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The unseen risks of synthetic fragrance: Safeguarding your health

Apr 24, 2024 | Global health issues

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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

Let’s step into a room with the fresh smell of clean sheets or sweet vanilla. These scents are part of our everyday life, offering a quick getaway for our noses. But what if these nice smells are hiding something harmful? This article takes a closer look at synthetic fragrances, showing the health risks they might have and how we can stay safe.

Fragrances are everywhere in products we use all the time. They might stay on our skin like in creams and perfumes, get washed off like in shampoos or shaving creams, or be part of things we use around the house. These products have chemicals that can make our skin react and, if we’re exposed to them enough, can cause skin allergies. (van Amerongen et al., 2021).

The chemical composition of Synthetic fragrances:

It’s quite shocking to learn that about 95% of the chemicals used in synthetic fragrances come from petroleum (Landrigan et al., 2023). This includes not just any chemicals, but some really nasty ones like benzene derivatives, which are known to cause cancer, and a whole bunch of other toxic stuff (Steinemann, 2016). So, every time we enjoy these scents, we’re actually exposing ourselves to a dangerous mix of chemicals, often without realizing it (Sarantis et al., 2010).

Synthetic fragrances are more than just a pleasant aroma in the air; they mess with our body’s hormonal system (Diamanti-Kandarakis et al., 2009). It’s like they crash the body’s system, setting off a chain reaction of health problems that can affect everything from our ability to have children to increasing the risk of hormone-related cancers (National Institute of Environmental Health Sciences, 2024).

The inhalation of synthetic fragrance can cause trouble for someone with asthma, setting off symptoms that can be really tough to deal with (Rádis-Baptista, 2023). It’s sad that the scents we use to relax or feel good might actually make it hard to breathe.

When it comes to our skin, it can react badly to synthetic fragrances, leading to irritation or even allergies (van Amerongen et al., 2021). What’s meant to make us feel nice and smell great can sometimes end up causing a lot of discomfort instead.

 Health Risks associated with synthetic fragrances:

Fragrances do more than just make us feel good; they might also help with stress and boost our memory. But there’s a downside. They can cause a bunch of health issues, like skin irritation, allergies, reactions that aren’t just rashes, sensitivity to sunlight, and other sudden skin problems. These issues can really mess with our day-to-day life and how we enjoy it.  (Pastor-Nieto & Gatica-Ortega, 2021).

Respiratory Distress:

The inhalation of synthetic fragrances can be a silent trigger for respiratory issues, particularly for those with pre-existing conditions like asthma. The volatile organic compounds (VOCs) in these fragrances can irritate the airways, leading to asthma attacks and exacerbating chronic lung diseases (Rádis-Baptista, 2023). Moreover, a study by the (Bălă et al., 2021) has highlighted that long-term exposure to certain VOCs can result in serious respiratory complications, including chronic obstructive pulmonary disease (COPD) It is possible that inhalation exposure of those with asthma, or otherwise susceptible individuals, to fragrance materials (and/or other components of domestic cleaning products) might trigger or exacerbate an asthmatic reaction (Basketter, Huggard, & Kimber, 2019)

Skin Irritation and Allergies: More than Skin Deep Synthetic fragrances are a common cause of contact dermatitis, a type of skin inflammation that results in itchy, red, and sometimes painful rashes. These fragrances contain allergens that can disrupt the skin’s protective barrier, making it more susceptible to irritation (van Amerongen et al., 2021). Furthermore, research has shown that certain fragrance compounds can sensitize the skin, leading to allergic reactions upon subsequent exposures  (Giménez-Arnau, 2019)

Cancer Risk: The Scented Shadow Perhaps the most alarming risk associated with synthetic fragrances is their potential link to cancer. Benzene derivatives, commonly found in these fragrances, are classified as carcinogens and have been associated with an increased risk of various cancers, including leukemia and lymphoma (Kazemi et al. 2022). A recent study has also raised concerns about the presence of other carcinogenic compounds in synthetic fragrances, suggesting a possible connection to breast and ovarian cancers (Steinemann, 2016).

Multiple Chemical Sensitivity (MCS): MCS is triggered by exposure to low levels of common contaminants, even at concentrations considered non-toxic for the general population. Imagine navigating a world where everyday scents transform into adversaries. (Zucco & Doty, 2021).

Chemical Intolerance (CI): CI is a condition resulting from exposure to odorous or pungent substances, impacting both physiology and brain function. Individuals with CI may process sensory information differently, experiencing heightened activity in the amygdala, responsible for emotions and fear responses. This heightened sensitivity may result in both physical and psychological distress. (Azuma et al., 2019).

Strategies to Minimize Exposure

Read Labels Carefully: Scrutinize product labels for the term “fragrance” and opt for those with transparent ingredient lists. Seek out brands that disclose the specific components of their fragrances.

Choose Natural Alternatives: Favor products scented with natural essential oils rather than synthetic fragrances. These oils not only provide delightful scents but also offer therapeutic benefits. Essential oils like lavender, eucalyptus, and citrus can uplift mood without compromising health.

Ventilate Indoor Spaces: Proper ventilation helps reduce indoor fragrance exposure. Open windows, utilize air purifiers, and minimize the use of air fresheners. Fresh air serves as nature’s best deodorizer.

DIY Fragrance Solutions: Empower yourself by creating personalized scents using essential oils. Experiment with blends that resonate with your senses, either by mixing them with carrier oils or using them in diffusers.

Educate Others: Advocate for informed choices by spreading awareness about the risks of synthetic fragrances. Encourage friends and family to make conscious decisions, contributing collectively to a healthier environment.

 Conclusion

While synthetic fragrances may exude an air of harmlessness, their impact on health is profound. As consumers, we wield the power to make discerning choices, opting for scents that enhance our lives without compromising well-being. By comprehending the hidden dangers and taking proactive steps, we can shield ourselves and future generations from the fragrant pitfalls that surround us.

Remember, health is our most precious fragrance—handle it with care.

REFERENCES

  1. van Amerongen, C. C. A., Ofenloch, R. F., Cazzaniga, S., Elsner, P., Gonçalo, M., Naldi, L., Svensson, Å., Bruze, M., & Schuttelaar, M. L. A. (2021). Skin exposure to scented products used in daily life and fragrance contact allergy in the European general population – The EDEN Fragrance Study. Contact Dermatitis, 84(6), 385-394. https://doi.org/10.1111/cod.13807
  2. Landrigan PJ, Raps H, Cropper M, Bald C, Brunner M, Canonizado EM, Charles D, Chiles TC, Donohue MJ, Enck J, Fenichel P, Fleming LE, Ferrier-Pages C, Fordham R, Gozt A, Griffin C, Hahn ME, Haryanto B, Hixson R, Ianelli H, James BD, Kumar P, Laborde A, Law KL, Martin K, Mu J, Mulders Y, Mustapha A, Niu J, Pahl S, Park Y, Pedrotti ML, Pitt JA, Ruchirawat M, Seewoo BJ, Spring M, Stegeman JJ, Suk W, Symeonides C, Takada H, Thompson RC, Vicini A, Wang Z, Whitman E, Wirth D, Wolff M, Yousuf AK, Dunlop S. The Minderoo-Monaco Commission on Plastics and Human Health. Ann Glob Health. 2023 Mar 21;89(1):23. doi: 10.5334/aogh.4056. Erratum in: Ann Glob Health. 2023 Oct 11;89(1):71. PMID: 36969097; PMCID: PMC10038118.
  3. Steinemann, A. C. (2016). Fragranced consumer products: exposures and effects from emissions. Air Quality, Atmosphere & Health, 9, 861–8661
  4. Sarantis, H., Naidenko, O. V., Gray, S., Houlihan, J., Malkan, S., Archer, L., Scranton, A. G., Nudelman, J., & Davis, M. (2010). Not so sexy: The health risks of secret chemicals in fragrance. Campaign for Safe Cosmetics and Environmental Working Group. Retrieved from www.ewg.org/sites/default/files/report/SafeCosmetics_FragranceRpt.pdf1
  5. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, Zoeller RT, Gore AC. Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocr Rev. 2009 Jun;30(4):293-342. doi: 10.1210/er.2009-0002. PMID: 19502515; PMCID: PMC2726844.
  6. National Institute of Environmental Health Sciences. (2024). Endocrine disruptors. Retrieved from https://www.niehs.nih.gov/health/topics/agents/endocrine
  7. Rádis-Baptista G. Do Synthetic Fragrances in Personal Care and Household Products Impact Indoor Air Quality and Pose Health Risks? J Xenobiot. 2023 Mar 1;13(1):121-131. doi: 10.3390/jox13010010. PMID: 36976159; PMCID: PMC10051690.
  8. Bălă, G.-P., Râjnoveanu, R.-M., Tudorache, E., Motișan, R., & Oancea, C. (2021). Air pollution exposure—the (in)visible risk factor for respiratory diseases. Environmental Science and Pollution Research, 28, 19615–19628. https://doi.org/10.1007/s11356-021-12412-7
  9. Basketter, D. A., Huggard, J., & Kimber, I. (2019). Fragrance inhalation and adverse health effects: The question of causation. Regulatory Toxicology and Pharmacology, 104, 151-156. https://doi.org/10.1016/j.yrtph.2019.03.011
  10. Giménez-Arnau, E. (2019). Chemical compounds responsible for skin allergy to complex mixtures: How to identify them? Dermatochemistry Laboratory, University of Strasbourg-Institut de Chimie, CNRS UMR 7177, Institut le Bel. Retrieved from http://www.unistra.fr/index.php?id=egimenez
  11. Kazemi Z, Aboutaleb E, Shahsavani A, Kermani M, Kazemi Z. Evaluation of pollutants in perfumes, colognes and health effects on the consumer: a systematic review. J Environ Health Sci Eng. 2022 Feb 3;20(1):589-598. doi: 10.1007/s40201-021-00783-x. PMID: 35669814; PMCID: PMC9163252.
  12. Zucco, G. M., & Doty, R. L. (2021). Multiple chemical sensitivity. Brain Sciences, 12(1), 46. https://doi.org/10.3390/brainsci12010046
  1. Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Chemical intolerance: involvement of brain function and networks after exposure to extrinsic stimuli perceived as hazardous. Environ Health Prev Med. 2019 Oct 22;24(1):61. doi: 10.1186/s12199-019-0816-6. PMID: 31640568; PMCID: PMC6806489.
  2. Pastor-Nieto, M. A., & Gatica-Ortega, M. E. (2021). Ubiquity, hazardous effects, and risk assessment of fragrances in consumer products. Current Treatment Options in Allergy, 8(1), 21-41. https://doi.org/10.1007/s40521-020-00275-7

Tuberculosis: Causes, Prevention and Management

Apr 19, 2024 | Infectious diseases and outbreaks

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Written By THT Editorial Team

Sujata Shakya

Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)

Tuberculosis (TB) is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also impact other parts of the body. Understanding the causes, prevention, and management of TB is essential for controlling its spread and reducing its impact on public health.

Causes of Tuberculosis:

Tuberculosis is caused by the transmission of Mycobacterium tuberculosis from an infected individual to a susceptible person. The bacteria can be spread through the air when an infected individual coughs, sneezes, or speaks, releasing respiratory droplets containing the bacteria (1). Factors such as overcrowded living conditions, poor ventilation, and compromised immune systems increase the risk of TB transmission (2).

Prevention of Tuberculosis:

Preventative measures play a crucial role in reducing the incidence of TB. Some examples of preventative measures include:

Vaccination: Bacille Calmette-Guérin (BCG) vaccine is used to prevent severe forms of TB in children. It provides partial protection against TB and reduces the risk of disseminated TB in infants and young children (3). However, the BCG vaccine’s effectiveness in preventing pulmonary TB, the most common form of the disease, varies and is generally less effective in adults.

Infection Control: Implementing effective infection control measures is crucial to prevent the spread of TB. This includes identifying and promptly isolating individuals with active TB, ensuring proper ventilation in healthcare facilities, and promoting cough etiquette (4).

Screening and Testing: Active case finding and early detection of TB cases are essential for preventing further transmission. Regular screening of high-risk populations, such as close contacts of TB patients, healthcare workers, and individuals living with HIV, is recommended. Diagnostic tests such as sputum smear microscopy, molecular tests, and chest X-rays are used to detect TB infection (5).

Treatment of Latent TB Infection: Individuals with latent TB infection, who have the TB bacteria in their bodies but do not have active disease, can progress to active TB if not treated. Treating latent TB infection with antibiotics, such as isoniazid or rifampin, can prevent the development of active TB disease (6).

Management of Tuberculosis:

TB management focuses on early diagnosis, appropriate treatment, and adherence to medication. Some key aspects of TB management include:

Directly Observed Therapy (DOT): DOT is a strategy in which healthcare providers or trained community health workers directly observe patients taking their TB medications. This approach ensures treatment adherence and helps prevent the development of drug-resistant TB (7).

Drug Therapy: TB is treated with a combination of antibiotics for a specific duration. The standard treatment regimen for drug-susceptible TB includes a combination of isoniazid, rifampin, ethambutol, and pyrazinamide. Drug-resistant TB requires more complex treatment regimens using second-line drugs (8).

Contact Investigation: Identifying and testing individuals who have had close contact with TB patients is crucial for early detection of TB cases and preventing further transmission. Contact investigation involves screening and testing close contacts to identify latent TB infection or active TB disease (9).

Adherence Support: Ensuring treatment adherence is vital for successful TB management and prevention of drug resistance. Providing patient education, counseling, and support services can improve medication adherence and treatment outcomes (10).

Conclusion:

Preventing and managing tuberculosis requires a comprehensive approach involving vaccination, infection control measures, screening and testing, treatment of latent infection, and effective management of active TB cases. By implementing evidence-based preventative measures and ensuring early diagnosis and appropriate treatment, communities can work towards reducing the burden of tuberculosis and protecting public health.

REFERENCES

Endometriosis: Understanding Its Impact and Exploring Treatment Avenues

Apr 16, 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) 

Endometriosis is a disorder where endometrial-like tissue forms outside the uterine cavity, causing chronic pelvic discomfort, intense menstrual pain, dyspareunia, and potential infertility (Parasar et al. 2017). This ectopic endometrial tissue can adversely affect a woman’s reproductive health. While treatments focus on symptom relief and enhancing life quality, endometriosis remains incurable. (Malvezzi et al. 2020).

Symptoms of Endometriosis: Endometriosis manifests as ectopic tissue growth resembling the uterine lining, leading to symptoms that can profoundly affect a woman’s well-being. Notable symptoms include:

Dysmenorrhea: Affected women may suffer from debilitating cramps during menstruation, often radiating to the abdomen or back, surpassing typical menstrual discomfort. (Chauhan et al.2022)

Pain during Intimacy: The condition may result in pain during or following sexual activity, causing considerable distress. (Chauhan et al. 2022)

Painful Excretory Functions: Pain may occur during bowel movements or urination, especially coinciding with menstrual periods. (Mayo Clinic, 2024)

Menorrhagia or Metrorrhagia: There may be unusually heavy flows during periods or bleeding between cycles, disrupting the regular menstrual pattern. (Chauhan et al. 2022)

Infertility: Often linked to infertility, endometriosis might be identified in fertility assessments for women struggling to conceive. (Bulun et al. 2019)

Fatigue: Persistent tiredness or exhaustion can interfere with daily routines and affect overall health.

Additional Symptoms: Other possible symptoms include mood disorders, low body weight, increased pain sensitivity, and irregular spotting or bleeding outside of menstrual cycles.

Approaches to Managing Endometriosis:

Analgesics: Medications such as NSAIDs, including ibuprofen, and analgesics like paracetamol, are utilized to alleviate endometriosis-related discomfort.

Endocrine Therapy: This strategy involves reducing estrogen levels to diminish endometriosis lesions and lessen discomfort. Treatment modalities encompass oral contraceptives, progestins, and GnRH analogs.  (Bulun et al. 2019)

Operative Interventions: Selective surgery, often via laparoscopy, aims to excise endometriosis lesions while retaining reproductive organs, potentially enhancing fertility prospects. (Chauhan et al. 2022)

Reproductive Assistance: In cases of endometriosis-induced infertility, options such as surgical lesion removal, ovarian stimulation coupled with IUI, and IVF are explored. (Lee et al. 2020)

It’s crucial to recognize that treatment choices hinge on various personal factors, including age, symptom intensity, reproductive aspirations, and personal preferences. While these interventions aim to mitigate symptoms and elevate life quality, they are not curative. Engaging in a dialogue with a medical professional is vital to tailor treatment plans to one’s unique health profile.

For further information on endometriosis treatment options and considerations, please refer to the provided sources or book consultations here.

REFERENCES

  1. Parasar P, Ozcan P, Terry KL. Endometriosis: Epidemiology, Diagnosis and Clinical Management. Curr Obstet Gynecol Rep. 2017 Mar;6(1):34-41. doi: 10.1007/s13669-017-0187-1. Epub 2017 Jan 27. PMID: 29276652; PMCID: PMC5737931.
  2. Malvezzi H, Marengo EB, Podgaec S, Piccinato CA. Endometriosis: current challenges in modeling a multifactorial disease of unknown etiology. J Transl Med. 2020 Aug 12;18(1):311. doi: 10.1186/s12967-020-02471-0. PMID: 32787880; PMCID: PMC7425005.
  3. Chauhan S, More A, Chauhan V, Kathane A. Endometriosis: A Review of Clinical Diagnosis, Treatment, and Pathogenesis. Cureus. 2022 Sep 6;14(9):e28864. doi: 10.7759/cureus.28864. PMID: 36225394; PMCID: PMC9537113.
  4. Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, Kohlmeier A, Yin P, Milad M, Wei J. Endometriosis. Endocr Rev. 2019 Aug 1;40(4):1048-1079. doi: 10.1210/er.2018-00242. PMID: 30994890; PMCID: PMC6693056.
  5. Mayo Clinic. (2024). Endometriosis – Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
  6. Lee D, Kim SK, Lee JR, Jee BC. Management of endometriosis-related infertility: Considerations and treatment options. Clin Exp Reprod Med. 2020 Mar;47(1):1-11. doi: 10.5653/cerm.2019.02971. Epub 2020 Feb 24. Erratum in: Clin Exp Reprod Med. 2020 Jun;47(2):153. PMID: 32088944; PMCID: PMC7127898.

Licorice Root: A Simple Guide to Its Sweet Benefits

Apr 12, 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

Licorice root (जेठी मधु), from the plant Glycyrrhiza glabra, is more than just a candy flavor. It’s been used in traditional medicine for ages because of its health benefits.

Stomach Saver: This root is like a superhero for your stomach. It’s got substances—glycyrrhizin and flavonoids—that fight off ulcers by forming a protective layer on the stomach’s surface, reducing acid, and helping heal ulcers which has been supported by findings from Rahnama et al. (2013), who studied the healing effects of licorice on Helicobacter pylori infected peptic ulcers.”

Virus Fighter: Licorice root might also be a secret weapon against viruses, especially those that mess with your liver. It’s got stuff in it that stops viruses from multiplying and tweaks your immune system to help your liver stay healthy as demonstrated by Wang et al. (2015), licorice has been identified to have significant antiviral and antimicrobial properties.”

Swelling Be Gone: Got swelling? Licorice root might help with that too. It’s got anti-inflammatory powers that could take down swelling, which is great news if you’re dealing with arthritis, asthma, or skin issues which is supported by the findings of Yang et al. (2017), who investigated the anti-inflammatory properties of licorice.”

Cough Calmer: And if you’ve got a cough that won’t quit, licorice root might be your go-to. It’s been used to soothe your throat and help you get rid of mucus, making it easier to breathe and lessening coughs ( Seladi-Schulman 2022)

Stress Buster: Licorice root is also an adaptogen, which means it helps your body deal with stress. It can help keep your cortisol—your body’s stress alarm—under control, which might make you feel more chill. (Armanini et al. 2004)

But, Heads Up: Just like with anything, you can not have too much of a good thing. If you go overboard with licorice root, it can throw your body’s mineral balance out of whack, leading to high blood pressure and low potassium, which is no bueno. (Wahab et al. 2021)

Doctor Knows Best: So, it’s super important to use licorice root the right way. Talk to a healthcare pro before diving in, especially if you’ve got other health stuff going on or you’re taking meds that might not play nice with it. And keep an eye on your potassium levels to stay safe.

REFERENCES

  1. Rahnama M, Mehrabani D, Japoni S, Edjtehadi M, Saberi Firoozi M. The healing effect of licorice (Glycyrrhiza glabra) on Helicobacter pylori infected peptic ulcers. J Res Med Sci. 2013 Jun;18(6):532-3. PMID: 24250708; PMCID: PMC3818629.
  2. Wang L, Yang R, Yuan B, Liu Y, Liu C. The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Acta Pharm Sin B. 2015 Jul;5(4):310-5. doi: 10.1016/j.apsb.2015.05.005. Epub 2015 Jun 17. PMID: 26579460; PMCID: PMC4629407.
  3. Yang R, Yuan BC, Ma YS, Zhou S, Liu Y. The anti-inflammatory activity of licorice, a widely used Chinese herb. Pharm Biol. 2017 Dec;55(1):5-18. doi: 10.1080/13880209.2016.1225775. Epub 2016 Sep 21. PMID: 27650551; PMCID: PMC7012004.
  4. Seladi-Schulman, J., Ph.D. (2022, November 10). The 7 best teas to help ease a cough. Healthline. Retrieved from https://www.healthline.com/health/tea-for-cough
  5. Armanini D, Mattarello MJ, Fiore C, Bonanni G, Scaroni C, Sartorato P, Palermo M. Licorice reduces serum testosterone in healthy women. Steroids. 2004 Oct-Nov;69(11-12):763-6. doi: 10.1016/j.steroids.2004.09.005. PMID: 15579328.
  6. Wahab S, Annadurai S, Abullais SS, Das G, Ahmad W, Ahmad MF, Kandasamy G, Vasudevan R, Ali MS, Amir M. Glycyrrhiza glabra (Licorice): A Comprehensive Review on Its Phytochemistry, Biological Activities, Clinical Evidence and Toxicology. Plants (Basel). 2021 Dec 14;10(12):2751. doi: 10.3390/plants10122751. PMID: 34961221; PMCID: PMC8703329.

 

Influenza: Causes, Prevention and Management

Apr 10, 2024 | Infectious diseases and outbreaks

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Written By THT Editorial Team

Sujata Shakya

Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)

Influenza, also known as the flu, is a contagious respiratory illness caused by influenza viruses. Influenza viruses are of different types (A, B, C) and are further classified into subtypes based on their surface antigens. Influenza is a significant public health concern, causing morbidity and mortality worldwide. This research-based article provides an overview of the causes, prevention, and management of influenza.

Causes of Influenza:

Influenza is caused by influenza viruses, which primarily target the respiratory system. The viruses spread mainly through respiratory droplets generated when an infected person talks, coughs, or sneezes. Influenza viruses can also spread by touching contaminated surfaces and then touching the mouth, nose, or eyes.

Prevention of Influenza:

Preventing influenza infections is critical to reducing the burden of illness. Several strategies can help prevent influenza, including:

Vaccination: Influenza vaccination is the most effective way to prevent influenza infections. The influenza vaccine is designed to match the circulating influenza viruses and provides immunity against the viruses. Annual vaccination is recommended for all individuals aged six months and older (1).

Non-pharmaceutical Interventions: Non-pharmaceutical interventions such as frequent hand washing, covering the nose and mouth with a tissue or sleeve while coughing or sneezing, and staying home when sick can reduce the spread of influenza viruses (2).

Antiviral Medications: Antiviral medications can be used to prevent influenza infections, especially in high-risk population, such as immunocompromised individuals, older adults, and those with underlying medical conditions. Antivirals can also be used for post-exposure prophylaxis in individuals who have been in close contact with an infected person (3).

Management of Influenza:

Influenza infections can range from mild to severe, and management approaches depend on the severity of the illness. The following management approaches are commonly used:

Symptomatic Treatment: Symptomatic treatment, such as antipyretics and analgesics, can alleviate symptoms such as fever, body aches, and headaches. Over-the-counter medications such as acetaminophen and ibuprofen can be used for the relief of symptoms (4).

Antiviral Medications: Antiviral medications can be used to treat influenza infections, especially in individuals at high risk for complications, such as older adults, young children, pregnant women, and those with underlying medical conditions. Treatment with antivirals should be started within 48 hours of onset of symptoms (3).

Hospitalization: Severe influenza infections can require hospitalization, especially in individuals at high risk for complications. Supportive care, including oxygen therapy, mechanical ventilation, and antiviral medications, may be needed (5).

Examples of Preventative Measures:

In addition to vaccination and non-pharmaceutical interventions, several examples of preventative measures can be implemented to reduce the spread of influenza, such as:

Environmental Cleaning: Regular cleaning and disinfection of frequently touched surfaces, such as doorknobs, keyboards, and countertops, can reduce the spread of influenza viruses (2).

School Closures: Closing schools during influenza outbreaks can reduce the spread of influenza viruses. School closures should be implemented early and for an extended period to be effective (6).

Social Distancing: Social distancing measures such as avoiding large gatherings, working from home, and staying home when sick can reduce the spread of influenza viruses (7).

Conclusion:

Influenza is a significant public health concern, leading to morbidity and mortality worldwide. Preventing influenza infections through vaccination, non-pharmaceutical interventions, and antiviral medications is critical to reducing the burden of illness. Environmental cleaning, school closures, and social distancing are examples of additional preventative measures that can be implemented. By adopting these preventive measures and following evidence-based management approaches, the impact of influenza can be minimized, protecting individuals and communities.

REFERENCES

  1. Centers for Disease Control and Prevention. (2022). Key facts about seasonal flu vaccine. Retrieved from https://www.cdc.gov/flu/prevent/keyfacts.htm
  2. Centers for Disease Control and Prevention. (2022). Preventing the flu: Good health habits can help stop germs. Retrieved from https://www.cdc.gov/flu/prevent/actions-prevent-flu.htm
  3. Uyeki, T. M., Bernstein, H. H., & Bradley, J. S. (2019). Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clinical Infectious Diseases, 68(6), e1-e47.
  4. National Institute for Health and Care Excellence. (2017). Acute respiratory tract infections: Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care. Retrieved from https://www.nice.org.uk/guidance/ng109
  5. Fry, A. M., Goswami, D., Nahar, K., Sharmin, A. T., Rahman, M., Gubareva, L., … & Azim, T. (2019). Efficacy of oseltamivir treatment started within 5 days of symptom onset to reduce influenza illness duration and virus shedding in an urban setting in Bangladesh: a randomised placebo-controlled trial. The Lancet Infectious Diseases, 19(2), 209-218.
  6. Jackson, C., Vynnycky, E., Hawker, J., Olowokure, B., Mangtani, P., & The UK Influenza Pandemic Preparedness Strategy Expert Group. (2013). School closures and influenza: systematic review of epidemiological studies. BMJ Open, 3(2), e002149.
  7. Glass, R. J., Glass, L. M., Beyeler, W. E., & Min, H. J. (2006). Targeted social distancing design for pandemic influenza. Emerging Infectious Diseases, 12(11), 1671-1681.

Rezum Therapy: A Minimally Invasive Treatment for Benign Enlargement of Prostate

Apr 9, 2024 | Men's Health

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

Introduction:

Benign Prostatic Enlargement (BPE) is a prevalent condition in men, characterized by bothersome urinary symptoms such as increased frequency, urgency, weak urine flow, and incomplete bladder emptying. While lifestyle modifications, dietary adjustments, and medication can help manage mild cases, individuals with more severe symptoms may find relief through surgical intervention. Among the traditional surgical options, transurethral resection of the prostate (TURP) is commonly employed, albeit with its associated risks, including bleeding, sexual dysfunction, and a prolonged recovery period [1].

A Less Invasive Option:

The Rezum System emerges as a promising alternative to conventional surgical methods. This innovative approach utilizes the application of thermal energy, in the form of steam, to target and treat the enlarged prostate tissue [2][3]. By delivering controlled bursts of steam directly to the prostate gland, Rezum therapy offers a minimally invasive solution that effectively alleviates urinary symptoms while mitigating the risks commonly associated with TURP, such as bleeding, ejaculatory dysfunction, and retrograde ejaculation [4]

How Rezum Works:

At the heart of the Rezum System lies a specialized device equipped with a small, flexible needle-like instrument. This instrument is inserted into the prostate tissue under direct visualization, allowing for precise delivery of thermal energy in the form of steam. The targeted application of steam induces localized tissue necrosis, leading to the gradual shrinkage of the enlarged prostate over time. Importantly, this targeted approach ensures the preservation of surrounding healthy tissue and structures, minimizing the risk of adverse effects commonly observed with conventional surgical methods [5].

What to Expect after Treatment:

 Patients undergoing Rezum therapy can anticipate a significant improvement in urinary symptoms, resulting in enhanced quality of life and restored urinary function. Clinical studies have demonstrated notable enhancements in urinary flow rates, reduction in post-void residual urine volume, and improvements in symptom scores following Rezum therapy. While some individuals may experience transient side effects such as temporary dysuria, urinary frequency, or urgency immediately post-treatment, these symptoms typically resolve within a few weeks and are generally milder compared to those observed following traditional surgical interventions [4].

Conclusion:

Rezum therapy represents a paradigm shift in the management of benign prostatic enlargement, offering a patient-centered, minimally invasive solution that effectively addresses bothersome urinary symptoms while minimizing the associated risks. By harnessing the therapeutic potential of steam, Rezum therapy exemplifies the advancements in medical technology and underscores the importance of individualized care in the field of urology [5][6].

REFERENCES

  1. Lee CL, Kuo HC. Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts. Ci Ji Yi Xue Za Zhi. 2017 Apr-Jun;29(2):79-83. doi: 10.4103/tcmj.tcmj_20_17. PMID: 28757771; PMCID: PMC5509197.
  2. McVary, K. T., Roehrborn, C. G., & Barkin, J. (2019). Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: 4-Year Results from Randomized Controlled Study. Urology, 126, 171-179.
  3. McVary, K. T., Gange, S. N., Gittelman, M. C., Goldberg, K. A., Patel, K., Shore, N. D., … & Roehrborn, C. G. (2016). Erectile and ejaculatory function preserved with convective water vapor energy treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: randomized controlled study. Journal of Sexual Medicine, 13(6), 924-933.
  4. McVary, K. T., Rogers, T., & Roehrborn, C. G. (2016). Rezūm water vapor thermal therapy: practical guide for urologists and primary care physicians treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. Therapeutic Advances in Urology, 8(3), 172-181.
  5. Dixon, C.M., Cedano, E., & Mynderse, L. A. (2018). Rezūm water vapor thermal therapy for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: A systematic review of the literature. Current Urology Reports, 19(6), 44.
  6. Roehrborn, C.G., Gange S.N., Shore N.D., et al.(2020). Five year results of the prospective randomized controlled Rezūm system study: Convective radiofrequency thermal therapy for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.Journal of Urology ,203(5),1042-1050.

Revolutionizing Prostate Cancer Treatment: The TULSA-Pro Procedure

Mar 31, 2024 | Men's Health

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

Prostate Cancer:

Prostate cancer is the leading cause of cancer death and the second most common non-cutaneous cancer in males worldwide which is a significant health concern (Abudoubari et al., 2023). Wang et al. (2022) found in their study on global prostate cancer incidence and mortality that a total of 1 414 259 new cases of prostate cancer and 375 304 related deaths were reported in 2020 globally.  There are marked variations in the rate of prostate cancer in different populations worldwide which suggests its genetic predisposition (Tzelepi et al, 2022). Apart from that, age, family history, ethnicity, and tobacco smoking are additional risk factors (Berenguer et al.2023). Most of the prostate cancers identified currently are asymptomatic. Diagnosis in these cases is based on elevated prostate-specific antigen (PSA) level, digital rectal examination (DRE), and prostate biopsy. Localized and advanced diseases can cause urinary retention, blood in the urine (hematuria), blood in semen, and pelvic discomfort, back pain, weight loss (Peters et al.2023)

Recent Advances in Prostate Cancer:

The treatment landscape for prostate cancer has seen remarkable progress in recent years. Standard treatment for localized prostate cancer includes active surveillance, radical prostatectomy, and radiation therapy with or without hormonal therapy. New therapies targeting the disease’s resistance to conventional treatments are emerging. One such advancement is a therapy that combines an experimental drug, AZD5069, with enzalutamide, a hormone therapy, showing promising results in shrinking tumors and reducing PSA levels (Guo et al.2023). Another breakthrough is the development of 177 Lu-PSMA-617, a targeted radioligand therapy that delivers radiation directly to cancer cells, demonstrating effectiveness in controlling advanced prostate cancer (Sartor et al.2021)

The TULSA-Pro Procedure:

TULSA-Pro stands for Transurethral Ultrasound Ablation. It is one of the focal ablative therapies for localized prostate cancer which is minimally invasive, providing proper oncological outcome with preserving urinary continence and erectile dysfunction due to nerve sparing.

Procedure:

TULSA procedure is performed in 1.5 Tesla MRI with the patient under general anesthesia. An ultrasound applicator is placed in the prostatic urethra to deliver the focused waves to ablate the cancerous tissue sparing the healthy tissue and a rectal cooling device is placed adjacent to the prostate. Both devices are irrigated with water for thermal protection of the rectum and urethra. MRI shows real-time visual monitoring during the procedure. (Klotz et al.2021)

Post-Procedure Recovery:

Patients can be discharged the same day or can be admitted overnight. They benefit from shorter recovery times and fewer side effects like urinary incontinence and erectile dysfunction.

Clinical Evidence and Results Recent studies highlight TULSA-Pro’s effectiveness:

PSA Reduction: Studies report 75% decrease in PSA levels post-procedure, indicating effective tumor ablation (Peters et al.2023)

Preservation of Erectile Function: TULSA-Pro has been shown to minimize damage to neurovascular bundles, reducing the incidence of erectile dysfunction. (Klotz et al.2021)

Urinary Continence: Patients experience lower urinary leakage rates than traditional surgical treatments (Peters et al.2023).

Quality of life: IPSS urinary symptom score, quality of life score, and voiding/storage sub scores recovered to baseline 3 months post-procedure. Urinary continence and sexual function also recovered to baseline earlier than other measures ( Klotz et al.2021).

Advancements and Future Directions: The TULSA-Pro procedure is evolving, with advancements enhancing its precision and outcomes.

Conclusion

TULSA is a minimally invasive procedure that uses planar ultrasound energy with real-time MRI-based treatment planning, thermal dosimetry, and closed-loop temperature feedback for effective prostate cancer ablation.  It signifies a new era in prostate cancer treatment ongoing research promises to refine this innovative approach, broadening its adoption and benefiting patients and healthcare providers globally.

REFERENCES

  • Abudoubari, S., Bu, K., Mei, Y., Maimaitiyiming, A., An, H., & Tao, N. (2023). Prostate cancer epidemiology and prognostic factors in the United States. Frontiers in Oncology, 13. https://doi.org/10.3389/fonc.2023.1142976
  • Wang, L., Lu, B., He, M., Wang, Y., Wang, Z., & Du, L. (2022). Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019. Frontiers in Public Health, 10, 811044. https://doi.org/10.3389/fpubh.2022.811044
  • Tzelepi V. Prostate Cancer: Pathophysiology, Pathology and Therapy. Cancers (Basel). 2022 Dec 31;15(1):281. doi: 10.3390/cancers15010281. PMID: 36612276; PMCID: PMC9818719.
  • Berenguer, C. V., Pereira, F., Câmara, J. S., & Pereira, J. A. M. (2023). Underlying Features of Prostate Cancer-Statistics, Risk Factors, and Emerging Methods for Its Diagnosis. Current Oncology, 30(2), 2300-2321. https://doi.org/10.3390/curroncol30020178 this is for no .2
  • Peters, I., Hensen, B., Glandorf, J., et al. (2023). “First experiences using transurethral ultrasound ablation (TULSA) as a promising focal approach to treat localized prostate cancer: a monocentric study.” BMC Urology, 23, Article number: 1421
  • Guo, C., Sharp, A., Gurel, B., et al. (2023). Targeting myeloid chemotaxis to reverse prostate cancer therapy resistance. Nature, 623, 1053–1061. https://doi.org/10.1038/s41586-023-06696-z
  • Sartor, O., de Bono, J., Chi, K. N., Fizazi, K., Herrmann, K., Rahbar, K., Tagawa, S. T., & the VISION Investigators. (2021). Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. The New England Journal of Medicine, 385(12), 1091-1103. https://doi.org/10.1056/NEJMoa2107322
  • Klotz, L., Pavlovich, C.P., Chin, J., Hatiboglu, G., Koch, M., Penson, D., Raman, S., Oto, A., Fütterer, J., Serrallach, M., Relle, J., Lotan, Y., Heidenreich, A., Bonekamp, D., Haider, M., Tirkes, T., Arora, S., Macura, K.J., Costa, D.N., Persigehl, T., Pantuck, A.J., Bomers, J., Burtnyk, M., Staruch, R., & Eggener, S. (2021). Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer. Journal of Urology, 205, 769–779. https://doi.org/10.1097/ju.0000000000001362
  • Feigl, G. C., Heckl, S., Kullmann, M., Filip, Z., Decker, K., Klein, J., Ernemann, U., Tatagiba, M., Velnar, T., & Ritz, R. (2019). Review of first clinical experiences with a 1.5 Tesla ceiling-mounted moveable intraoperative MRI system in Europe. Bosnian Journal of Basic Medical Sciences, 19(1), 24-30. https://doi.org/10.17305/bjbms.2018.3777

Navigating the Challenges of Infertility: Causes, Treatments, and preventative Strategies

Mar 30, 2024 | Women's Health

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

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

 Infertility is a significant concern affecting 1 in 6 couples globally (WHO 2023), with various causes and treatment options available to address this issue. When exploring infertility, it is crucial to understand the common causes, treatment options, and preventative measures associated with the condition.

Causes of Infertility in Men and Women

Infertility can arise from a multitude of factors in both men and women. In men, common causes include low sperm count, poor sperm motility, hormonal imbalances, genetic factors like Klinefelter syndrome, mumps infection affecting sperm production, and lifestyle factors such as smoking, drug use, exposure to chemicals, stress and obesity[2][3][4]. On the other hand, in women, causes of infertility may stem from ovulation disorders, , tubal blockages, various uterine factors like endometriosis, fibroid, cervical factor, post-surgery scarring, and age-related decline in egg quality and quantity[1][2][4].

Treatment Options for Infertility

Treatment for infertility varies depending on the underlying cause. For men, treatment options may include lifestyle changes like avoiding drugs and alcohol, hormone therapy to regulate hormone levels affecting sperm quality, surgical interventions to correct anatomical issues or blockages, and assisted reproductive technologies (ART) procedures [3][4]. In women, treatments can range from medications to induce ovulation, timed intercourse or improve egg quality to surgical procedures to address structural abnormalities [1][2][4].

Preventative Measures for Infertility

Preventing infertility involves adopting healthy lifestyle practices. Both men and women can benefit from avoiding smoking and excessive alcohol consumption, maintaining a healthy weight through diet and exercise, reducing exposure to environmental toxins or chemicals that may impact fertility, and seeking timely treatment for sexually transmitted infections (STIs)[4][5]. Additionally, regular testing for STIs and addressing any underlying health conditions promptly can help prevent infertility. Moreover, with recent advances, egg or embryo freezing is an option for career-oriented couples wanting to delay pregnancy.

The emotional and social aspect of Infertility:

The journey through infertility can be emotionally taxing and socially isolating. Couples may experience a rollercoaster of hope and disappointment with each treatment cycle. The societal pressure to have children can exacerbate feelings of failure or inadequacy. It’s essential to recognize the emotional toll and provide support through counseling services, support groups, and open communication with loved ones [6].

*Technological innovations in infertility treatments:*

The field of reproductive medicine is continually evolving, with new technologies enhancing the success rates of fertility treatments. Techniques like ovarian tissue freezing and sperm DNA fragmentation tests are on the forefront of these advancements. These innovations offer new hope for couples who have had limited success with traditional fertility treatments [7].

*Nutritional Influences on Infertility *

Recent studies suggest that nutrition plays a vital role in fertility. Diets rich in certain nutrients, such as omega-3 fatty acids, iron, vitamin D and other micronutrients have been linked to improved fertility outcomes. Conversely, diets high in processed foods and sugar may negatively affect reproductive health. Nutrition counseling can be a valuable component of infertility treatment plans [8].

Global perspective on infertility

Infertility is a global issue, with varying prevalence rates and treatment accessibility around the world. In some cultures, infertility carries a significant stigma, which can impact the willingness to seek treatment. Understanding these cultural nuances is important for providing compassionate and appropriate care to individuals facing infertility [9].

In conclusion, infertility is a complex issue that affects both men and women due to various factors ranging from genetic conditions to lifestyle choices. Understanding the common causes of infertility and the available treatment options is essential for individuals facing fertility challenges. By incorporating preventative measures such as maintaining a healthy lifestyle and seeking timely medical care i.e. failing to conceive after one year of regular sexual intercourse, individuals can take proactive steps towards preserving their fertility and addressing infertility issues effectively.

* More information on recent breakthroughs on technological innovations :

The Semen Microbiome and Its Impact on Male Fertility

Recent Advances in Male Infertility Research

*More information on nutrition :

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

REFERENCES

[1] Planned Parenthood. (2024). what is infertility? Retrieved March 24, 2024, from https://www.plannedparenthood.org/learn/pregnancy/infertility

[2] Brazier, Y. (2023, December 22). Infertility in males and females. Medical News Today. Medically reviewed by Kallen, A., MD. Retrieved from https://www.medicalnewstoday.com/articles/165748

[3] Cleveland Clinic. (2024). Male infertility. Retrieved from https://my.clevelandclinic.org/health/diseases/17201-male-infertility

[4] Mayo Clinic. (n.d.). Infertility. Retrieved from https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317

[5] ARC Fertility. (n.d.). Prevention of infertility. Retrieved from https://www.arcfertility.com/patient-resources/infertility-tutorial/prevention/

[6] American Psychological Association. (2024). The psychological impact of infertility. Retrieved from https://www.apa.org/topics/fertility/infertility-impact

[7] Human Fertilisation & Embryology Authority. (2024). Advances in fertility treatment. Retrieved from https://www.hfea.gov.uk/treatments/explore-all-treatments/advances-in-fertility-treatment/

[8] The Nutrition Society. (2023). Nutrition and fertility. Retrieved from https://www.nutritionsociety.org/papers/nutrition-and-fertility

[9] World Health Organization. (2024). Infertility: A global public health issue. Retrieved from https://www.who.int/reproductivehealth/topics/infertility/perspective/en/

 

Prevention of Cyberbullying in Nepal

Mar 27, 2024 | Mental health and well being

Dr. Kishor Adhikari

Written By Sonika Parajuli, Bachelor of Arts in Social work, 4th year  ( Major – Psychology ) Xavier International College

Sabina Maharjan

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

Introduction

Cyberbullying, a new form of bullying has been defined as “willful and repeated harm inflicted through aggressive actions through the use of computers, cell phones, and other electronic devices.” (Hutson, 2016, p. 13). It is important to know that cyberbullying can happen to anyone. Relatively little can be said about a typical cyber target or a typical cyberbully: they can be rich kids or poor kids, left-out kids or popular ones, A-students or struggling students, majority or minority students, someone who has been bullied before of someone who rarely uses technology, it can be someone who uses technology to pass their free time by browsing and chatting, but also someone who mostly uses it for online learning, research, time management or school.

Some of the World wide data:

According to a report by National Information Technology, Centre, more than 1,000 cases of cybercrime were reported in Nepal in 2020. The most common forms of online harassment and cyberbullying include cyberstalking, revenge porn, online scheming, online shaming and trolling. Cyberbullying behaviours are not limited to name-calling; they can include other forms of teasing, defamation, intimidation, rumour spreading, displaying unflattering or compromising photos without consent, hacking into individual’s computer, spreading virus. (Aricak et al., 2008).

There are several forms of cyberbullying including:

  • Flaming- It involves sending angry or vulgar messages to an individual or group.
  • Harassment- The act of sending insulting messages, making threats, stalking, or engaging in other forms of unwelcome communication or conduct to an individual.
  • Denigration- This means sending untrue or unkind statements about someone to other people.
  • Cyberstalking- Threatening to harm someone or using intimidation tactics is known as cyberstalking.
  • Masquerading- The process of impersonating someone and sending information that puts that person in danger or casts them in a negative light is called masquerading.
  • Outing and trickery- accessing embarrassing information about an individual and releasing it to the public.
  • Exclusion- It involves purposefully excluding an individual from an online platform.
  • Catfishing- an individual creates a fabricated identity on the internet with the aim of manipulating and harming a victim through various means, often by exploiting the victim’s emotions.
  • Cyberflashing- When an individual receives sexually explicit image without their consent, they have experienced cyber flashing. This can happen through peer-tp-peer Wi-Fi networks or Bluetooth Airdrop, both within and outside of school settings.
  • Ghosting- When individuals stop talking to someone online without explanation, it is called ghosting. Frequently, instead if directly addressing the matter, individuals opt to simply ignore the person they are targeting.
  • Griefing- The repetitive behaviour of intentionally bothering or annoying others by deliberately eliminating your character, steal your game possessions, or harass you through chat is called griefing.
  • Hate pages- On social media platforms like Instagram, teens make fake accounts to bully others. They post embarrassing photos, share secrets, or spreads mean messages. This is called hate pages.
  • Outing- This happens when someone shares another person’s gender identity or sexual orientation without their permission. It is especially harmful for teens who already struggle with mental health and may be more likely to harm themselves.

According to Stop Bullying (2020), the following are the most common places where cyberbullying occurs:

  • Social Media, such as Facebook, Instagram, Snapchat, and Tik Tok
  • Text messaging and messaging apps on mobile or tablet devices.
  • Instant messaging, direct messaging, online chatting over the internet.
  • Online forums, chat rooms, and message boards, such as Reddit.
  • Online gaming communities.

Cyberbullying can take many forms. It can include harassment (insults or threats), spreading rumours, impersonation, outing and trickery (gaining an individual’s trust and then using online media to distribute their secrets) or exclusion (excluding an individual from activities). These activities can be performed via e-mail, instant messaging, text message, social networking sites such as Facebook or Tumblr, and other websites (Peebles E.,2014).

Short Message Service (SMS), which is more commonly known as text messaging, is also a vehicle for cyberbullying. Text messaging appears to be the most widely used platform for cyberbullying among middle and high school students, followed by online gaming (Smith et al., 2008). DePaolis and Williford (2015), found that 11% of elementary school children under the age of ten reported weekly victimization through online gaming. The social media sites used for 8 cyber victimization included Facebook, Twitter, and Instagram. The least utilized platforms for cyberbullying included instant messaging, email, and chat rooms.

Some References of Case Studies of Nepal

One of the disturbing cases was of Goma Karki, a 16-year-old girl from Nepal, who committed suicide after discovering someone had created a fake Facebook account in her name and posted offensive content. Goma’s family filed a complaint with the Cyber Crime Bureau, which tracked the cell phone number used to create the account and arrested Yubaraj Karki, who confessed to creating the fake profile.

  • Rita Khadka’s Facebook account was compromised in August 2019. She didn’t learn about it until her friends alerted her to the pornographic photographs being shared from her account. She quickly reported the posts to Nepal Police’s cybercrime division and deleted them from her account.
  • According to a study by the Nepal Telecommunications Authority, 26% of students in Kathmandu reported experiencing cyber bullying.

How does Cyberbullying occur?

The exact reason of why people do cyberbullying is unknown.

  • Lack of empathy.
  • A desire for power and control.
  • To take revenge
  • Peer pressure
  • Deficient digital communication skills
  • Escapism, which according to Cambridge dictionary mean a way of avoiding an unpleasant or boring life, especially by thinking, reading, etc. about more exciting but impossible activities.
  • Seeking entertainment
  • Inadequate regulation
  • Lack of parental supervision over children’s Internet use or their computer activities.
  • To boost their egos.
  • To entertain themselves and their friends.
  • To get attention.
  • Some do it because people around them are doing it as well.

Effects of Cyber bullying

Psychological Impacts

  • Victims of cyberbullying are likely to experience Anxiety, Depression, and the feeling of low self esteem
  • Low confidence
  • More susceptible to developing Post Traumatic Stress Disorder.
  • Developing thoughts about suicide and harming oneself.
  • Constant feeling of fear and stress
  • Feeling ashamed, nervousness, anxious and insecurity regarding what people say or think about you.

Physical Impacts

  • Headaches
  • Stomach aches and sleeping problems

Social Impacts

  • Victims of Cyberbullying are at higher risk of being marginalised and stigmatised by society.
  • They might feel ashamed or embarrassed about the harassment, leading them to avoid social activities and relationships.
  • Social isolation.
  • Their peers might not accept them.
  • They do not easily trust other people and are always suspicious of others.
  • For adult: could able to go for work and could not do the routine work

Academic Impacts

  • They struggle to fit in at school and perform poorly academically.
  • Drop in grades
  • Skips school.
  • Gets into trouble at school
  • Loses interest in School
  • Avoid going to school.

(Pradhan, 2023)

Possible signs of cyber bullying

  • Mentally – Feeling upset after messaging or being on the internet, embarrassed, stupid, even afraid or angry most of the time, low self-esteem, reluctant to talk or secretive about their online activities and mobile phone use.
  • Emotionally – feeling ashamed or losing interest in the things you love, feeling upset after using the internet or their mobile phone, anger and irritable.
  • Physically – tired (loss of sleep), or experiencing symptoms like stomach aches and headaches.

Socially- Avoiding formerly enjoyable social situations, not wanting to go to school and/or avoiding meeting friends and school mates, significant increase or decrease in time spent in texting, gaming or using social media.

Internet safety for children

  • Be careful what pictures or videos you upload.
  • Only add people you know and trust to friends/followers lists online.
  • When talking to strangers, keep your personal information safe and location hidden.
  • Keep your password to yourself and change it regularly.
  • Block or report someone who is behaving badly.
  • Do not reply to offending e-mails, text messages or online conversations.
  • Always keep a copy of offending e-mails, text messages or a screen grab of online conversation
  • Make sure you tell an adult you trust, for example, a parent, a carer, a teacher, or the anti-bullying co-ordinator or call a helpline.
  • Do not share your last name, home address, school name or telephone number. You don’t know how the person will use your information.
  • While creating screen name, do not include personal information like your last name or date of birth.
  • Do not share your passwords with anyone and when you use a public computer, make sure your logout of the accounts you have accessed before leaving the terminal.
  • Do not agree to meet an online friend, until you have your parents’ permissions sometimes people pretend to be someone and turb out to be someone else and they recognize the people better.
  • Do not buy anything online without talking to your parents first. Some ads may try to trick you by offering free things as a way of collecting your personal information.
  • Talk to your parents before you open an email attachment or download software as the attachments sometimes might contain virus and make sure not to open an attachment from someone you don’t know.
  • Make sure that you have control over who can access your information online by activating and improving privacy setting on all your social media accounts.
  • Keep in mind that when you use a public internet connection, you cannot know how secure it is. It is best to avoid doing any online banking, sharing sensitive information while using public Wi-Fi.

How can the parents keep their children internet safe?

  • Monitor child’s social media use.
  • Being involved and talking to children. Once a picture is shared online it cannot be taken back.
  • Remind your children that they never know who they really are. They might seem friendly, but because you can’t see them in real life, it is best to be careful.
  • Advise them to never share their email or social media password with anyone, even their best friend.
  • Help them determine what is and is not appropriate to share online.
  • Set hours and limit access to using technology online.
  • Create a code of conduct for your children, such as they will not use social media to humiliate or embarrass other people, even if they are being targeted by cyberbullying.
  • Establish that if your child experiences cyberbullying and shares that with you, their use and access to technology won’t be restricted. However, if your child demonstrates cyberbullying behavior and you find out, identify consequences for your child.
  • If your child is being bullied online, be supportive of your child. Let them know that you will work together to take steps to stop bullying.

How can the Teachers keep the children internet safe?

  • Promote a positive and safe classroom culture. Provide resources in the classroom to help students identify, respond to, and avoid cyberbullying.
  • Step up when you encounter a teachable moment related to cyberbullying or respectful online communication,
  • Encourage students to pay attention to “red flag moments”—when something happens on digital media that makes them feel uncomfortable, worried, sad, or anxious.
  • Explain to students the three ways they can and should respond if they witness cyberbullying: support the target of the bullying (be an ally); try to stop the cyberbullying (be an upstander); and/or tell a trusted adult (report it). It may not be part of your lesson plan, and it may set you off track for a bit, but every time you reinforce anti-cyberbullying messages, you’re doing the critical work of cyberbullying prevention.
  • Incorporate lessons on cyberbullying into your existing curriculum.
  • Talk to parents if encountered any inappropriate cyberbullying.

How can the Adult keep themselves internet safe and reduce the cyberbullying?

  • Make sure you are up to date with the privacy settings. Social media regularly update their privacy options. Stay informed about these changes.
  • Limit access of your contact details. Avoid sharing your email or phone number with unfamiliar individuals.
  • Avoid sharing inappropriate images or videos. Keep in mind that a current romantic partner could be and ex in the future. So it is essential to prevent the possibility of someone possessing and potentially posting compromising material of you online.
  • Refuse friend or follower requests from unknown individuals. If you are unfamiliar with the person sending the request, simply ignore it.
  • Avoid immediate responses to cyberbullying. Cyber bullies often aim to provoke emotional reactions from their targets. When faced with negative online comments, unappealing photos or tags, or any form of unkind behaviour, consider stepping away from your device for at least an hour. Utilize this time to create emotional distance and carefully contemplate your response.
  • Capture screenshots to document instances of cyberbullying. This method ensures you have a record of any harmful comments or photos.
  • Use reporting and blocking features available on social media platforms to address cyberbullying effectively.

Who helps in Nepal?

  • Child Safe Net

Child safe net has been established with the vision of enhancing the safety of digital technology for children and young individuals. They raise awareness about using the internet and devices safest to protect young people from issues like Internet Addiction, Online sexual abuse, and exploitation, cyberbullying, and gaming addiction, while also promoting digital literacy, since 2018.

  • Nepal Police Cyber Bureau

Toll free Emergency Child Helpline- 1098

Toll free Nepal Police Hotline- 100

Nepal Police Cyber Bureau- 9851286770

REFERENCES

The Semen Microbiome and Its Impact on Male Fertility

Mar 18, 2024 | Men's Health

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

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

 In 1981, Lynn Margulis published Symbiosis in the journal Cell Evolution, she proposed that life emerged not as the outcome of a competitive race but by interacting organisms joined together for a very specific order. Human body not only consist of trillions of cells but trillions of ancient species including bacteria and it may be surprising that the mitochondria that makes the energy for the body originated from an ancient bacteria and it retained its unique genome that is known as Mitochondrial DNA.

These microbiomes, occupies and live in a harmony in different part of the body and body fluids especially in  the gut, vaginal, and in the semen microbiome. These microbiomes involved in the health and well-being of humans.  Recent research has shed light on the significance of the semen microbiome and its potential influence on male fertility. This article aims to explore the latest findings on the semen microbiome and its relevance to male fertility, drawing from verifiable sources to provide a comprehensive understanding of this emerging field.

Understanding the Semen Microbiome

The semen microbiome, once thought to be microbe-free, has been revealed to host its own microbial community, akin to the microbiomes of the gut and vagina (Hill, 2021). This microbiome comprises a diverse array of microbes originating from various glands in the upper reproductive tract, as well as “drifter” bacteria from urine, the urethra, and potentially from a person’s blood or their sexual partners (Winters & Walsh, 2019). However, the impact of these individual species of bacteria on health has long been a mystery (Hill, 2021).

Recent Research Findings

A recent investigation conducted at the University of California, Los Angeles (UCLA) delved into the semen microbiome’s potential link to infertility, yielding insightful findings (Winters & Walsh, 2019). The study, published in Scientific Reports, identified a bacterial species, Lactobacillus iners (L. iners), associated with sperm motility issues in individuals experiencing infertility (Winters & Walsh, 2019). This microbe, commonly found in the vaginal microbiome, has been linked to impaired sperm motility, a key factor contributing to male infertility (Winters & Walsh, 2019).

The study involved the genetic sequencing of semen samples from 73 men, half of whom were fertile and the other half seeking fertility consultation due to issues such as lower sperm count or motility (Winters & Walsh, 2019). The researchers identified five common bacteria species in the semen microbiome, with high levels of L. iners correlating with impaired sperm motility in men experiencing infertility (Winters & Walsh, 2019). This discovery is significant as it suggests a potential link between the semen and vaginal microbiomes, indicating their influence on each other and their role in fertility (Winters & Walsh, 2019).

Implications for Male Fertility

The findings of this study have far-reaching implications for male fertility. With approximately 50% of infertility cases attributed to male individuals, understanding the role of the semen microbiome in infertility is crucial (Hill, 2021). The research paves the way for the development of targeted treatments aimed at rectifying issues with sperm parameters, potentially alleviating the burden of infertility for couples (Hill, 2021).

Furthermore, the identification of specific bacteria, such as L. iners, and their potential impact on sperm motility opens new avenues for exploring drug targets to address infertility (Hill, 2021). This could lead to the development of innovative treatments tailored to rebalance the semen microbiome, akin to current approaches used to treat bacterial vaginosis in the vaginal microbiome (Hill, 2021).

Future Directions and Implications for Clinical Practice

While the research on the semen microbiome and its connection to male infertility is still in its nascent stages, the findings have set the stage for future comprehensive investigations into the complex relationship between the semen microbiome and fertility (Winters & Walsh, 2019). These studies could potentially lead to the identification of new biomarkers for clinical laboratory testing, offering valuable insights for couples experiencing fertility issues (Winters & Walsh, 2019).

In conclusion, the emerging field of semen microbiome research has unveiled a new dimension in the understanding of male fertility. By shedding light on the role of the semen microbiome in influencing sperm parameters and male fertility, these findings have the potential to revolutionize the diagnosis and treatment of male infertility, offering hope to countless couples striving to conceive.

REFERENCES

  1. Hill, J. E. (2021). The Semen Microbiome: A New Contributor to Male Fertility? Scientific American.
  2. Winters, K., & Walsh, T. J. (2019). Microbial Communities in Semen Could Impact Fertility. University of California – Los Angeles Health Sciences.