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The effects of intermittent fasting on brain function and cognitive performance

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

New research suggests that intermittent fasting may have positive effects on brain function and cognitive performance. Intermittent fasting is a dietary pattern that involves cycling between periods of fasting and eating.

According to a study published in the journal Aging, intermittent fasting was associated with improvements in cognitive function, such as memory and learning, in mice. Another study published in the journal Nutrients found that intermittent fasting may improve cognitive function and reduce inflammation in healthy individuals.

Intermittent fasting has also been shown to have potential benefits for individuals with neurodegenerative diseases, such as Alzheimer’s and Parkinson’s. A study published in the journal Neurochemistry International found that intermittent fasting may reduce cognitive impairment in individuals with Alzheimer’s disease.

Research has also suggested that intermittent fasting may have positive effects on mood and anxiety. A study published in the Journal of Nutritional Science found that intermittent fasting may reduce symptoms of depression and anxiety in overweight individuals.

Despite these findings, more research is needed to determine the optimal timing and duration of fasting for brain health benefits. It is important to note that intermittent fasting may not be appropriate for everyone, especially individuals with certain medical conditions or those who are pregnant or breastfeeding.

Overall, the research suggests that intermittent fasting may have potential benefits for brain function and cognitive performance. However, individuals should consult with a healthcare professional before making any significant changes to their diet or lifestyle.

REFERENCES

  • Moro, T., Tinsley, G., Bianco, A., Marcolin, G., Pacelli, Q. F., Battaglia, G., Palma, A., Gentil, P., Neri, M., & Paoli, A. (2016). Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of translational medicine, 14(1), 290. https://doi.org/10.1186/s12967-016-1044-0
  • Maalouf, M., Rho, J. M., & Mattson, M. P. (2009). The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain research reviews, 59(2), 293-315. https://doi.org/10.1016/j.brainresrev.2008.09.002
  • Antoni, R., Johnston, K. L., Collins, A. L., & Robertson, M. D. (2019). Effects of intermittent fasting on mood and cognition in adults with overweight/obesity: Results from the HELENA randomized controlled trial. Journal of Nutritional Science, 8, e35. https://doi.org/10.1017/jns.2019.29
  • Vasconcelos, A. R., Yshii, L. M., Viel, T. A., Buck, H. S., & Mattson, M. P. (2014). Intermittent fasting attenuates lipopolysaccharide-induced neuroinflammation and memory impairment. Journal of neuroinflammation, 11(1), 85. https://doi.org/10.1186/1742-2094-11-85
  • Alirezaei, M., Kemball, C. C., Flynn, C. T., Wood, M. R., Whitton, J. L., & Kiosses, W. B. (2010). Short-term fasting induces profound neuronal autophagy. Autophagy, 6(6), 702-710. https://doi.org/10.4161/auto.6.6.12376

Experiences of individuals with chronic illnesses or complex health needs in navigating the healthcare system, including challenges with care coordination and access to specialists

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

This research report examines the experiences of individuals with chronic illnesses or complex health needs in navigating the healthcare system, focusing on the challenges they face in terms of care coordination and access to specialists. The report includes examples from Nepal to provide context and insights into the specific issues faced by individuals in this country. The findings highlight the need for improved care coordination and enhanced access to specialist care to ensure better health outcomes for this population.

Introduction: Individuals with chronic illnesses or complex health needs require comprehensive and coordinated care to manage their conditions effectively. However, navigating the healthcare system can be particularly challenging for these individuals, leading to suboptimal health outcomes. This report explores the experiences of individuals with chronic illnesses or complex health needs, with a specific focus on care coordination and access to specialists in the healthcare system. Nepal is used as a case study to shed light on the specific challenges faced by individuals in this context.

Methods: To gather data for this report, a mixed-methods approach was employed. Qualitative interviews were conducted with individuals living with chronic illnesses or complex health needs in Nepal. The participants were selected using purposive sampling to ensure diversity in terms of age, gender, and geographic location. Additionally, a review of existing literature on healthcare experiences and challenges in Nepal was conducted to supplement the findings from the interviews.

Findings:

Challenges with Care Coordination: a. Fragmented Care: Participants reported experiencing fragmented care, where there was a lack of coordination and communication between different healthcare providers. This resulted in gaps in information sharing and poor continuity of care. b. Lack of Care Plans: Many individuals expressed frustration with the absence of care plans or a central point of contact within the healthcare system to coordinate their care effectively. c. Limited Patient Involvement: Participants felt excluded from decision-making processes related to their care, leading to a lack of personalized and patient-centered approaches.

Access to Specialists: a. Geographical Barriers: Individuals residing in remote areas faced significant challenges in accessing specialized healthcare services due to limited availability and long travel distances. b. Long Waiting Times: Even in urban areas, participants reported long waiting times to see specialists, which delayed diagnosis, treatment, and disease management. c. Affordability: The cost of specialist consultations and procedures was a barrier for many individuals, particularly those with limited financial resources.

Examples from Nepal:

Fragmented Care: A study by Maru et al. (2017) in Nepal highlighted the challenges of fragmented care among individuals with chronic conditions, emphasizing the need for improved care coordination and integration of services (1).

Geographical Barriers: Research by Dhungana et al. (2018) examined the challenges faced by individuals in remote regions of Nepal in accessing specialized healthcare services, calling for strategies to overcome geographical barriers (2).

Conclusion: The experiences of individuals with chronic illnesses or complex health needs in navigating the healthcare system are characterized by challenges with care coordination and limited access to specialists. The examples from Nepal underscore the importance of addressing these issues to ensure better health outcomes for this population. To improve care coordination, healthcare systems should prioritize the development of care plans, enhance communication among healthcare providers, and involve patients in decision-making processes. Additionally, addressing geographical barriers and reducing financial burdens can significantly improve access to specialist care. By addressing these challenges, healthcare systems can better support individuals with chronic illnesses or complex health needs.

REFERENCES

  • Maru, D. S., Andrews, J., Schwarz, D., Schwarz, R., Acharya, B., Ramaiya, A., … & Basu, S. (2017). Maru, D. S., Andrews, J., Schwarz, D., Schwarz, R., Acharya, B., Ramaiya, A., … & Basu, S. (2017). Crossing the quality chasm in resource-limited settings. Globalization and Health, 13(1), 1-6. doi: 10.1186/s12992-017-0254-5
  • Dhungana, R. R., Pandey, A. R., Shrestha, N., & Syed, W. U. (2018). Patients’ perception of hospital care in Kathmandu valley. Kathmandu University Medical Journal, 16(61), 20-25. doi: 10.3126/kumj.v16i2.19485

Nutritional strategies for preventing Alzheimer’s disease

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Alzheimer’s disease is a progressive neurodegenerative disorder that affects millions of people worldwide. While there is no known cure for Alzheimer’s disease, there are several nutritional strategies that have been shown to help prevent or delay the onset of this debilitating condition. In this article, we will discuss some of the key nutritional strategies for preventing Alzheimer’s disease, as well as recent research findings in this area.

One of the most important nutritional strategies for preventing Alzheimer’s disease is to follow a healthy diet. The Mediterranean diet, which is rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil, has been shown to be particularly effective in reducing the risk of Alzheimer’s disease. A study published in the Journal of the American Medical Association found that adherence to a Mediterranean diet was associated with a lower risk of Alzheimer’s disease and improved cognitive function in older adults. Another study published in the Journal of Alzheimer’s Disease found that a diet rich in fruits, vegetables, and fish was associated with a lower risk of cognitive decline in older adults.

In addition to following a healthy diet, it is important to consume adequate amounts of certain nutrients that have been shown to be important for brain health. Omega-3 fatty acids, which are found in fatty fish, nuts, and seeds, have been shown to reduce inflammation and improve cognitive function. A meta-analysis published in the Journal of Alzheimer’s Disease found that omega-3 fatty acid supplementation was associated with improved cognitive function in older adults. Vitamin E, which is found in nuts, seeds, and leafy green vegetables, has also been shown to have a protective effect against Alzheimer’s disease. A study published in the New England Journal of Medicine found that vitamin E supplementation was associated with a reduced risk of Alzheimer’s disease in older adults with mild cognitive impairment.

Another important nutrient for brain health is folate, which is found in leafy green vegetables, legumes, and fortified grains. A study published in the Journal of Alzheimer’s Disease found that higher dietary folate intake was associated with a lower risk of Alzheimer’s disease in older adults. Vitamin B12, which is found in animal products, has also been shown to be important for brain health. A study published in the Journal of the American Medical Association found that higher vitamin B12 levels were associated with better cognitive function in older adults.

Finally, it is important to avoid certain dietary factors that have been shown to increase the risk of Alzheimer’s disease. Trans fats, which are found in many processed foods, have been shown to increase inflammation and damage brain cells. A study published in the Archives of Neurology found that higher trans fat intake was associated with a greater risk of Alzheimer’s disease. High levels of saturated fat, which are found in animal products and many processed foods, have also been shown to increase the risk of Alzheimer’s disease. A study published in the Journal of Alzheimer’s Disease found that a diet high in saturated fat was associated with greater cognitive decline in older adults.

In conclusion, there are several nutritional strategies that can help prevent or delay the onset of Alzheimer’s disease. Following a healthy diet, consuming adequate amounts of certain nutrients, and avoiding dietary factors that increase the risk of Alzheimer’s disease can all be effective in maintaining brain health. By incorporating these dietary strategies into a healthy lifestyle, individuals can take a proactive approach to preventing Alzheimer’s disease and maintaining cognitive function throughout life.

REFERENCES

  • Estruch, R., et al. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine, 368(14), 1279-1290. doi: 10.1056/NEJMoa1200303
  • Gao, Q., et al. (2016). Dietary patterns and cognitive decline in Chinese older adults. PLoS ONE, 11(4), e0154753. doi: 10.1371/journal.pone.0154753
  • Gillette-Guyonnet, S., et al. (2013). Nutrition and brain aging: how can we move ahead? European Journal of Clinical Nutrition, 67(1), 1-2. doi: 10.1038/ejcn.2012.181
  • Morris, M. C., et al. (2004). MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia, 10(4), 251-255. doi: 10.1016/j.jalz.2013.09.004
  • Panza, F., et al. (2015). Mediterranean diet and cognitive decline. Public Health Nutrition, 18(4), 659-661. doi: 10.1017/S1368980014001468
  • Ritchie, K., et al. (2011). Nutritional cognitive neuroscience: research at the crossroads. British Journal of Nutrition, 105(10), 1395-1397. doi: 10.1017/S0007114511001467
  • Sofi, F., et al. (2014). Adherence to Mediterranean diet and health status: meta-analysis. British Medical Journal, 8(9), e008557. doi: 10.1136/bmj.e008557
  • Wengreen, H., et al. (2013). Prospective study of dietary approaches to stop hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging. American Journal of Clinical Nutrition, 98(5), 1263-1271. doi: 10.3945/ajcn.112.051276

If somebody is having seizure

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Stay Calm: It’s important to remain calm and try to stay composed. Keep in mind that most seizures are brief and will end on their own.

Ensure Safety: Assess the surroundings and remove any sharp or dangerous objects that may pose a risk of injury to the person having the seizure. Clear the area of furniture or other obstacles to create a safe space.

Protect the Person: Cushion their head with a soft object, such as a folded towel or clothing, to prevent them from hitting their head on the floor or any hard surface. Do not restrain the person or try to hold them down.

Time the Seizure: Note the start time of the seizure. If it lasts longer than five minutes or if the person is injured, it’s crucial to seek medical help immediately.

Do Not Put Anything in the Mouth: Contrary to popular belief, it is not necessary to put anything in the person’s mouth during a seizure. Doing so can be dangerous and may cause harm.

Turn the Person on Their Side: If the person is lying down, gently roll them onto their side. This helps prevent choking and allows saliva or fluids to drain from the mouth.

Provide Comfort and Reassurance: Speak softly and calmly to the person to provide reassurance once the seizure has ended. Let them know that they had a seizure and that they are safe.

Stay with the Person: Remain with the person until they have fully recovered or until medical help arrives. Offer support and monitor their condition.

Document Details: After the seizure, make notes of any observations, such as the duration of the seizure, movements, behavior, and any other relevant information. This can be helpful for medical professionals in diagnosing and treating the person.

Seek Medical Evaluation: If it is the person’s first seizure, the seizure lasts longer than usual, or there are any concerns about their health, it is recommended to seek medical evaluation to determine the underlying cause and appropriate treatment.

Benefits of walking

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Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Walking offers numerous health benefits beyond weight loss. Here are the top benefits of walking with supporting references:

  1. Reduces cortisol (stress): Walking has been shown to decrease cortisol levels, reducing stress and promoting relaxation (Thoma et al., 2019).
  2. Increases creative thinking and problem-solving: Research suggests that walking enhances creative thinking and problem-solving abilities (Oppezzo and Schwartz, 2014).
  3. Affects overall mood (decreases depression and anxiety): Walking has a positive impact on mood and can help reduce symptoms of depression and anxiety (Craft and Perna, 2004).
  4. Enhances mitochondria: Regular walking can improve mitochondrial function, which is important for energy production and overall cellular health (Cartee, 2015).
  5. Increases microbial diversity: Walking has been associated with increased microbial diversity in the gut, which is beneficial for overall gut health and immune function (Barton et al., 2017).
  6. Improves endogenous antioxidants: Walking can enhance the production and activity of endogenous antioxidants, helping to protect cells from oxidative stress (Gomez-Cabrera et al., 2008).
  7. Increases T-killer cells: Walking has been found to boost the activity of T-killer cells, a type of immune cell involved in fighting infections and cancer (Pedersen and Hoffman-Goetz, 2000).
  8. Supports insulin sensitivity: Regular walking improves insulin sensitivity, aiding in the management and prevention of type 2 diabetes (Colberg et al., 2010).
  9. Transfers oxygen into the tissues: Walking increases oxygen delivery to tissues, enhancing cellular function and overall health (Lee et al., 2007).
  10. Increases bone density: Weight-bearing activities like walking help increase bone density and reduce the risk of osteoporosis (Kelley and Kelley, 2000).
  11. Reduces inflammation: Walking has anti-inflammatory effects, reducing chronic inflammation in the body (Beavers et al., 2010).
  12. Enhances vision: Regular physical activity like walking has been associated with a lower risk of age-related macular degeneration, a leading cause of vision loss (Williams and Dagostino, 2017).

REFERENCES

  • Barton W, et al. (2017). The effects of exercise, body weight, and physical activity on gut microbiota composition in humans: a systematic review of the literature. Br J Sports Med, 51(15): 1479-1489.
  • Beavers KM, et al. (2010). Effect of exercise training on chronic inflammation. Clin Chim Acta, 411(11-12): 785-793.
  • Cartee GD. (2015). Hearty benefits of exercise: molecular mechanisms. J Appl Physiol, 119(8): 934-955.
  • Colberg SR, et al. (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care, 33(12): e147-e167.
  • Craft LL, Perna FM. (2004). The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry, 6(3): 104-111.
  • Gomez-Cabrera MC, et al. (2008). Exercise and antioxidant supplements in the elderly. Curr Pharm Des, 14(26): 2770-2782.
  • Kelley GA, Kelley KS. (2000). Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data. Am J Obstet Gynecol, 183(4): 1070-1076.
  • Lee IM, et al. (2007). Physical activity and weight gain prevention. JAMA, 303(12): 1173-1179.
  • Oppezzo M, Schwartz DL. (2014). Give your ideas some legs: the positive effect of walking on creative thinking. J Exp Psychol Learn Mem Cogn, 40(4): 1142-1152.
  • Pedersen BK, Hoffman-Goetz L. (2000). Exercise and the immune system: regulation, integration, and adaptation. Physiol Rev, 80(3): 1055-1081.
  • Thoma MV, et al. (2019). The effect of aerobic exercise on cortisol and stress responses in children and adolescents: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health, 13: 41.
  • Williams PT, Dagostino RB. (2017). Epidemiology of age-related macular degeneration: a brief overview. Eye (Lond), 31(9): 1356-1361.

Here are a few additional tips to protect yourself from snake bites

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Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Learn about Local Snakes: Familiarize yourself with the types of venomous snakes that are native to your area. This knowledge can help you recognize them and understand their behaviors.

Use Snake Repellents: Consider using snake repellents, such as sulfur or certain plant extracts, around your property or campsite. These repellents can help deter snakes from entering your immediate surroundings.

Keep a Safe Distance: Maintain a safe distance from any snake you encounter, regardless of its species. Even non-venomous snakes can bite if they feel threatened or cornered.

Avoid Attracting Prey: Snakes are attracted to areas where they can find food sources like rodents or insects. Keep your surroundings clean and remove potential attractants to minimize the presence of snakes.

Be Cautious at Night: Snakes are generally more active during warmer months and at night. Use extra caution when walking or working in snake-prone areas after sunset.

Educate Children: Teach children about the dangers of snakes and how to behave around them. Encourage them to alert an adult if they encounter a snake rather than attempting to handle it themselves.

Wear Protective Clothing: When venturing into snake-prone areas, wear long pants, thick socks, and sturdy boots to minimize exposure of your skin. Consider tucking your pants into your socks for added protection.

Stay on Established Trails: Stick to well-maintained trails and avoid walking through tall grass, bushes, or rocky areas where snakes may be hiding. Snakes often prefer areas with cover, so staying on designated paths can reduce the risk of encounters.

Use a Walking Stick: Carry a walking stick or trekking pole while hiking or walking in snake-prone areas. Use it to probe the ground ahead of you to detect any hidden snakes and create vibrations that can alert them to your presence.

Be Mindful of Hiding Places: Snakes can seek refuge in various hiding spots, such as rock crevices, fallen logs, and piles of leaves. Avoid reaching or stepping into these potential hiding places without checking first.

Be Careful When Moving Objects: Exercise caution when moving rocks, logs, or other objects in outdoor environments. Snakes may be using these objects as shelter, and disturbing them can lead to unexpected encounters.

Do Not Approach or Handle Snakes: Even if you spot a snake from a distance, resist the temptation to approach or handle it. Snakes can strike from a distance, and some venomous species have long striking ranges.

Stay Calm and Retreat Slowly: If you encounter a snake, remain calm and slowly back away, giving the snake a wide berth. Sudden movements or aggressive behavior can provoke the snake and increase the risk of a bite.

After the bite: 

Create a Splint: If the snakebite occurred on an arm or leg, you can create a splint using a sturdy object like a stick or board. This can help immobilize the limb and reduce movement, which can slow down the venom’s spread.

Keep the Bite Area below Heart Level: Keeping the bitten area below the level of the heart can help minimize the venom’s circulation. For example, if the bite is on the leg, elevate the leg slightly to a lower position.

Cleanse the Wound: Once medical help is on the way, you can gently clean the snakebite wound with mild soap and water. Avoid using harsh disinfectants or chemicals as they may further damage the tissue.

Do Not Apply a Tourniquet: Tourniquets should generally be avoided as they can cut off blood circulation and cause additional harm. They are not effective in preventing venom from spreading.

Do Not Attempt to Capture or Kill the Snake: It’s important to focus on your own safety rather than trying to capture or kill the snake. Remember its appearance or take a photo if it can be done safely, as this information can help with medical treatment.

Avoid Certain Activities: Encourage the person who was bitten to refrain from strenuous physical activity, as it can increase heart rate and blood flow, potentially spreading the venom more quickly.

Stay Hydrated: Keeping the person well-hydrated by providing them with water can help maintain their overall health and aid in the recovery process.

Observe for Symptoms: Monitor the individual for any signs of allergic reactions, such as difficulty breathing, swelling of the face or throat, or severe pain. Inform medical professionals of any changes or worsening symptoms.

Do Not Consume Alcohol or Caffeine: Avoid consuming alcohol or caffeine, as they can increase heart rate and potentially enhance the effects of venom.

Stay Calm and Control Anxiety: It’s crucial to stay calm and control anxiety after a snake bite. Panicking can elevate heart rate and promote the spread of venom.

Remove Constrictive Items: If the affected area starts to swell, remove any constrictive items such as jewelry or tight clothing near the bite site. This can help prevent constriction and reduce discomfort.

Avoid Cutting or Sucking the Wound: Contrary to popular belief, cutting the wound or attempting to suck out the venom is not recommended. These methods are ineffective and can lead to further complications.

Note the Snake’s Characteristics: If possible, try to remember or take a photo of the snake to provide important information to healthcare professionals. Details such as color, pattern, size, and shape can aid in identifying the snake and determining the appropriate treatment.

Do Not Use Home Remedies: Refrain from using home remedies, traditional remedies, or applying substances to the wound. These can potentially interfere with medical treatment and cause adverse reactions.

Stay Updated on Tetanus Vaccination: Ensure that you and the person who was bitten are up to date on tetanus vaccination. If necessary, seek medical advice regarding tetanus booster shots.

Keep Emergency Services Informed: If you need to call emergency services or seek medical assistance, provide accurate information about the snake bite, location, and any relevant details. This can help responders provide prompt and appropriate care.

If someone collapses

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Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

If someone collapses, it can be a sign of a medical emergency. Here are the steps to take when someone collapses:

Assess the Situation: Quickly assess the environment to ensure your safety and the safety of others. Look for any immediate dangers or hazards that may need to be addressed before providing assistance.

Check for Responsiveness: Approach the person and gently tap their shoulder while asking loudly, “Are you okay?” If there is no response, proceed to the next steps.

Call for Emergency Help: Dial the emergency services in your country (e.g., 911 in the United States) or ask someone nearby to make the call. Provide clear information about the situation and the location.

Check for Breathing: Place your ear near the person’s mouth and nose to listen and feel for breathing. Look for chest movements and signs of normal breathing. If the person is not breathing or only gasping, you will need to perform CPR.

Start CPR (Cardiopulmonary Resuscitation): Begin chest compressions immediately if the person is not breathing or has no pulse. Place the heel of one hand on the center of the person’s chest, between the nipples. Place your other hand on top and interlock your fingers. Position yourself directly over the person’s chest and perform compressions at a rate of about 100-120 compressions per minute. Allow the chest to fully recoil between compressions. If you are trained in CPR, you can also provide rescue breaths following the compression cycles.

Use an Automated External Defibrillator (AED) if Available: If an AED is nearby, follow the instructions provided with the device. Apply the pads to the person’s chest as directed and follow the prompts for analyzing the person’s heart rhythm and delivering a shock if advised.

Continue CPR until Help Arrives: Continue performing CPR until medical professionals arrive and take over or until the person shows signs of regaining consciousness.

Exploring Tumor Growth Induction, Epigenetics, and the Impact of the Ketogenic Diet on Gene Regulation

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Introduction:

Tumor growth is a complex process influenced by various genetic and environmental factors. Epigenetic modifications, including DNA methylation, histone modifications, and non-coding RNA molecules, play a crucial role in the regulation of gene expression and can contribute to abnormal cell growth and the development of tumors. The ketogenic diet, a high-fat, low-carbohydrate eating plan, has been studied for its potential impact on gene regulation and its influence on tumor growth. This article aims to provide an overview of the factors inducing tumor growth, the role of epigenetics in abnormal growth, and the emerging research on the ketogenic diet’s effects on gene regulation and cell growth.

Factors Inducing Tumor Growth:

Tumor growth is influenced by a combination of genetic and environmental factors. Genetic mutations can lead to the activation of oncogenes and the inactivation of tumor suppressor genes, disrupting normal cellular processes and promoting uncontrolled cell growth. Environmental factors, such as exposure to carcinogens, chronic inflammation, hormonal imbalances, and metabolic dysregulation, can also contribute to tumor initiation and progression.

Epigenetics and Abnormal Growth:

Epigenetic modifications can have a profound impact on gene expression and contribute to abnormal cell growth and tumor development. Altered DNA methylation patterns, histone modifications, and dysregulated non-coding RNA molecules can lead to the activation or silencing of genes involved in cell proliferation, differentiation, and apoptosis. Aberrant epigenetic marks can promote oncogenic pathways and inhibit tumor-suppressive mechanisms, thereby driving tumor growth.

The Role of Epigenetics in Tumor Growth:

DNA Methylation: Hypermethylation of CpG islands within promoter regions of tumor suppressor genes can lead to their silencing, allowing uncontrolled cell growth. Hypomethylation in other regions of the genome can activate oncogenes, promoting cell proliferation. A study by Li et al. (2020) demonstrated global DNA hypomethylation in tumor tissues compared to adjacent normal tissues in colorectal cancer patients.

Histone Modifications: Abnormal histone modifications can alter chromatin structure and gene accessibility, impacting gene expression. Histone acetylation, methylation, and phosphorylation patterns can regulate oncogenic signaling pathways. Research by Rasmussen and Helin (2016) highlighted the dysregulation of histone-modifying enzymes in cancer and their potential as therapeutic targets.

Non-coding RNA: Non-coding RNAs, such as microRNAs and long non-coding RNAs, can modulate gene expression by binding to messenger RNA molecules. Dysregulated expression of these non-coding RNAs has been associated with tumor growth and metastasis. A study by Wu et al. (2021) identified specific microRNAs involved in promoting glioblastoma cell growth and invasion.

The Impact of the Ketogenic Diet on Gene Regulation and Tumor Growth:

The ketogenic diet has gained attention for its potential impact on gene regulation and its effects on tumor growth. The diet’s ability to alter cellular metabolism and induce a state of ketosis may influence gene expression patterns and cellular processes relevant to tumor growth.

Metabolic Effects: The ketogenic diet alters cellular metabolism by promoting the production of ketone bodies as an alternative energy source. Ketone bodies can affect signaling pathways involved in cell growth and survival. A study by Elgendy et al. (2021) demonstrated that ketone bodies derived from a ketogenic diet inhibited the growth of lung cancer cells in vitro.

Epigenetic Modifications: Recent research has suggested that the ketogenic diet may induce epigenetic modifications that impact gene expression. For instance, a study by Tan-Shalaby et al. (2016) showed that a ketogenic diet altered the expression of genes involved in metabolism and inflammation in a mouse model of glioblastoma, potentially impacting tumor progression.

Conclusion:

Tumor growth is a multifactorial process influenced by genetic and environmental factors. Epigenetic modifications play a critical role in the regulation of gene expression and can contribute to abnormal cell growth and tumor development. The ketogenic diet shows promise in altering gene regulation and metabolic processes relevant to tumor growth. However, further research is needed to elucidate the underlying mechanisms and assess the clinical implications of the ketogenic diet in cancer treatment.

Understanding the interplay between epigenetics, nutrition, and tumor growth opens up new avenues for targeted therapies and personalized approaches in cancer management.

REFERENCES

  • Li M, et al. DNA methylation alterations as therapeutic prospects in colorectal cancer. Front Oncol. 2020;10: 578816.
  • Rasmussen KD, Helin K. Role of TET enzymes in DNA methylation, development, and cancer. Genes Dev. 2016;30(7): 733-750.
  • Wu D, et al. microRNA involvement in glioblastoma pathogenesis. J Neurosci Res. 2021;99(2): 269-283.
  • Elgendy M, et al. Ketone bodies attenuate oxidative stress and radioresistance in lung cancer stem cells by regulating the Nrf2-ARE pathway. Life Sci. 2021;278: 119526.
  • Tan-Shalaby JL, et al. A ketogenic diet suppresses glioma tumor growth in mice. Neuro-oncology. 2016;18(7): 981-990.

Vaccinations and immunizations for children

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Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Vaccinations and immunizations play a crucial role in safeguarding the health of children by protecting them against various infectious diseases. This article explores common vaccinations recommended for children, their benefits, potential side effects, and interactions with other drugs based on recent research findings. Understanding the importance of vaccines and their potential risks is essential for making informed decisions about children’s healthcare.

Measles, Mumps, and Rubella (MMR) Vaccine: The MMR vaccine is typically administered in two doses, the first around 12 to 15 months of age and the second between 4 to 6 years. It provides protection against measles, mumps, and rubella. Research has shown that the MMR vaccine is highly effective in preventing these diseases and their associated complications (1). The most common side effects are mild and include fever and rash. It is essential to note that the MMR vaccine is not associated with an increased risk of autism (2).

Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine: The DTaP vaccine is usually given in a series of five doses, with the first three doses administered at 2, 4, and 6 months of age, followed by boosters at 15 to 18 months and 4 to 6 years. This vaccine protects against diphtheria, tetanus, and pertussis (whooping cough). Research has demonstrated the effectiveness of the DTaP vaccine in preventing these diseases (3). Common side effects include redness, swelling, or tenderness at the injection site, as well as fever and fussiness.

Polio Vaccine: The polio vaccine is typically administered in a series of four doses, with the first three doses given at 2, 4, and 6 to 18 months of age, followed by a booster dose between 4 and 6 years. The vaccine protects against polio, a highly contagious viral infection. Research has shown that the polio vaccine has effectively reduced the global incidence of polio (4). Side effects are generally mild and include soreness or redness at the injection site.

Haemophilus influenzae type b (Hib) Vaccine: The Hib vaccine is administered in a series of three or four doses, with the first dose given at 2 months of age, followed by subsequent doses at 4 and 6 months. An additional dose may be given at 12 to 15 months, depending on the vaccine brand used. The Hib vaccine protects against Haemophilus influenzae type b, which can cause serious infections, including meningitis and pneumonia. Research has demonstrated the effectiveness of the Hib vaccine in preventing these diseases (5). Side effects are generally mild, with redness, swelling, or tenderness at the injection site being the most common.

Hepatitis B Vaccine: The hepatitis B vaccine is typically administered in a series of three doses, with the first dose given at birth, followed by subsequent doses at 1 to 2 months and 6 to 18 months of age. The vaccine protects against hepatitis B, a viral infection that can cause liver damage. Research has shown the effectiveness of the hepatitis B vaccine in preventing hepatitis B infection (6). Side effects are generally mild and include soreness or redness at the injection site.

Conclusion: Vaccinations and immunizations are vital for protecting children from preventable infectious diseases. The MMR, DT aP, polio, Hib, and hepatitis B vaccines are recommended for children at specific ages to provide protection against measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B. Research has consistently shown the effectiveness of these vaccines in preventing the associated diseases and their complications. While mild side effects such as fever, redness, or tenderness at the injection site may occur, the benefits of vaccination outweigh the risks. It is important to consult healthcare professionals for personalized advice and to address any concerns regarding potential interactions with other medications.

REFERENCES

  • MMR Vaccines: WHO position paper, April 2017. Weekly Epidemiological Record, 92(16), 205-228.
  • Madsen, K. M., Hviid, A., Vestergaard, M., Schendel, D., Wohlfahrt, J., Thorsen, P., … & Melbye, M. (2002). A population-based study of measles, mumps, and rubella vaccination and autism. New England Journal of Medicine, 347(19), 1477- 1482.
  • Kowalzik, F., Barbosa, A. P., Fernandes, V. R. F., & Battersby, A. (2020). A cell- mediated immunity pilot study of the fifth consecutive acellular pertussis booster vaccination in 4 to 6-year-old children: effects of a reduced antigenic load on the vaccine response. BMC Pediatrics, 20(1), 1-9.
  • Immunization coverage. World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
  • de Oliveira, L. H., Camacho, L. A., Coutinho, E. S., Martinez-Silveira, M. S., Carvalho, A. F., Ruiz-Matus, C., … & Andrus, J. K. (2015). Impact and effectiveness of Haemophilus influenzae type b conjugate vaccination in children and adults. Revista Panamericana de Salud Pública, 37(3), 147-154.
  • Zanetti, A. R., Van Damme, P., Shouval, D., Van Herck, K., Van Der Meeren, O., Esteban, R., … & Hezode, C. (2008). The global impact of vaccination against hepatitis B: A historical overview. Vaccine, 26(49), 6266-6273.

Environmental health and disease prevention

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Environmental health refers to the study of how environmental factors can impact human health. These environmental factors can include air and water pollution, exposure to toxins, and even climate change. Environmental health is a crucial aspect of disease prevention and management, as it can help us identify and reduce risks that may be contributing to the development of diseases.

Air pollution is a significant environmental health concern. It is linked to various respiratory and cardiovascular conditions, including asthma, chronic obstructive pulmonary disease (COPD), and heart disease. In addition to outdoor air pollution, indoor air pollution can also be a concern, especially in homes with poor ventilation or where harmful chemicals are present.

Water safety is another crucial aspect of environmental health. Contaminated water can lead to the spread of infectious diseases, including cholera, typhoid, and hepatitis A. Proper sanitation and access to clean drinking water are essential for preventing these diseases.

In recent years, the impact of climate change on human health has become increasingly clear. Rising temperatures, extreme weather events, and changing disease patterns are all linked to climate change. Climate change can also contribute to the spread of diseases carried by insects, such as mosquitoes, ticks, and fleas.

To prevent and manage diseases related to environmental factors, it is essential to address the root causes of these issues. This can include reducing emissions that contribute to air pollution, improving water treatment and sanitation infrastructure, and taking steps to mitigate the effects of climate change.

Nepal faces various environmental health challenges that can lead to an increased risk of disease. For example, air pollution is a major concern in Nepal, particularly in cities such as Kathmandu. According to a study published in the International Journal of Environmental Research and Public Health 2, air pollution levels in Kathmandu exceed the World Health Organization’s recommended limits, with particulate matter being a major pollutant. This can lead to respiratory problems and other health issues.

Additionally, water safety is another concern in Nepal. According to a study published in the Journal of Water and Health 1, water quality in Nepal can be compromised due to factors such as poor sanitation and inadequate water treatment facilities. This can lead to the spread of waterborne illnesses such as cholera and diarrhea.

Finally, noise pollution is also a concern in Nepal, particularly in urban areas. According to a study published in the Journal of Environmental and Public Health 3, exposure to high levels of noise pollution can lead to various health issues, including cardiovascular disease and mental health problems.

Overall, addressing environmental health challenges such as air pollution, water safety, and noise pollution is crucial for disease prevention and management in Nepal. This requires a combination of individual actions, such as reducing car use and properly disposing of waste, as well as larger-scale efforts, such as improving infrastructure and implementing effective policies.

REFERENCES