt a great alternative to your standard go-to attire, but it also adds an element of class to your overall appearance, which does wonders for those who prefer something urban and modern over the very conventional look we are accustomed to. You can wear a mandarin shirt to formal events like weddings, galas, dinners, and ceremonies. This provides a very clean, minimal, and refreshing look as opposed to a folded collar. Mandarin shirts are more eastern than western and will instantly make you stand out from everyone else. 
	&nbsp;</li>
</ul>
<quillbot-extension-portal></quillbot-extension-portal>

The shirt you wear is the most powerful message you are signaling when you do not have your blazer on. Your shirt is nonverbally communicating and speaking for you to make sure about your intentions, whether you like it or not. Hence, every time you wear a shirt, making sure it&#39;s perfect is an absolute no-brainer. 
&nbsp;

Rafay Zafar

تعارف

چیک اپ آپ کی اندرونی حالت بتا سکتا ہے" مگر لگتا ہے کہ ہم وقت کے ساتھ ساتھ یہ بھول گئے ہیں۔ کبھی ایسا خاندانی ذمہ داریوں، اور کبھی یہ کام کی مصروفیت کی وجہ سے ہوتا ہے۔ ہم ایک ایسی عادت بنا&nbsp; چکے ہیں، کہ ہماری طبیعت ٹھیک نہ ہونے پر بھی ہم چیک اپ کے لیے نہیں جاتے!لیکن کیا آپ جانتے ہیں کہ ایسی بیماریوں کی ایک فہرست موجود ہے،جن سے متعلق اگر مناسب روٹین ہیلتھ چیک اپ کرایا جائے تو ان سے بچا یا جا سکتا ہے؟ یہ شروع کرنے والوں کے لیے، معمول کی صحت جانچ آپ کو کسی بھی ہلکی علامات کا&nbsp; تعین کرنے کی اجازت دے گی،جو علامات شاید ابتدائی طور پر خطرناک نہ لگیں۔ یہ آپ کے ڈاکٹر کو ایسی بیماریوں کی تشخیص کرنے کی بھی اجازت دیتا ہے جو غیرمعمولی طور پر غیر علامتی ہوں۔آج کل لوگوں نے واقعی اپنی صحت کی قدر کرنی چھوڑ دی ہے۔ وہ اپنے ڈاکٹروں کے پاس تب ہی جاتے ہیں جب کوئی بیماری بڑھ&nbsp; جائے۔ہم میں سے کچھ لوگ بیماری کو چیلنج کرنا بھی چاہتے ہیں اور دیکھنا چاہتے ہیں کہ ہسپتال داخل ہونے سے پہلے ہم اسے کس حد تک لے جا سکتے ہیں!کسی بھی دوسری دوا کی طرح ڈاکٹر اس بیماری کے علاج کے لیے تجویز کر سکتا ہے، اس کی روک تھام کے لیے ہیلتھ چیک اپ ضروری ہے۔ اور جیسا کہ ہم میں سے بہت سے لوگ متفق ہوں گے: "احتیاط، علاج سے بہتر ہے"۔&nbsp;

یہ سمجھنا ضروری ہے کہ مرد اور عورت جسمانی طور پر مختلف&nbsp; ہیں، اس لیے مختلف بیماریوں کے لیے جانچ ضروری ہے اور بعض صورتوں میں، یہ مکمل طور پر جنس یا آپ کی عمر پر منحصر ہے۔ <div> </div>

باقاعدگی سے میڈیکل چیک اپ کی اہمیت کی وضاحت

<ul><li>بلڈ پریشر </li></ul>اگر آپ مرد ہیں، عمر 18 سے 39 سال کے درمیان ہے، تو آپ کو ہر 2 سال میں ایک بار اپنا بلڈ پریشر چیک کروا کر کنٹرول کرنا چاہیے۔ اگر اس چیک اپ کے دوران آپ کا اوپری دباؤ (Systolic) 120 سے اوپر ہے اور نچلا دباو (Diastolic) 80 سے زیادہ ہے ، تو جانچ سالانہ بنیادوں پر ہونی چاہیے (1)۔ <ul><li>کولیسٹرول</li></ul>غذائیت اور طرز زندگی کی وجہ سے، کولیسٹرول کی جانچ خاص طور پر مردوں کے لیے اہم ہو جاتی ہے۔ کولیسٹرول کی جانچ کے لیے تجویز کردہ عمر ایسے مردوں کے لیے 35 سال ہے، جن میں کورونری دل کی بیماری کے خطرے کے عوامل معلوم نہیں ہیں اور ان مردوں کے لیے جن میں کورونری دل کی بیماری کے خطرے کے عوامل معلوم ہیں،یہ ان کے لیے 20 سال ہے۔ اگر اس میں کوئی&nbsp; دیگر بیماریاں شامل ہیں، تو آپ کو اسے زیادہ کثرت سے چیک کروانا چاہیے۔ تاہم، اگر نتائج نارمل ہیں، تو جانچ کو صرف 5 سال کے عرصے کے بعد دہرایا جا سکتا ہے (1)۔&nbsp; <ul><li>ذیابیطس</li></ul>ذیابیطس اور ہائی بلڈ پریشر اکثر ساتھ ساتھ چلتے ہیں۔ لہذا، اگر آپ ہائی بلڈ پریشر کے مریض ہیں، تو آپ کی ذیابیطس کی جانچ کیے جانے کا زیادہ امکان ہے۔ HbA1c عام طور پر اورل گلوکوز ٹولرنس ٹیسٹ (OGTT) کے ساتھ ٹیسٹ کیا جاتا ہے۔OGTT کے لیے، 141 mg/dL اور 200 mg/dL (7.8 - 11.1 mmol/L) کے درمیان خون میں شکر کی سطح کو ناقص گلوکوز ٹالیرنس سمجھا جاتا ہے جبکہ 200 mg/dl (11.1mmol/L) سے زیادہ ہونے کا مطلب ہے کہ وہ شخص ذیابیطس کا شکار ہے۔ ایک عام HbA1C کی سطح 5.7٪ سے کم ہے جبکہ 5.7 - 6.4٪ کی سطح،&nbsp; پہلے سے ذیابیطس کے مسئلے کی نشاندہی کرتی ہے، جبکہ 6.5٪ یا اس سے زیادہ ذیابیطس کا مضبوط اشارہ ہے (2)۔ آپ کی طبی تاریخ کی تفصیل حاصل کرنے کے بعد، آپ کا ڈاکٹر فیصلہ کرے گا کہ آیا بعض انفیکشنز، جیسے سیفیلس، کلیمائڈیا، اور ایچ آئی وی کی جانچ ضروری ہے یا نہیں۔ <ul><li>پروسٹیٹ کینسر</li></ul>مہلک خلیات کے حوالے سے، مردوں میں کچھ سنگین اعدادوشمار دیکھے گئے ہیں، جس کی وجہ سے&nbsp; معمول کی بنیاد پر جانچ ضروری ہو جاتی ہے۔ امریکن کینسر سوسائٹی کے تخمینے کے مطابق 2022 میں امریکہ میں پروسٹیٹ کینسر کے 268,490 نئے کیسز رپورٹ ہوئے اور 34,500 لوگ اس بیماری کی وجہ سے جان سے ہاتھ دھو بیٹھے۔ یہ 8 میں سے 1 مرد کے برابر ہے، جب وہ 65&nbsp; کے ہو جائیں تو&nbsp; خطرہ بڑھ جاتا ہے۔(3)&nbsp;نیشنل کمپری ہینسو کینسر نیٹ ورک کے ذریعہ قائم کردہ، پروسٹیٹ کینسر کی ابتدائی شناخت کے رہنما اصول 45 سال سے زیادہ عمر کے مردوں پر زور دیتے ہیں کہ وہ اسکریننگ کروائیں اور پھر نتائج کے مطابق معمول کے چیک اپ کا پلان بنائیں۔پروسٹیٹ اسپیسیفک اینٹیجن (PSA) کے ساتھ ڈیجیٹل ریکٹل ایگزامینیشن (DRE) آپ کی پروسٹیٹ کینسر (5) کی اسکریننگ کے لیے کیا جاتا ہے۔ PSA پروسٹیٹ کے مخصوص کیمیکلز کی جانچ کرنے کے لیے ایک خون کا ٹیسٹ ہے ،جبکہ DRE مقعد میں ایک انگلی کا دخول ہے تاکہ پروسٹیٹ کے ظاہری پہلوؤں کو محسوس کیا جا سکے (4)۔ <ul><li>مثانے کا کینسر</li></ul>اگرچہ یہ بزرگوں کی بیماری ہے، جس میں اوسط عمر 73 سال ہے، مثانے کا کینسر ایک اور مہلک بیماری ہے جو عورتوں کے مقابلے مردوں میں چار گنا زیادہ پائی جاتی ہے (5)۔2018 میں GLOBOCAN کے جمع کردہ اعداد و شمار کے مطابق 550,000 لوگوں میں مثانے کے کینسر کی تشخیص ہوئی (6)۔ مثانے کے کینسر کی اسکریننگ کا طریقہ پیشاب کی&nbsp; بنیادی تفصیلی رپورٹ اور پیشاب کی سائٹولوجی کے ذریعے کیا جاتا ہے،&nbsp; جو بے قاعدگیوںکا پتہ لگانے میں مدد کرتا ہے۔ <ul><li>کولوریکٹل کینسر</li></ul>کولوریکٹل کینسر ایک ایسا کینسر ہے جو ہر سال صرف امریکہ میں 27,000 جانیں لیتا ہے۔یہ سفارش کی جاتی ہے کہ 45 سال کی عمر میں مردوں میں اسکریننگ کے طریقہ کار کے طور پر کالونیسکوپی کی جائے۔ مہلک خلیوں کی خاندانی تاریخ اسکریننگ کو اور بھی اہم بناتی ہے (5)۔

جنسی طور پر منتقل ہونے والے انفیکشن خواتین کے ساتھ جنسی تعلق رکھنے والے مردوں کو درج ذیل کی&nbsp; اسکریننگ کرانی چاہیے: کلیمائڈیا، سوزاک، آتشک، ہرپس، ایچ آئی وی، ہیپاٹائٹس بی اور سی۔مردوں کے ساتھ جنسی تعلق رکھنے والے مردوں کو درج ذیل کی&nbsp; اسکریننگ کروانی چاہیے:&nbsp;کلیمائڈیا، سوزاک ، آتشک، ہرپس، ایچ آئی وی، ایچ پی وی، مقعد کا کینسر، ہیپاٹائٹس بی اور سی۔<div> </div>

خواتین کو اپنی مجموعی صحت کے لیے بھی اسکریننگ کی ضرورت ہے۔اس کی وجہ یہ ہے کہ عورت کو ماہواری، حمل، اور پھر بعد از سن یاس گزرنا پڑتا ہے، یہ سب متعدد متعلقہ عوارض کا سبب بن سکتے ہیں جیسے کہ تکلیف دہ ماہواری، قبل از وقت ڈیلیوری، اور مہلک امراض کا خطرہ بڑھنا۔ ذیل میں چند وٹامنز اور معدنیات اور ان کے تجویز کردہ یومیہ الاؤنس ہیں، جو ایک عورت بہترین صحت کو یقینی بنانے کے لیے لے سکتی ہیں (7)۔<ul><li>آئرن: 19-50 سال کی عمر کے لوگوں کے لیے، یہ 18 ملی گرام فی دن ہے جب کہ 51 سال یا اس سے زیادہ عمر والوں کے لیے، یہ 8 ملی گرام فی دن ہے۔</li><li>میگنیشیم: اگر 19-30 سال کی عمر ہو، تو 310 ملی گرام فی دن؛ اگر عمر 31 سال اور اس سے زیادہ ہے تو 320 ملی گرام فی دن</li><li>وٹامن ڈی: 1-70 سال کی عمر: 15 ایم سی جی فی دن (600 آئی یو یا بین الاقوامی یونٹ)</li><li>وٹامن سی: 75 ملی گرام فی دن</li><li>وٹامن ای: 15 ملی گرام فی دن </li><li>پھیپھڑوں کا کینسر</li></ul>اگر آپ دن میں ایک پیکٹ تمباکو نوشی کرتے ہیں، تو آپ کے لیے پھیپھڑوں کے کینسر کے لیے اسکریننگ کرنا ضروری ہے۔اسکریننگ ایک کمپیوٹیڈ ٹوموگرافی (CT) کے ذریعہ کی جاتی ہے اور اسے سالانہ کرنا پڑتا ہے۔ <ul><li>سروائیکل / رحم کے نچلے حصے کا کینسر</li></ul>سروائیکل کینسر دنیا بھر میں خواتین میں پایا جانے والا چوتھا سب سے عام مہلک مرض ہے۔ 2020 میں تقریباً 604,000 نئے کیسز اور 342,000 اموات رپورٹ ہوئیں، جن میں سے 90% ڈیٹا کم اور درمیانی آمدنی والے ممالک سے حاصل کیا گیا (8)۔سروائیکل کینسر والی عورت کو اسکرین کرنے کے لیے، 21-65 سال کی عمر کی خواتین کے لیے ہر 3 سال بعد Pap ٹیسٹ کی سفارش کی جاتی ہے۔ Pap سمیر ٹیسٹ وہ ہوتا ہے جس میں آپ کا ڈاکٹر آپ کے سرویکس سے نمونے لیتا ہے اور مائکروسکوپ کے ذریعے جانچتا ہے۔ <ul><li>چھاتی کا سرطان</li></ul>خواتین میں ایک اور خطرناک بیماری چھاتی کا کینسر ہے۔ 2015-2020 کے درمیان تشخیص کیے گئے کل 7.8 ملین کیسز نے اسے دنیا بھر میں سب سے زیادہ عام کینسر بنا دیا۔ صرف 2020 میں، دنیا بھر میں 2.3 ملین خواتین تھیں جن کی تشخیص ہوئی اور 685,000 اموات چھاتی کے کینسر کی وجہ سے ہوئیں (9)۔چھاتی کے کینسر کی اسکریننگ 50 سال کی عمر کے بعد ہر 2 سال میں میموگرافی (آپ کی چھاتی کا ایکسرے) کے ذریعے کی جاتی ہے۔[10] جنسی طور پر منتقل ہونے والے انفیکشنجو خواتین 24 سال اور اس سے زیادہ عمر کی ہیں اور جنسی طور پر متحرک ہیں ان کو جنسی طور پر منتقل ہونے والے انفیکشن جیسے کلیمائڈیا، سوزاک، ہرپس، ٹرائیکوموناس، ایچ آئی وی، ایچ پی وی، سروائیکل کینسر، ہیپاٹائٹس بی، ہیپاٹائٹس سی اور آتشک کی اسکریننگ کرانی چاہیے۔ کلیمائڈیا اسکریننگ خاص طور پر ہر سال لڑکیوں کے 24 سال کی ہونے کے بعد کی جانی چاہیے۔حاملہ خواتین کی اسکریننگ کی جانی چاہئے: کلیمائڈیا، سوزاک ، ہرپس، ایچ آئی وی، ایچ پی وی، سروائیکل کینسر، ہیپاٹائٹس بی، ہیپاٹائٹس سی اور آتشک ۔

بچوں میں بیماریوں کی اسکریننگ ایک اور بال گیم ہے اور یہ بھی بہت اہم ہے۔ <div> </div>

شدید غذائی قلت (SAM)، جسے شدید عدم نمو بھی کہا جاتا ہے،&nbsp; کم غذائیت کی سب سے اہم شکل ہے اور اس میں شرح اموات 10-30% ہے۔ مطالعات سے پتہ چلتا ہے کہ ترقی پذیر ممالک کے بچوں میں غذائیت کی کمی اور نمو کے نتائج کا گہرا تعلق ہے۔ واضح رہے کہ اگر بچہ اس وقت غذائی قلت سے بھی بچ جاتا ہے،&nbsp; تو اس کا بالغ ہونے پر خاص طور پر جسمانی اور ادراکی نشوونما کے حوالے سے سخت اثر پڑے گا۔پاکستان ڈیموگرافک سروے (2017-18) کے مطابق، 5 سال سے کم عمر کے 37.6% بچے ناقص نمو کا شکار تھے، جب کہ 17% شدید طور پر ناقص نمو کا شکار تھے۔ مزید برآں، 7.1% عدم نمو ، 2% شدید طور پر عدم نمو کا شکار پائے گئےاور 23% کا وزن کم تھا (11)۔ لہٰذا، 5 سال یا اس سے کم عمر کے بچے کی نگرانی کرنا ضروری ہو جاتا ہے، تاکہ موجودہ کمی کا علاج کیا جا سکے۔ترقیاتی اسکریننگ ٹیسٹ II (ڈینور) جسے DDST II بھی کہا جاتا ہے، بچے کی نشوونما کے لیے اسکریننگ کے لیے استعمال کیا جاتا ہے۔ DDST II کے 4 اجزاء ہیں: ذاتی سماجی رویے کی نمو، جسمانی نمو، زبان، اور مجموعی موٹر ڈیولپمنٹ۔اس کے علاوہ جسمانی نشوونما کو جانچنے کے لیے اینتھروپومیٹرک پیمائش بھی لی جاتی ہے۔ اینتھروپومیٹرک پیمائش میں قد، وزن، سر کا سائز، باڈی ماس انڈیکس (BMI)، جسم کا حجم جو کہ موٹاپے (کمر، کولہے، اور اعضاء)، اور جلد کی موٹائی شامل ہیں۔

خلاصہ

مذکورہ اعدادوشمار سے یہ بات طے کی جا سکتی ہے کہ بعض بیماریاں خاموش قاتل ہیں اور ان کی جلد از جلد شناخت کی ضرورت ہے۔ کسی کے ساتھ کچھ بھی ہو سکتا ہے، اپنا خیال رکھنے کا بہترین طریقہ یہ ہے کہ اپنے آپ کو ایک مناسب موقع فراہم کریں۔ صرف اپنے ڈاکٹر کے پاس جانے سے آپ کا خطرہ 50 فیصد کم ہوجاتا ہے۔ لبلبے کے کینسر جیسی کچھ بیماریاں عام طور پر شدید درجے کے مراحل میں علامتی ہوتی ہیں، تاہم اگر خون کا معمول کا ٹیسٹ کیا جائے، تو یہ جلد امیجنگ اور شخیص کی ضمانت دے سکتا ہے۔ اس طرح کی بہت سی مثالیں ہو سکتی ہیں لیکن بنیادی سوال یہ ہے کہ "کیا آپ خود سے کافی پیار کرتے ہیں؟"

اہم نکات

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