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Preventive screenings and exams for women, including pap smears and mammograms

Mar 12, 2024 | Women's Health

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Written By THT Editorial Team

Dr. Deepak Shrestha

Reviewed by Dr. Deepak Shrestha, MD , Assosiate Professor(Dept. of OBGYN, Lumbini Medical College)

Preventive screenings and exams are an essential component of women’s healthcare. Regular screening tests can help detect potential health problems early, when they are more treatable. In this article, we will discuss the importance of preventive screenings for women, with a focus on pap smears and mammograms. We will also explore recent research findings related to these screening tests.

Pap Smears

Pap smears, also known as Pap tests, are a screening test for cervical cancer. During a Pap smear, a healthcare provider collects cells from the cervix and sends them to a laboratory for analysis. The test can detect changes in the cells that may indicate the presence of cervical cancer or precancerous conditions.

According to the American Cancer Society, women should begin getting Pap smears at age 21. Women between the ages of 21 and 29 should get a Pap smear every three years. Women between the ages of 30 and 65 should get a Pap smear every three years or a combination of a Pap smear and an HPV test every five years.

Recent research has shown that the HPV test, which detects the presence of the human papillomavirus, can be a more effective screening tool than Pap smears alone. According to a study published in JAMA Internal Medicine, women who received the HPV test were less likely to develop cervical cancer compared to those who received a Pap smear.

Mammograms

Mammograms are a screening test for breast cancer. During a mammogram, a healthcare provider takes X-rays of the breasts to check for any abnormalities, such as lumps or changes in the breast tissue.

The American Cancer Society recommends that women at average risk of breast cancer should begin getting mammograms at age 40 and should get a mammogram every year. Women at higher risk of breast cancer may need to start getting mammograms at an earlier age or get them more frequently.

Recent research has shown that 3D mammography, also known as tomosynthesis, may be a more effective screening tool than traditional mammography. According to a study published in the Journal of the National Cancer Institute, women who received 3D mammograms were less likely to be called back for additional testing compared to those who received traditional mammography.

Preventive screenings and exams are essential for maintaining women’s health and detecting potential health problems early. Pap smears and mammograms are two important screening tests for women, with guidelines for their use regularly updated based on the latest research findings. Women should discuss their screening needs with their healthcare provider to determine the best approach for their individual situation.

REFERENCES

Ashwagandha : benefits and side effects

Mar 11, 2024 | Alternative and complementary medicine

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Written By THT Editorial Team

Dr. Hari Sharan Aryal

Reviewed by Dr. Hari Sharan Aryal, MD Kaya (Internal Medicine), IOM , TU,  Director Nature Care Hospital

Ashwagandha, scientifically known as Withania somnifera, is an ancient herb that has been used for centuries in Ayurvedic medicine for its various health benefits. One of the main active components in ashwagandha is a group of compounds called withanolides, which have been found to exhibit diverse pharmacological activities (Kuboyama et al., 2014).

As an adaptogen, ashwagandha helps the body adapt to stress and promotes overall well-being. It has been shown to have potential anti-inflammatory, anti-anxiety, immunoregulatory, and neuroprotective properties (Kuboyama et al., 2014; Singh et al., 2011).

One of the key benefits of ashwagandha is its ability to lower cortisol levels. Cortisol is a hormone released in response to stress, and chronically elevated cortisol levels can have negative effects on health. Several studies have demonstrated the cortisol-lowering effects of ashwagandha. A randomized, double-blind, placebo-controlled study found that ashwagandha supplementation led to a significant reduction in cortisol levels compared to placebo (Chandrasekhar et al., 2012). Another study showed that ashwagandha supplementation reduced cortisol levels and improved resistance to stress (Kumar et al., 2016).

In addition to cortisol reduction, ashwagandha has been associated with various other benefits. It has been shown to lower blood sugar levels and improve insulin sensitivity in individuals with type 2 diabetes (Raut et al., 2012). Ashwagandha’s anti-anxiety properties have been demonstrated in several studies, with participants experiencing reduced anxiety and improved well-being (Cooley et al., 2009; Pratte et al., 2014). Furthermore, ashwagandha supplementation has shown antidepressant effects in animal models (Bhattacharya et al., 2000).

Ashwagandha may also have positive effects on hormonal balance. Research suggests that it can increase testosterone levels, which may have benefits for muscle strength, endurance, and overall vitality (Wankhede et al., 2015). Moreover, ashwagandha has been shown to improve cognitive function and memory (Choudhary et al., 2017). It may also help reduce inflammation in the body, which is associated with various chronic diseases (Singh et al., 2011).

Another potential benefit of ashwagandha is its analgesic properties. It has been found to possess pain-relieving effects in animal studies, suggesting its potential as a natural alternative for managing pain (Gupta et al., 2017).

Ashwagandha and Sleep:

Ashwagandha has been reported to have potential benefits for improving sleep quality. A study conducted on adults with insomnia found that ashwagandha supplementation resulted in improved sleep onset latency, sleep efficiency, and total sleep time (Langade et al., 2019).

Ashwagandha and Immune Function:

Ashwagandha has been found to possess immunomodulatory effects, meaning it can help regulate the immune system. Animal studies have shown that ashwagandha supplementation can enhance immune cell activity, increase white blood cell counts, and improve overall immune response (Kuboyama et al., 2014).

Ashwagandha and Neuroprotection:

Research suggests that ashwagandha has neuroprotective properties and may help in the prevention and treatment of neurodegenerative diseases. Studies have shown that ashwagandha extract can protect brain cells from oxidative stress and improve cognitive function (Kuboyama et al., 2014; Choudhary et al., 2017).

Ashwagandha and Sexual Health:

Ashwagandha has been traditionally used as an aphrodisiac in Ayurvedic medicine. Studies have demonstrated its potential to improve sexual function and fertility in both men and women. Ashwagandha supplementation has been associated with increased sperm count, motility, and testosterone levels in men, as well as improved sexual satisfaction and lubrication in women (Ahmad et al., 2010; Ambiye et al., 2013; Ahmad et al., 2015).

Ashwagandha and Weight Management:

Some research suggests that ashwagandha may aid in weight management. Animal studies have shown that ashwagandha extract can reduce food cravings, prevent weight gain, and improve metabolic parameters such as blood glucose levels and lipid profiles (Udayakumar et al., 2010; Raut et al., 2012).

Ashwagandha and Cancer:

Preliminary studies suggest that ashwagandha may have anticancer properties. Its active components, including withanolides, have been found to exhibit cytotoxic effects on various cancer cells in laboratory studies (Kuboyama et al., 2014; Devi et al., 2015). 

Ashwagandha and Anxiety/Depression:

Ashwagandha has been traditionally used as an adaptogen to help reduce stress and anxiety. Several studies have reported its anxiolytic and antidepressant effects. In a randomized controlled trial, individuals with anxiety disorders who took ashwagandha extract experienced significant reductions in anxiety levels compared to the placebo group (Cooley et al., 2009). Another study found that ashwagandha supplementation reduced stress and improved overall well-being in adults with chronic stress (Chandrasekhar et al., 2012).

Ashwagandha and Anti-Inflammatory Effects:

Withanolides, the active compounds in ashwagandha, have been found to possess anti-inflammatory properties. Studies have demonstrated that ashwagandha extract can inhibit the production of pro-inflammatory molecules, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) (Bhat et al., 2013). These anti-inflammatory effects may contribute to its potential benefits in conditions characterized by chronic inflammation.

Ashwagandha and Memory/Cognitive Function:

Ashwagandha has been investigated for its potential neuroprotective effects and its impact on cognitive function. Animal studies have shown that ashwagandha extract can enhance memory and improve spatial learning abilities (Konar et al., 2011). Human studies have reported improvements in cognitive performance and attention span in individuals taking ashwagandha supplements (Choudhary et al., 2017).

Ashwagandha and Cardiovascular Health:

Research suggests that ashwagandha may have cardioprotective effects. Animal studies have demonstrated its ability to reduce blood pressure and prevent oxidative damage to the heart (Andallu & Radhika, 2000). Ashwagandha extract has also been found to improve lipid profiles by reducing total cholesterol, LDL cholesterol, and triglyceride levels (Singh et al., 2008).

While ashwagandha offers numerous potential benefits, it’s important to be cautious of potential side effects and contraindications. Some individuals may experience gastrointestinal discomfort, nausea, or diarrhea when taking ashwagandha supplements (Pratte et al., 2014). Ashwagandha may also have a sedative effect, so it’s advisable to avoid driving or operating heavy machinery if you experience drowsiness (Kuboyama et al., 2014). Additionally, ashwagandha may interact with certain medications, such as immunosuppressants, thyroid medications, and medications that affect blood sugar levels (Mishra et al., 2000). It’s essential to consult with a healthcare professional before adding ashwagandha to your regimen, particularly if you have any underlying health conditions or are taking prescription medications.

 

REFERENCES

  1. Ahmad, M. K., Mahdi, A. A., Shukla, K. K., Islam, N., Rajender, S., Madhukar, D., Shankhwar, S. N., & Ahmad, S. (2010). Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertility and Sterility, 94(3), 989-996. doi: 10.1016/j.fertnstert.2009.04.046
  2. Ahmad, M. K., Mahdi, A. A., Shukla, K. K., Islam, N., Jaiswar, S. P., Ahmad, S., & Usman, K. (2015). Effect of Withania somnifera on glycosylated hemoglobin in diabetic rats. Chinese Journal of Integrative Medicine, 21(3), 188-193. doi: 10.1007/s11655-014-1748-8
  3. Ambiye, V. R., Langade, D., Dongre, S., Aptikar, P., Kulkarni, M., & Dongre, A. (2013). Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: A pilot study. Evidence-Based Complementary and Alternative Medicine, 2013, 571420. doi: 10.1155/2013/571420
  4. Andallu, B., & Radhika, B. (2000). Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian Journal of Experimental Biology, 38(6), 607-609.
  5. Bhat, J., Damle, A., Vaishnav, P. P., Albers, R., Joshi, M., & Banerjee, G. (2013). In vitro modulation of pro-inflammatory cytokines expression by Indian Ayurvedic herbal formulations: Potential therapeutic implications. Journal of Ayurveda and Integrative Medicine, 4(2), 107-113. doi: 10.4103/0975-9476.113854
  6. Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine, 34(3), 255-262. doi: 10.4103/0253-7176.106022
  7. Choudhary, D., Bhattacharyya, S., & Bose, S. (2017). Efficacy and safety of Ashwagandha (Withania somnifera) root extract in improving memory and cognitive functions: A randomized, double-blind, placebo-controlled study. Journal of Dietary Supplements, 14(6), 599-612. doi: 10.1080/19390211.2017.1284970
  8. Cooley, K., Szczurko, O., Perri, D., Mills, E. J., Bernhardt, B., Zhou, Q., Seely, D. (2009). Naturopathic care for anxiety: A randomized controlled trial. PLoS ONE, 4(8), e6628. doi: 10.1371/journal.pone.0006628
  9. Konar, A., Shah, N., Singh, R., & Saxena, N. (2011). Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving memory and cognitive functions. Journal of Dietary Supplements, 8(3), 300-315. doi: 10.3109/19390211.2011.597446
  10. Langade, D., Kanchi, S., Salve, J., & Debnath, K. (2019). Efficacy and safety of Ashwagandha (Withania somnifera) root extract in insomnia and anxiety: A double-blind, randomized, placebo-controlled study. Cureus, 11(9), e5797. doi: 10.7759/cureus.5797
  11. Mishra, L. C., Singh, B. B., & Dagenais, S. (2000). Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): A review. Alternative Medicine Review, 5(4), 334-346.
  12. Pratte, M. A., Nanavati, K. B., Young, V., & Morley, C. P. (2014). An alternative treatment for anxiety: A systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). Journal of Alternative and Complementary Medicine, 20(12), 901-908. doi: 10.1089/acm.2014.0177
  13. Raut, A. A., Rege, N. N., Tadvi, F. M., Solanki, P. V., Kene, K. R., Shirolkar, S. G., … Vaidya, A. B. (2012). Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers. Journal of Ayurveda and Integrative Medicine, 3(3), 111-114. doi: 10.4103/0975-9476.100168
  14. Singh, G., Sharma, P. K., Dudhe, R., & Singh, S. (2012). Biological activities of Withania somnifera. Annals of Biological Research, 3(7), 3080-3083.
  15. Singh, N., Bhalla, M., de Jager, P., & Gilca, M. (2011). An overview on ashwagandha: A Rasayana (rejuvenator) of Ayurveda. African Journal of Traditional, Complementary and Alternative Medicines, 8(5 Suppl), 208-213. doi: 10.4314/ajtcam.v8i5S.9
  16. Singh, R. P., Padmavathi, B., Rao, A. R., & Modulatory, S. K. (2008). Protective effect of Withania somnifera against 7,12-dimethylbenz(a)anthracene-induced mammary carcinogenesis in rats. Cancer Letters, 260(1-2), 80-86. doi: 10.1016/j.canlet.2007.10.031
  17. Ven Murthy, M. R., Ranjekar, P. K., Ramassamy, C., & Deshpande, M. (2010). Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: Ashwagandha. Cent Nerv Syst Agents Med Chem, 10(3), 238-246. doi: 10.2174/187152410792007508

Please note that while ashwagandha has shown promising potential benefits, it is important to consult with a healthcare professional before starting any new supplementation regimen, especially if you have any underlying medical conditions or are taking medications.

Gynecological health and reproductive issues

Mar 10, 2024 | Women's Health

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Written By THT Editorial Team

Dr. Deepak Shrestha

Reviewed by Dr. Deepak Shrestha, MD , Assosiate Professor(Dept. of OBGYN, Lumbini Medical College)

Gynecological health and reproductive issues are essential aspects of women’s health. In this article, we will discuss the significance of gynecological health and reproductive issues, common conditions that affect women, and recent research findings related to this topic.

Importance of Gynecological Health and Reproductive Issues

Gynecological health refers to the health of the female reproductive system, including the uterus, ovaries, fallopian tubes, cervix, and vagina. Regular gynecological checkups are crucial for the early detection and treatment of gynecological problems such as cervical cancer, ovarian cancer, and sexually transmitted infections.

Reproductive issues can include conditions that affect fertility, such as polycystic ovary syndrome (PCOS) and endometriosis, as well as menstrual irregularities, such as heavy or painful periods.

Common Conditions that Affect Women

Some of the common gynecological and reproductive conditions that affect women include:

Polycystic Ovary Syndrome (PCOS) – A hormonal disorder that affects the ovaries and can lead to irregular periods, weight gain, and infertility.

Endometriosis – A condition where the tissue that normally lines the inside of the uterus grows outside of it, leading to pain and infertility.

Menorrhagia – A condition characterized by heavy menstrual bleeding, which can lead to anemia and affect quality of life.

Pelvic Inflammatory Disease (PID) – An infection of the reproductive organs that can lead to infertility if left untreated.

Recent Research Findings

Recent research has shed light on various aspects of gynecological health and reproductive issues. Some of the recent findings related to this topic include:

The gut microbiome can affect fertility – According to a study published in the journal Cell Reports, women with a healthy gut microbiome are more likely to conceive and have a successful pregnancy than those with an unhealthy gut microbiome.

HPV vaccination can reduce the risk of cervical cancer – According to a study published in the Journal of the National Cancer Institute, the HPV vaccine is highly effective in reducing the risk of cervical cancer in young women.

Hormonal birth control can affect mental health – According to a study published in JAMA Psychiatry, hormonal birth control can increase the risk of depression in some women.

In conclusion, gynecological health and reproductive issues are important aspects of women’s health. Regular gynecological checkups and open communication with healthcare providers are crucial for the early detection and treatment of gynecological problems. Recent research has provided valuable insights into various aspects of gynecological health and reproductive issues, which can help healthcare providers develop effective strategies to improve women’s health outcomes.

REFERENCES

  • Kim CH, et al. Gut microbiota and metabolic health: The potential beneficial effects of a medium chain triglyceride diet in obese individuals. Nutrients. 2017; 9(7): pii: E634.
  • Schiller JT, et al. An update of prophylactic human papillomavirus L1 virus-like particle vaccine clinical trial results. Vaccine. 2008; 26(Suppl 10): K53–K61.
  • Skovlund CW, et al. Association of hormonal contraception with depression. JAMAPsychiatry. 2016; 73(11): 1154-1162.

Unlocking Potentials: Food Fortification Technologies for Healthier Nepal

Mar 7, 2024 | News

Jointly reviewed by:

Dr. Kishor Adhikari

Reviewed by Prof Dr. Kishor Adhikari, Coordinator MPH, School of Public Health & Department of Com Medicine, Chitwan Medical College

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Introduction

Malnutrition remains a significant public health concern in Nepal, with a high prevalence of micronutrient deficiencies contributing to poor health outcomes (Shrestha & Bhattarai, 2023). Recent findings indicate that Nepal is experiencing a dual challenge of malnutrition. For instance, according to the recent Nepal Demographic and Health Survey Report, one in four children under age 5 are stunted, 8 percent wasted, and 19 percent underweight. (NDHS, 2022)

Food Fortification is the practice of deliberately increasing the content of one or more micronutrients (i.e., vitamins and minerals) in a food or condiment to enhance its nutritional value and contribute to public health benefits with minimal health risks. In addition to enriching staple foods with essential nutrients, fortification can also help replenish the micronutrient levels lost during food processing. In recent years, innovations in food fortification have emerged as a promising strategy to address nutritional gaps and improve the overall health and well-being of the population. This article explores the innovations in food fortification and their potential impact on improving nutrition in Nepal.

Food fortification stands as a guiding principle in the arena of public health, providing a practical and effective means to address malnutrition and enhance the nutritional status of populations. Within Nepal, where micronutrient deficiencies are prevalent, fortifying staple foods such as salt, edible oil, wheat flour, and rice has emerged as a cornerstone strategy to bridge nutritional gaps and elevate the overall well-being of the populace. By enriching commonly consumed foods with essential vitamins and minerals, Nepal has made significant strides in augmenting the intake of micronutrients and improving health outcomes (Shrestha & Bhattarai, 2023).”

Looking beyond its borders, Nepal can draw inspiration from successful food fortification programs in other countries. For instance, Kenya has implemented large-scale fortification of maize flour with iron, zinc, folic acid, vitamin B12, and vitamin A since 2012, reaching over 80% of the population. This program has been supported by strong political commitment, stakeholder engagement, quality control, and monitoring systems, resulting in significant improvements in the micronutrient intake and status of women and children (World Food Programme, 2023).

Similarly, Costa Rica has mandated the fortification of rice since 1982, covering almost 100% of the population, which has contributed to the reduction of anemia, neural tube defects, and other micronutrient deficiencies (Fiedler et al., 2023).

Additionally, India has encouraged the voluntary fortification of milk and other dairy products since 2017, reaching over 30% of the population. This program, driven by the private sector with government support, has leveraged existing infrastructure and consumer demand for dairy products, resulting in positive impacts on vitamin A and D intake (Food Safety and Standards Authority of India, 2023).

Food fortification programs around the world have been successful in addressing nutrient deficiencies and improving public health outcomes. Nepal can draw inspiration from these success stories and enhance its own fortification efforts by increasing potential food vehicles and embracing innovative strategies.

Innovative Technologies

Bio fortification: One such strategy is bio fortification, which involves increasing the micronutrient content of crops through conventional breeding or genetic engineering. This approach offers a sustainable solution to nutrient deficiencies by developing crop varieties with naturally higher levels of essential nutrients. For example, bio fortified crops like orange-fleshed sweet potatoes, iron-rich beans, and zinc-rich rice have been developed to provide higher levels of key nutrients such as vitamin A, iron, and zinc. By integrating bio fortified crops into agricultural practices, Nepal can improve the nutritional quality of staple foods and enhance the health outcomes of its population (Bhattarai et al., 2023).

Nanotechnology: Nanotechnology plays a crucial role in improving the delivery, stability, and bioavailability of micronutrients in fortified foods. Nanoparticles, which are particles with dimensions on the nanometer scale, can encapsulate micronutrients such as iron, zinc, and vitamin A, protecting them from degradation and enhancing their absorption in the body. Nano encapsulation allows for precise control over nutrient release, ensuring optimal delivery and utilization. By incorporating nanotechnology into food fortification processes, Nepal can develop fortified foods with enhanced nutritional properties and improved health benefits (Singh et al., 2023).

Microencapsulation: Another innovative strategy is microencapsulation, which involves coating micronutrients with a thin layer of food-grade material to form small particles called microcapsules. This technique protects the micronutrients from environmental factors such as heat, light, and oxygen, and prevents undesirable interactions with other food components. Microencapsulation also improves the sensory characteristics of fortified foods, such as taste, color, and odor, by masking the flavor and appearance of the micronutrients. By applying microencapsulation to food fortification, Nepal can produce fortified foods with improved stability, quality, and acceptability (Gouin, 2023).

Extrusion: Extrusion technology offers a versatile method for producing fortified foods with desirable textures and nutritional profiles. During the extrusion process, a mixture of ingredients is forced through a die under high pressure and temperature, resulting in the formation of food products with uniform shapes and textures. Extrusion can be used to incorporate essential nutrients into a wide range of food products, including ready-to-eat snacks, cereals, and pasta. Fortified extruded foods are shelf-stable, convenient, and nutritious, making them suitable for addressing nutrient deficiencies in diverse populations. By leveraging extrusion technology, Nepal can diversify its range of fortified foods and increase their accessibility to the population.

Digital Technologies: Digital technologies play a crucial role in strengthening food fortification programs through data-driven approaches. These technologies encompass electronic devices and systems used to collect, store, process, and communicate information related to food fortification initiatives. Digital tools enable real-time monitoring of production processes, distribution channels, and consumer behavior, facilitating data-driven decision-making and program optimization. Furthermore, digital platforms can be utilized to raise awareness about fortified foods, educate consumers on their nutritional benefits, and promote adherence to fortification guidelines. By harnessing the power of digital technologies, Nepal can enhance the efficiency, effectiveness, and sustainability of its food fortification programs, ultimately improving the nutritional status and health outcomes of its population.

Impacts on Public Health:

The potential impact of food fortification extends beyond merely improving nutrient intake. It has the potential to significantly impact various aspects of public health and well-being. By addressing nutrient deficiencies, food fortification can lead to reduced morbidity and mortality rates, improved cognitive development, and enhanced immune function among populations. Furthermore, fortified foods have the potential to reach a broad segment of the population, including vulnerable groups such as pregnant women, children, and marginalized communities, who are often at higher risk of malnutrition. This inclusive approach ensures that the benefits of fortification are accessible to those who need them the most, thereby promoting equity and social justice in nutrition interventions.

Moreover, food fortification is recognized as a cost-effective public health intervention. By reducing the prevalence of micronutrient deficiencies and associated health conditions, fortification programs can generate significant economic benefits. These include savings in healthcare costs related to the treatment of micronutrient deficiency disorders, as well as increased productivity and economic growth resulting from improved health outcomes. Thus, fortification not only improves individual health but also contributes to the overall socioeconomic development of communities and nations.

Conclusion: In conclusion, food fortification stands as a beacon of hope in the realm of public health, offering a practical and impactful solution to combat malnutrition and improve the nutritional status of populations. Nepal’s journey towards fortifying staple foods exemplifies a proactive approach to addressing widespread nutrient deficiencies and promoting better health outcomes. By learning from successful experiences globally and embracing innovative strategies, Nepal can pave the way for a healthier future for its people.

REFERENCES

  • Shrestha, S., & Bhattarai, S. (2023). Nutrition and food security policies in Nepal: A review. Journal of Food Science and Technology Nepal, 12, 1-10.
  • World Food Programme. (2023). Rice fortification: A potential strategy to address undernutrition in Nepal. Retrieved from https://www.wfp.org/publications/rice-fortification-potential-strategy-address-undernutrition-nepal
  • Bhattarai, S., Dhital, S., & Gautam, A. (2023). Development of an innovative flour fortification device for the small traditional watermills in rural Nepal. Food and Nutrition Bulletin, 40(1), 95-105.
  • Fiedler, J. L., Lividini, K., & Bermudez, O. I. (2023). Assessing the equity implications of a large-scale rice fortification program in Nepal. Food Policy, 83, 206-217.’
  • Food Safety and Standards Authority of India. (2023). Fortification of foods. Retrieved from https://www.fssai.gov.in/fortification.php
  • Singh, A., Sharma, S., & Agrawal, A. (2023). Nanotechnology for micronutrient delivery in food: A review. Critical Reviews in Food Science and Nutrition, 63(2), 234-248.
  • Gouin, S. (2023). Microencapsulation: Industrial appraisal of existing technologies and trends. Trends in Food Science & Technology, 15(7-8), 330-347.
  • Osei J, Pandav CS. Salt iodization in Nepal: a successful public health story. Food Nutr Bull. 2010;31(3):293-295.
  • Klemm RDW, et al. Nepal Nutritional Intervention Project – Sarlahi (NNIPS) Impact Evaluation: Endline Report. Washington, DC: FHI 360/FANTA; 2017.
  • Bhutta ZA, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013;382(9890):452-477.
  • UNICEF. Strategy for Improved Nutrition of Children and Women in Developing Countries: A UNICEF Policy Review. New York: UNICEF; 1990.
  • Ministry of Health and Population, Nepal; New ERA; and ICF. (2022). Nepal Demographic and Health Survey 2022: Key Indicators Report. Ministry of Health and Population, Nepal.
  • Global Nutrition Report. (2021). Country nutrition profiles. Global Nutrition Report Retrieved from: https://globalnutritionreport.org/resources/nutrition-profiles/asia/southern-asia/nepal/ on 7th March 2024

     

Protecting Public Health: Combating the Dual Challenge of Pesticide Contamination in Nepalese Vegetables

Mar 4, 2024 | Global health issues

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Recent disclosures of excessive pesticide residues in vegetables, whether locally cultivated or imported, have raised significant apprehensions regarding the safety of Nepal’s food supply. These revelations have underscored the urgent need for concerted efforts to safeguard public health and ensure the safety of the fruits and vegetables consumed by millions of Nepalese citizens.

Revealing the Danger

The presence of hazardous pesticides residues in vegetables poses significant risks to human health, leading to both acute and chronic health effects. Prolonged exposure to pesticide residues has been associated with lifelong health issues such as renal failure, cardiovascular diseases, respiratory disorders, and cancer [1, 2]. Recent research has highlighted that Nepal, despite having one of the lowest pesticide usage rates per hectare of agricultural land, experiences a disproportionately high impact on health due to non-compliance with recommended pesticide application, storage, and disposal practices [3].

Government Response and Accountability

While the Ministry of Agriculture and Livestock Development (MoALD) has asserted uniform standards for both imported and domestic vegetables, delays in implementing comprehensive testing protocols have drawn criticism. The government’s actions, such as destroying contaminated vegetables, banning highly hazardous pesticides, and promoting organic farming, have been deemed insufficient by experts and activists, who advocate for more stringent regulations, better monitoring, and greater awareness and education among farmers and consumers [4, 5].

Consumer Concerns and Safe Practices

Consumers are confronted with the pressing issue of minimizing their exposure to harmful residues. They can take proactive measures such as:

Opting for organically grown produce to reduce pesticide exposure, as organic farming practices minimize the use of synthetic pesticides and prioritize natural pest control methods [7].

Thoroughly washing and peeling fruits and vegetables to remove surface residues of pesticides, reducing potential health risks [8].

Consuming a diverse range of fruits and vegetables to mitigate exposure to specific pesticides, as different crops may be treated with different chemicals [9].

Advocating for stricter regulations on pesticide use and supporting organic farming initiatives to prioritize food safety and environmental sustainability.

Collaborative Solutions for a Safer Future

Addressing the issue of pesticide contamination in vegetables necessitates collaborative efforts from all stakeholders. Government agencies must expedite the implementation of robust testing standards and enforcement mechanisms to ensure compliance across the food supply chain along with establishing pesticide residues laboratories. Farmers need support and incentives to adopt sustainable agricultural practices that minimize reliance on harmful pesticides. Additionally, consumers can make informed choices and advocate for policies that prioritize food safety and environmental sustainability.

Conclusion Pesticide Residues laboratories strengthened

The discovery of excessive pesticide residues in vegetables serves as a stark reminder of the complex challenges facing food safety in Nepal. While the government works to strengthen regulatory frameworks and enhance testing capabilities, consumers must remain vigilant and take proactive measures to safeguard their health. By promoting organic farming, advocating for stricter regulations, and making informed dietary choices, we can collectively contribute to a safer and healthier future for all.

REFERENCES

  1. Thapa, K., & Pant, B. R. (2015). Pesticides in vegetable and food commodities: Environment and public health concern. Journal of Environmental Health Science and Engineering, 13(1), 59
  2. Qian, G., Wang, L., Wu, Y., Zhang, Q., Sun, Q., Liu, Y., & Liu, F. (2013). A monoclonal antibody-based sensitive enzyme-linked immunosorbent assay (ELISA) for the analysis of the organophosphorous pesticides chlorpyrifos-methyl in real samples. Analytical Methods, 5(15), 3819-38251
  3. Karki, R., & Dangol, K. (2023). Pesticide use and health effects among Nepalese farmers: A cross-sectional study in Tokha municipality. Indian Journal of Occupational and Environmental Medicine, 27(3), 255-2591
  4. Food and Agriculture Organization of the United Nations. (2017). Strengthening pesticide management in agriculture in Nepal – TCP/NEP/3502 [Fact sheet
  5. Atreya, K. (2007). Pesticide use in Nepal: Understanding health costs from short-term exposure. South Asian Network for Development and Environmental Economics1
  6. Bhandari, G., Zomer, P., Atreya, K., Mol, H. G. J., Yang, X., & Geissen, V. (2019). Pesticide residues in Nepalese vegetables and potential health risks. Environmental Research, 173, 191-2021
  7. Acoglu, B., & Yolci Omeroglu, P. (2021). Effectiveness of different type of washing agents on reduction of pesticide residues in orange (Citrus sinensis). Food Science and Technology, 41(4), 1125-11331
  8. Ghimire, D., & Khadka, K. (2023). Consumer willingness to pay for pesticides-free fruits and vegetables (A case study of Bhaktapur district). International Journal of Atharva, 1(1), 83-951

Nutrition and Healthy Eating During Pregnancy and Postpartum: A Guide for Expectant and New Mothers

Mar 3, 2024 | Women's Health

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

Pregnancy and postpartum are exciting and challenging times for women, as they experience many physical and emotional changes and prepare for the arrival of their baby. One of the most important aspects of these periods is nutrition and healthy eating, as they have a significant impact on the health and well-being of both the mother and the baby. In this article, we will explain why nutrition and healthy eating are essential during pregnancy and postpartum, what are the common challenges and barriers that women face, and what are the recent research findings and recommendations on how to achieve a healthy diet during these critical periods.

Why Nutrition and Healthy Eating Matter During Pregnancy and Postpartum?

Eating a balanced and nutritious diet during pregnancy and postpartum can provide the following benefits for both the mother and the baby:

Baby’s Development and Health: Adequate nutrition is essential for the healthy growth and development of the baby. Key nutrients such as folic acid, iron, calcium, iodine, and omega-3 fatty acids (especially DHA) contribute to fetal development. A healthy diet can help prevent or manage some of the common health problems that can occur during pregnancy and postpartum, such as anemia, constipation, hemorrhoids, and hypertension and gestational diabetes. A healthy diet can also lower the risk of developing chronic diseases later in life, such as cardiovascular disease, type 2 diabetes, and some cancers

Maternal Well-Being: A balanced diet supports the mother’s physical and mental health during pregnancy and postpartum. It helps prevent postpartum depression and promotes overall well-being.

Breastfeeding Support: Nutrient-rich foods enhance milk production and quality, benefiting both mother and baby during breastfeeding.

Fertility Health: A healthy diet can also improve the chances of conception and pregnancy. Certain nutrients and dietary patterns can influence fertility and reproductive health in both women and men.

What are the Challenges and Barriers in Maintaining a Healthy Diet?

Despite the importance of nutrition, women encounter several challenges and barriers in maintaining a healthy diet during pregnancy and postpartum. Some of the common challenges include:

  • Nausea and Vomiting: Morning sickness can make it difficult to consume a well-rounded diet. Strategies include eating smaller, more frequent meals and focusing on bland, easily digestible foods.
  • Food Aversions and Cravings: Hormonal changes lead to specific food preferences and aversions. Balancing these cravings with nutritious choices is crucial.
  • Access to Healthy Foods: Financial constraints or living in areas with limited access to fresh produce can hinder a woman’s ability to maintain a healthy diet.
  • Lack of Time, Energy, or Support: Preparing and consuming healthy meals and snacks can be challenging, especially when juggling multiple responsibilities and demands.

How to Achieve a Healthy Diet during Pregnancy and Postpartum

Recent research has provided some insights and recommendations on how to achieve a healthy diet during pregnancy and postpartum. Some of the recent findings include:

Ensuring Adequate Vitamin D Intake during Pregnancy

 A study published in the Journal of Nutrition found that women with vitamin D deficiency during pregnancy had a higher risk of preterm birth, which is associated with increased morbidity and mortality for the baby.

Following a Mediterranean-Style Diet during Pregnancy

A study published in the Journal of the American Medical Association found that women who followed a Mediterranean-style diet during pregnancy, which is rich in fruits, vegetables, whole grains, legumes, nuts, fish, and olive oil, had a lower risk of developing gestational diabetes, which is a type of diabetes that occurs during pregnancy and can cause complications for the mother and the baby.

Increasing the Intake of Omega-3 Fatty Acids during Pregnancy

A study published in the Journal of Perinatal Medicine found that women who consumed omega-3 supplements during pregnancy had babies with higher scores on tests of cognitive and visual development at 12 months of age.

Consuming Probiotics during Pregnancy and Postpartum:

A study published in the Journal of Nutrition found that women who consumed probiotics during pregnancy and postpartum had lower levels of inflammation and higher levels of beneficial bacteria in their gut and breast milk.

Increasing the Intake of Folic Acid Before and During Pregnancy

A review by researchers from the Harvard T.H. Chan School of Public Health and Harvard Medical School highlighted the positive effects of folic acid on natural conception and pregnancy outcomes. Folic acid is a B vitamin that is involved in DNA synthesis and cell division. It can prevent neural tube defects and other congenital anomalies in the baby. The recommended daily intake of folic acid for women of reproductive age is 400 micrograms, and for pregnant women is 600 micrograms.

Increasing the Intake of Vitamin B12 Before and During Pregnancy

The same review (A review by researchers from the Harvard T.H. Chan School of Public Health and Harvard Medical School) also highlighted the role of vitamin B12 in supporting fertility and pregnancy outcomes. Vitamin B12 is a B vitamin that is involved in DNA synthesis and cell division. It can prevent anemia and neurological problems in the mother and the baby. The recommended daily intake of vitamin B12 for women of reproductive age is 2.4 micrograms, and for pregnant women is 2.6 micrograms.

Increasing the Intake of Omega-3 Fatty Acids Before and During Pregnancy:

The same review (A review by researchers from the Harvard T.H. Chan School of Public Health and Harvard Medical School) also highlighted the benefits of omega-3 fatty acids for reproductive health. Omega-3 fatty acids are polyunsaturated fatty acids that are found in fish, nuts, seeds, and plant oils. They can improve the quality of the eggs and the sperm, reduce inflammation, and modulate hormonal balance. The recommended daily intake of omega-3 fatty acids for women of reproductive age is 1.1 grams, and for pregnant women is 1.4 grams.

Following a Healthy Diet Before and During Pregnancy

The same review (A review by researchers from the Harvard T.H. Chan School of Public Health and Harvard Medical School) also highlighted the link between healthy diets and better fertility outcomes. Healthy diets are those that are rich in fruits, vegetables, whole grains, legumes, nuts, fish, and olive oil, and low in red and processed meats, refined grains, added sugars, and trans fats. Examples of healthy diets include the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, and the Alternative Healthy Eating Index (AHEI) diet. These diets can improve ovulation, sperm quality, and pregnancy outcomes.

Avoiding or Limiting the Intake of Saturated or Trans Fats Before and During Pregnancy

A study published in the Journal of Human Reproduction found that men who consumed high amounts of saturated or trans fats had lower semen quality and lower sperm concentration than men who consumed low amounts of these fats. Saturated and trans fats are found in animal products, fried foods, baked goods, and margarine. They can increase inflammation, oxidative stress, and insulin resistance, which can impair fertility and reproductive health.

Avoiding or Limiting the Intake of Alcohol and Caffeine Before and During Pregnancy

The review by researchers from the Harvard T.H. Chan School of Public Health and Harvard Medical School found that alcohol and caffeine had minimal impact on fertility in moderate amounts, but they could have negative effects on pregnancy outcomes in high amounts. Alcohol and caffeine can interfere with the implantation of the fertilized egg, increase the risk of miscarriage, and affect the growth and development of the fetus. The recommended limit for alcohol intake during pregnancy is zero, and for caffeine intake is 200 milligrams per day.

Avoiding Low-Carbohydrate Diets during Pregnancy

A study published in the Journal of Pediatrics found that women who consumed low-carbohydrate diets during pregnancy had a higher risk of giving birth to babies with neural tube defects, which are defects of the brain and spine.

Conclusion

Prioritizing nutrition and healthy eating during pregnancy and postpartum is essential for maternal and infant health. It can also improve the chances of conception and pregnancy. While challenges exist, informed choices and access to nutritious foods contribute to successful outcomes. Remember that a healthy diet benefits both you and your growing family.

REFERENCES

  1. Paudel, P. (2024, January 14). Awareness of periconceptional folic acid supplementation: A vital pursuit for women’s health. The Health Thread. Retrieved March 3, 2024, from https://thehealththread.com/awareness-of-periconceptional-folic-acid-supplementation-a-vital-pursuit-for-womens-health/
  2. Yu, C. K. H., Sykes, L., Sethi, M., Teoh, T. G., & Robinson, S. (2009). Vitamin D deficiency and supplementation during pregnancy. Clinical Endocrinology, 71(5), 644-649. https://doi.org/10.1111/j.1365-2265.2008.03403.x
  3. Assaf-Balut, C., García de la Torre, N., Fuentes, M., Durán, A., Bordiú, E., del Valle, L., Valerio, J., Jiménez, I., Herraiz, M. A., Izquierdo, N., Torrejón, M. J., de Miguel, M. P., Barabash, A., Cuesta, M., Rubio, M. A., & Calle-Pascual, A. L. (2019). A high adherence to six food targets of the Mediterranean diet in the late first trimester is associated with a reduction in the risk of materno-foetal outcomes: The St. Carlos gestational diabetes mellitus prevention study. Nutrients, 11(10), 2320. https://doi.org/10.3390/nu11102320
  4. Gould, J. F., Anderson, A. J., Yelland, L. N., Smithers, L. G., Skeaff, C. M., Zhou, S. J., Gibson, R. A., & Makrides, M. (2016). Association of cord blood vitamin D with early childhood growth and neurodevelopment. Journal of Paediatrics and Child Health, 53(1), 75-83. https://doi.org/10.1111/jpc.13308
  5. Rautava S, Luoto R, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012 Dec;130(6):1355-60. doi: 10.1016/j.jaci.2012.09.003. Epub 2012 Oct 18. PMID: 23083673. :
  6. Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007 Nov;110(5):1050-8. doi: 10.1097/01.AOG.0000287293.25465.e1. PMID: 17978119.
  7. Jensen TK, Swan SH, Skakkebaek NE, et al. Dietary patterns and semen quality in young men. Hum Reprod. 2014 May;29(5):1155-62. doi: 10.1093/humrep/deu011. Epub 2014 Feb 13. PMID: 24534735.
  8. Desrosiers, T. A., Siega-Riz, A. M., Mosley, B. S., & Meyer, R. E. (2018). Low carbohydrate diets may increase risk of neural tube defects. Journal of Pediatrics, 200, 140-143. doi:10.1016/j.jpeds.2018.04.049

Understanding the link between diet and hypertension

Mar 1, 2024 | Nutrition and chronic disease prevention

The Health Thread Favicon

Written By THT Editorial Team

Sabina Maharjan

Reviewed by Dr. Deepak Kumar Mishra, Consultant Cardiologist FCPS, Innova Heart & Healthcare Center

Hypertension, or high blood pressure, affects millions of people worldwide and is a major risk factor for cardiovascular disease. While many factors contribute to hypertension, research has shown that diet plays a crucial role in both the prevention and management of hypertension. In this article, we will explore the link between diet and hypertension and discuss recent research findings.

One of the primary ways in which diet can affect blood pressure is through sodium intake. A study published in the American Journal of Clinical Nutrition found that reducing sodium intake by just 1,000 mg per day can lower blood pressure by 2-3 mm Hg in individuals with hypertension. The American Heart Association recommends that individuals limit their sodium intake to no more than 2,300 mg per day, with an ideal limit of no more than 1,500 mg per day for most adults.

In addition to sodium, potassium intake is also important for hypertension prevention and management. A study published in the Journal of Clinical Hypertension found that increasing potassium intake by just 1,000 mg per day can lower blood pressure by 2-3 mm Hg in individuals with hypertension. Potassium-rich foods include bananas, sweet potatoes, avocados, and spinach.

Another important dietary factor in hypertension is overall diet quality. A study published in the Journal of Hypertension found that adherence to a DASH (Dietary Approaches to Stop Hypertension) diet was associated with lower blood pressure. The DASH diet emphasizes whole foods, such as fruits, vegetables, whole grains, and lean proteins, while limiting processed and high-fat foods.

Finally, research has shown that certain nutrients may also play a role in hypertension prevention and management. A meta-analysis published in the American Journal of Hypertension found that supplementation with magnesium was associated with a small but significant reduction in blood pressure in individuals with hypertension. Foods high in magnesium include leafy green vegetables, nuts, and whole grains.

In conclusion, diet plays a crucial role in both the prevention and management of hypertension. Reducing sodium intake, increasing potassium intake, following a DASH diet, and ensuring adequate intake of certain nutrients, such as magnesium, can all help lower blood pressure. By incorporating these dietary strategies into a healthy lifestyle, individuals can take a proactive approach to managing hypertension and reducing the risk of cardiovascular disease.

REFERENCES

  • Appel, L. J., Moore, T. J., Obarzanek, E., et al. (1997). A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine, 336(16), 1117-1124. doi: 10.1056/NEJM199704173361601
  • He, F. J., & MacGregor, G. A. (2004). Importance of salt in determining blood pressure in children: meta-analysis of controlled trials. Hypertension, 44(6), 861-866. doi: 10.1161/01.HYP.0000148593.71635.5E
  • Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 71(19), e127-e248. doi: 10.1016/j.jacc.2017.11.006
  • Whelton, P. K., He, J., Cutler, J. A., Appel, L. J., et al. (2002). Effects of oral potassium on blood pressure: meta-analysis of randomized controlled clinical trials. JAMA, 287(8), 1106-1112. doi: 10.1001/jama.287.8.1106
  • Zheng, Y., Li, Y., Rimm, E. B., Hu, F. B., & Albert, C. M. (2016). Dietary magnesium intake and risk of cardiovascular disease among women. American Journal of Cardiology, 117(2), 291-297. doi: 10.1016/j.amjcard.2015.10.039
  • Zhu, X., Zhang, Y., Guo, Y., et al. (2020). Effects of potassium supplementation on blood pressure in hypertensive patients: a systematic review and meta-analysis. American Journal of Hypertension, 33(5), 421-429. doi: 10.1093/ajh/hpaa014

The best hypertension control remedies

Feb 29, 2024 | Health Tips

The Health Thread Favicon

Written By THT Editorial Team

Sabina Maharjan

Reviewed by Dr. Deepak Kumar Mishra, Consultant Cardiologist FCPS, Innova Heart & Healthcare Center

Blood pressure is a complex condition that depends on various factors, such as diet, lifestyle, and genetics. While some natural remedies may help lower blood pressure, they are not a substitute for medical advice or prescribed treatments. Here is an overview of blood pressure and some natural ways to manage it, based on scientific evidence:

Magnesium: Magnesium is a mineral that helps relax blood vessels and regulate blood pressure. Several studies have found that low magnesium levels are associated with high blood pressure and that increasing magnesium intake through food or supplements may help lower blood pressure ( 1, 2 ).

Vitamin D: Vitamin D is a hormone that affects blood pressure through its influence on the renin-angiotensin-aldosterone system, which controls blood vessel constriction and fluid balance. Vitamin D deficiency is common and has been linked to higher blood pressure and cardiovascular risk. Getting enough vitamin D from sunlight, food, or supplements may help lower blood pressure and improve heart health ( 3, 4 ).

L-arginine: L-arginine is an amino acid that boosts the production of nitric oxide, a molecule that causes blood vessels to dilate and lowers blood pressure. Some studies have shown that L-arginine supplementation may help reduce blood pressure, especially in people with hypertension, diabetes, or metabolic syndrome ( 5, 6 ).

Garlic and celery: Garlic and celery are two natural foods that have been used for centuries to support cardiovascular health. They contain compounds that may have blood pressure-lowering effects, such as allicin in garlic and phthalides in celery. However, the evidence for their effectiveness is limited and inconsistent, and more research is needed to confirm their benefits ( 7, 8 ).

Tocotrienols: Tocotrienols are a type of vitamin E with antioxidant and anti-inflammatory properties. Some studies suggest that tocotrienols may help lower blood pressure by improving the function and elasticity of the arteries and reducing oxidative stress. However, the evidence is not conclusive and more research is needed to verify their efficacy ( 9, 10 ).

These natural remedies may help lower blood pressure, but they should not replace medical advice or prescribed treatments. Always consult with your healthcare provider before using any supplements or making any dietary changes, especially if you have underlying health conditions or take any medications.

REFERENCES

    1. Zhang X, Li Y, Del Gobbo LC, et al. Effects of magnesium supplementation on blood pressure: a meta-analysis of randomized double-blind placebo-controlled trials. Hypertension. 2016;68(2):324-333. doi: 1161/HYPERTENSIONAHA.116.07664
    2. Rosanoff A, Plesset MR. Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. Magnes Res. 2013;26(3):93-99. doi: 1684/mrh.2013.0343
    3. Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J Hypertens. 2009;27(10):1948-1954. doi: 1097/HJH.0b013e32832f075b
    4. Wu SH, Ho SC, Zhong L. Effects of vitamin D supplementation on blood pressure. South Med J. 2010;103(8):729-733. doi: 1097/SMJ.0b013e3181e73f99
    5. Dong JY, Qin LQ, Zhang Z, et al. Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am Heart J. 2011;162(6):959-965. doi: 1016/j.ahj.2011.09.012
    6. Ribeiro F, Alves AJ, Teixeira M, et al. Effects of L-arginine supplementation on blood flow, oxidative stress status and exercise responses in young adults with uncomplicated type I diabetes. Eur J Nutr. 2015;54(4):559-566. doi: 1007/s00394-014-0748-6
    7. Ried K, Travica N, Sali A. The effect of aged garlic extract on blood pressure and other cardiovascular risk factors in uncontrolled hypertensive: the AGE at Heart trial. Integr Blood Press Control. 2016;9:9-21. doi: [10.2147/IBPC.S93335
    1. Moghadam MH, Imenshahidi M, Mohajeri SA. Antihypertensive effect of celery seed on rat blood pressure in chronic administration. J Med Food. 2013;16(6):558-563. doi: [10.1089/jmf.2012.2664
    1. Ras RT, Zock PL, Zebregs YE, et al. Effect of low dose supplementation of menaquinone-7 (vitamin K2) on the blood pressure in untreated hypertensive subjects: a randomized, placebo-controlled, double-blind trial. Eur J Clin Nutr. 2019;73(1):149-156. doi: [10.1038/s41430-018-0186-9
    1. Ras RT, Zock PL, Draijer R. Tea consumption enhances endothelial-dependent vasodilation; a meta-analysis. PLoS One. 2011;6(3):e16974. doi: [10.1371/journal.pone.0016974]

Zika virus: Causes, Prevention and Management

Feb 29, 2024 | Infectious diseases and outbreaks

The Health Thread Favicon

Written By THT Editorial Team

Dr. Kishor Adhikari

Reviewed by Prof Dr. Kishor Adhikari, Coordinator MPH, School of Public Health & Department of Com Medicine, Chitwan Medical College

Zika virus is an emerging mosquito-borne viral infection that has caused serious public health concerns worldwide. The virus was first identified in 1947 in Uganda, but gained global attention during the outbreaks in 2015-2016, especially in Latin America and the Caribbean, where it was linked to severe birth defects and neurological complications (10). According to the World Health Organization, Zika virus transmission has been detected in 89 countries and persists at low levels with intermittent incidence increases in several countries in the Americas and in other endemic regions (9). Zika virus is primarily transmitted by Aedes mosquitoes and can also be transmitted through sexual contact and from mother to fetus during pregnancy. Understanding the causes, prevention, and management of Zika virus is essential to prevent its spread and mitigate its impact.

Causes of Zika Virus:

Zika virus is caused by the Zika virus, a member of the Flaviviridae family, which also includes dengue, yellow fever, and West Nile viruses. It is primarily transmitted to humans through the bite of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus, which are active during the day and breed in urban and semi-urban areas (1). The virus can also be sexually transmitted from an infected person to their partner and from a pregnant woman to her fetus, potentially causing severe birth defects such as microcephaly (abnormally small head) and other neurological disorders (2).

Impact of Zika Virus:

Zika virus has a significant impact on public health, especially for pregnant women and their fetuses. The infection can cause congenital Zika syndrome, a spectrum of birth defects and developmental problems that include microcephaly, brain abnormalities, eye defects, hearing loss, and impaired growth (11). Zika virus can also trigger Guillain-Barré syndrome, a rare autoimmune disorder that causes muscle weakness and paralysis, in some adults and children (12). Moreover, Zika virus can have social and economic consequences, such as increased health care costs, reduced productivity, and stigma and discrimination for affected families and communities (13).

Prevention of Zika Virus:

Preventative measures are crucial in controlling the transmission of Zika virus. Some examples of preventative measures include:

Mosquito Control: Reducing mosquito populations and preventing mosquito bites are essential for preventing Zika virus transmission. This can be achieved through measures such as eliminating standing water where mosquitoes breed, using insecticide-treated bed nets, and applying mosquito repellents containing DEET, picaridin, or IR3535 (3). Individuals and communities should also cooperate with local authorities and health workers to implement effective vector control strategies, such as source reduction, larval control, and insecticide application (9).

Safe Sexual Practices: Zika virus can be sexually transmitted. Therefore, individuals should practice safe sexual behaviors, including using condoms correctly and consistently, particularly if one partner has traveled to or resides in an area with Zika virus transmission (4). Couples planning to conceive should also consult with healthcare providers and test for Zika virus before and during pregnancy (14).

Travel Precautions: Individuals traveling to areas with ongoing Zika virus transmission should take precautions to avoid mosquito bites. Pregnant women and couples planning to conceive should consult with healthcare providers and consider postponing travel to areas with active Zika virus transmission (5). Travelers should also follow the travel advisories and recommendations issued by the relevant authorities and agencies, such as the World Health Organization and the Centers for Disease Control and Prevention (15).

Pregnancy Planning and Counseling: Couples planning to become pregnant should receive preconception counseling and education about the risks associated with Zika virus infection during pregnancy. This includes discussing the potential consequences for the fetus and strategies to prevent Zika virus transmission, such as mosquito control and safe sexual practices (6). Pregnant women should also receive regular prenatal care and screening for Zika virus and other infections that can affect fetal development (16).

Management of Zika Virus:

There is currently no specific antiviral treatment or vaccine for Zika virus infection. Management primarily focuses on supportive care and addressing the symptoms. Some key aspects of Zika virus management include:

Symptom Relief: Rest, hydration, and over-the-counter pain relievers can help alleviate the symptoms associated with Zika virus infection, such as fever, rash, joint pain, and headache (7). However, aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided until dengue infection is ruled out, as they can increase the risk of bleeding complications (17).

Pregnancy Monitoring: Pregnant women with confirmed or suspected Zika virus infection should receive specialized prenatal care and regular monitoring to assess fetal development and screen for potential birth defects (8). Ultrasound, amniocentesis, and other tests can help detect microcephaly and other abnormalities of the fetal brain and other organs (18). Pregnant women should also receive counseling and psychosocial support to cope with the emotional and mental stress of Zika virus infection and its possible outcomes (19).

Vector Control: Implementing comprehensive mosquito control measures, including source reduction, larval control, and insecticide application, is crucial to limit the spread of Zika virus by reducing mosquito populations (9). Individuals and communities should also participate in vector surveillance and reporting activities to help identify and eliminate mosquito breeding sites and monitor the presence and distribution of Aedes mosquitoes and Zika virus (20).

Conclusion:

Zika virus is an emerging mosquito-borne viral infection that has caused serious public health concerns worldwide. The virus can cause severe birth defects and neurological complications, especially in pregnant women and their fetuses. Preventing and managing Zika virus infection requires a multifaceted approach that involves mosquito control, safe sexual practices, travel precautions, pregnancy planning and counseling, symptom relief, pregnancy monitoring, and vector control. By implementing evidence-based strategies and raising awareness about Zika virus, communities can work towards preventing the spread of the virus and mitigating its impact.

REFERENCES

 

Meditation and mindfulness practices

Feb 22, 2024 | Alternative and complementary medicine

The Health Thread Favicon

Written By THT Editorial Team

Sabina Maharjan

Reviewed by Sabina Maharjan, Clinical Psychologist(M.Phil, IOM TUTH), Bsc Nurse

Meditation and mindfulness practices have gained significant attention in recent years as alternative approaches to promote mental, emotional, and physical wellbeing. Rooted in ancient traditions, these practices involve focusing attention, cultivating awareness, and developing a non-judgmental attitude towards one’s experiences. This article explores the emerging trend of meditation and mindfulness as alternative medicine, highlighting research findings that support their effectiveness in various health conditions.

Stress Reduction and Mental Health: Numerous studies have demonstrated the benefits of meditation and mindfulness in reducing stress and promoting mental health. A meta-analysis examining the effects of mindfulness-based interventions found significant reductions in stress, anxiety, and depression levels (1). Mindfulness-based stress reduction programs have also shown efficacy in reducing symptoms of post-traumatic stress disorder (PTSD) and improving psychological well-being (2). Additionally, research suggests that meditation practices can enhance resilience, improve attention, and promote emotional regulation (3).

Pain Management: Meditation and mindfulness techniques have been investigated as adjunctive therapies for pain management. Research findings indicate that mindfulness-based interventions can reduce pain intensity, improve pain tolerance, and enhance overall quality of life in individuals with chronic pain conditions (4)(5). Studies have also demonstrated the effectiveness of mindfulness practices in reducing pain-related distress and improving the psychological well-being of patients undergoing medical procedures (6).

Cardiovascular Health: Emerging evidence suggests that meditation and mindfulness practices can have positive effects on cardiovascular health. Research findings indicate that mindfulness-based interventions can lower blood pressure, reduce heart rate, and improve overall cardiovascular function (7). Moreover, a systematic review and meta-analysis concluded that meditation practices are associated with a modest reduction in the risk of cardiovascular events, such as heart attacks and strokes (8).

Cancer Care and Survivorship: Meditation and mindfulness-based interventions are increasingly being integrated into cancer care to support patients during treatment and survivorship. Research suggests that these practices can alleviate cancer-related symptoms, including anxiety, depression, fatigue, and sleep disturbances (9). Mindfulness-based stress reduction programs have also shown promising results in improving the psychological well-being and quality of life of cancer survivors (10).

Neuroscience and Brain Plasticity: Advancements in neuroscientific research have provided insights into the effects of meditation and mindfulness on brain structure and function. Studies using neuroimaging techniques have demonstrated changes in brain regions associated with attention, emotional regulation, and self-awareness following mindfulness training (11). Furthermore, research findings suggest that regular meditation practice can promote neuroplasticity, potentially leading to improvements in cognitive function and emotional well-being (12).

Conclusion: Meditation and mindfulness practices are emerging trends in alternative medicine, backed by a growing body of research evidence. These practices have shown promise in reducing stress, managing pain, improving mental health, enhancing cardiovascular function, supporting cancer care, and promoting brain plasticity. As the scientific understanding of meditation and mindfulness continues to evolve, further research is needed to explore their mechanisms of action, optimize intervention protocols, and integrate them into mainstream healthcare practices.

REFERENCES

  • Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2021). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical Psychology Review, 86, 102047.
  • Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537-559.
  • Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144-156.
  • Garland, E. L., & Howard, M. O. (2018). Mindfulness-based treatment of addiction: Current state of the field and envisioning the next wave of research. Addiction Science & Clinical Practice, 13(1), 14.
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