The Next 6 Golden Months

According to WHO recommendation, worldwide it is recommended that a mother should exclusively breast feed her baby upto the age of 6 months. The baby requires no additional supplement, not even a sip of water! Mother’s milk is adequate for the babies growth and development upto 6 months of age.

At or around 6 months of age, the mother is advised to practice what is called weaning. Weaning is the process by which intake of food, other than breast milk is slowly introduced into the babies diet. This is an important and crucial time in the babies’ life and affects the baby in the long run. It is important to introduce the food slowly and should always start with liquid foods and then semi-solid and then slowly onto more and more solidy foods. Also, it is important to remember that one should never introduce more than one type of food into the babies’ diet at once. Start with any one food type, like for example carrot juice for one week, gradually increasing the frequency of intake from once daily to 3 times a day over the week. At the end of one week, introduce the next type of food in addition to the first one for another whole week. And so on and so forth. This will not only help the baby adjust its gastrointestinal system to the different types of food slowly, but will also help parents detect any food allergies as they introduce new foods. Make sure your child has begun eating most of the adult foods by the age of 10 to 12 months, because if he hasn’t it will be very difficult from here forward.

An important point to remember is regarding cow’s milk. It is not advisable to feed the baby cow’s milk at least until the age of 12 months (1 year). Cow’s milk is notorious for its harmful effects on the gastrointestinal system causing occult blood loss and eventually anemia. Also, cow milk protein exerts a high load on the young kidney. That is why mothers should know that weaning does not mean an abrupt stoppage of breast milk and introduction of external sources of food. It is a gradual introduction of food complementary to breast milk. Always remember that it is best for the baby to be on breast milk at least upto the age of 12 months (1 year) and breast milk alone (with no additional foods, neither water) upto the age of 6 months.

CME held in Sharjah

Hmm..

Here is one blog I havent updated lately. Should get down to it. InshaAllah soon.

Chocolate and Healthy???

Yup! Its true. Chocolate could actually prove to be quite a hero.

Dark chocolate, not white chocolate, has been found to have these benfits!!!!

There are two different kinds of flavonoids called catechin and epicatechins. Catechins, which have recently been found to be abundant in cocoa and minimally processed chocolates, could also help prevent heart disease and possibly cancer, as well as boosting the immune system. Dark chocolate has also recently been found to contain more than four times the amount of catechins as that found in tea. Chocolate is also a good source of copper and magnesium, which helps to regulate heartbeat and blood pressure.

They have been found to do the following:
- Decrease blood pressure
- Improve circulation
- Lower death rate from heart disease
- Improve function of endothelial cells that line the blood vessels
- Defend against destructive molecules called free radicals, which trigger cancer, heart disease and stroke
- Improve Digestion and stimulate kidneys
- Has been used to help treat patients with anemia, kidney stones and poor appetite

On the heart,flavonoids have two positive effects. One, the antioxidants block arterial damage caused by free radicals. These unstable molecules (free radicals) may damage the arterial walls by blocking the artery wall lining. The second indicates, that chocolate inhibit platelet aggregation which could cause a heart attack or stroke. There have also been studies indicating that cocoa flavonoids relax the blood vessels which inhibit an enzyme that causes inflammation.

In turn, its known to reduce blood pressure and also control diabetes.

Of course eating large amounts of chocolate is still bad for you and could cause weight gain. But, taken in smaller quantities, it could prove to be very beneficial to your health. It all depends on the quantity and the type of chocolate that you are eating.

However, it is important to note that these health benefits are seen for people who eat traditional chocolate bars that include minimal amounts of heavily processed cocoa that have been blended with large amounts of sugars, dairy products, and artificial flavorings. But rather, to benefit from eating chocolate, one should be eating dark chocolates that have a high percentage of cocoa content. Even more beneficial to one's health is to eat cocoa is the crudest format possible.

Motivational Deficiency Disorder

The moment I read this, I was almost certain I had this disease myself. And so will a lot of you, who might read this. Don't worry, you don't!! Being lazy is normal. However, on being pointed out by my roommate - I think one of my doctors (no name - I'm gonna get into trouble), is suffering from this disorder. He is not 'just' lazy, but rather "extremely" lazy. More than I could ever imagine someone to be.

This disorder is relatively newly described. So there wasnt much information that I could collect. I shall, therefore, probably quote from the articles that I read.

Actually, its just 'an' atricle published by British Medical Journal (BMJ).

Extreme laziness may have a medical basis, say a group of high profile Australian scientists, describing a new condition called motivational deficiency disorder (MoDeD).

The condition is claimed to affect up to one in five Australians and is characterised by overwhelming and debilitating apathy. Neuroscientists at the University of Newcastle in Australia say that in severe cases motivational deficiency disorder can be fatal, because the condition reduces the motivation to breathe.

Neurologist Leth Argos is part of the team that has identified the disorder, which can be diagnosed using a combination of positron emission tomography (PET scan) and low scores on a motivation rating scale, previously validated in elite athletes. "This disorder is poorly understood," Professor Argos told the BMJ. "It is underdiagnosed and undertreated."

Professor Argos is an adviser to a small Australian biotechnology company, Healthtec, which is currently concluding phase II trials of indolebant, a cannabinoid CB1 receptor antagonist. Although still unpublished, the preliminary results from the company's phase II studies are promising, according to Professor Argos: "Indolebant is effective and well tolerated. One young man who could not leave his sofa is now working as an investment adviser in Sydney."

David Henry, a clinical pharmacologist at the University of Newcastle and long time critic of pharmaceutical marketing strategies, says that although he appreciates that some people with severe motivational deficiency disorder may need treatment, he is concerned that the prevalence estimates of one in five are inflated and that ordinary laziness is being medicalised. "Indolebant may bring some relief to those with a debilitating form of MoDeD, but common laziness is not a disease. People have an absolute right to just sit there."

*Just in case you're wondering... CB1 receptors are receptors in the brain, mostly in the basal ganglia and limbic system. Bsal ganglia are associated with motor and learning functions, and limbic system is involved with emotions and motivation.

I would like to emphasize this particular sentence from the article..
"he is concerned that the prevalence estimates of one in five are inflated and that ordinary laziness is being medicalised."

This could actually pose as a danger, at some point. Just as these days, any small margin of lack of attention, is diagnosed as Attention Deficit Disorder (ADD) - or minor fatigue, depression and weight loss is considered as hyperthyroidism. I witnessed a worried and anxious mother, who was convinced that her daughter was suffering from hyperthyroidism. Her daughter was apparently, sleeping more, looked more depressed, and was losing a lot of weight (she failed to mention that she was eating less too).

Similarly, we will reach the stage (or have we already? - considering my reaction to the article initially) where any minute amount of laziness (which is normal) is considered as a disorder, and there will be unnecessary drug intake.

Also, it is probably one the "best" excuses so far that kids can use as to why they did not complete their homework, assaignments and did not study well for their exams.

Quoting David Henry, from above, "People have an absolute right to just sit there."!!

Chicken Pox

Its been a long long time since I updated my blog. I confess to the fact that I did lose interest in blogging. Good news is - I'm back! The reason for this particular subject, is because my sister texted me two days back - describing some symptoms that my baby brother was suffering from, and wanted to know if it pointed to chicken pox.

Chicken pox, is another name for Varicella - named after the culprit, Varicella Zoster Virus (VZV) and rarely also called Human Herpes Virus - 3 (HHV-3), because it belongs to the herpes virus family.

* Inetersting History - My decision to write about Chicken Pox, was accompanied by an interest in "why the name chicken pox?". Its strange, but this is what wikipedia told me: Small pox was discovered before chicken pox was. And hence, it was not simply considered a different disease on its own, but rather a milder form of small pox - and therefore a "chicken" form of small pox (meaning not as dangerous). The other reasons are a little silly. One being, because the lesions look like the skin was pecked by chickens and that the lesion were similar to a chick pea (I dont see the similarity). A not so believable one is that it was derived from an old English term "giccin" (does that sound like "chicken" to you?) which means "itching". And in the medieval times, the term "pox" meant "curse". So they considered chicken pox to be a plague brought by a black magic curse.

Chicken pox is highly infectious. You can get the infection from an infected person either by direct contact or by inhalation of droplets in the air (when the infected person coughs or sneezes). The infection can also spread through the fluid inside the lesions, and thats usually how you might spread it from one part of the body to another.

Once you get infected, it takes around 10 to 14 days to show any signs or symptoms (in some cases, upto 21 days). The disease is more common in children, but can affect adults. However, in adults the disease has more severe manifestations. A point to be noted, is that once you get chicken pox, you develop life-long immunity to it. This means that once you get chicken pox, you wont get it again (with the exception of certain immuno-compromised conditions).

The disease starts with a low-grade fever, cough, sore throat (sometimes mistaken for common cold or flu), headache, weakness and in some children abdominal pain. Around 1 to 2 days later, the child develops a rash which usually starts on the head and the trunk and spreads to the rest of the body. The rash is known to be highly pruritic (or itchy).

The rash is known to appear in crops. A lesion follows through a series of stages before it dies off. It starts as red macule (a flat area of discoloration - in this case red), and then becomes a papule (a raised lesion) and then a vesicle (raised lesion filled with clear fluid) and later a pustule (raised lesion with pus). The end stage of the lesion is when it crusts and then heals. Healing is usually without scarring, but it may leave a scar if the child scratches the lesions and causes it to rupture. The vesicle stage of the rash is described as a "pearl or dewdrop on a rose petal" appearance, because the fluid filled lesion sits on top of a reddish background. The hallmark of the rash, is that fact that you always see multiple stages of the lesion on the body at the same time. A new lesion takes upto 6 days to crust. And new crops continue to erupt for upto 3 to 5 days.

Remember that an infected person can transmit the infection starting from 2 days before the rash until all the skin lesion crust. Its hard to tell chicken pox before the rash appears (unless you know that your child was exposed - maybe a classmate had it few days back). But, the parents are advised not to send their children to school to avoid contact until all the lesions have crusted (this usually takes one week).

There is no treatment. You just allow the disease to take its course. It is usually self-limiting (unless you are immuno-compromised, or under steroid therapy or you have another disease). You can always get a prescription for a topical cream or ointment to reduce the itching. And it is very important that the patient does not scratch the lesions! I have heard of parents who cover their kids' hands either with a mitten or even just a plastic bag, to prevent them from scratching. It is also important that the child is provided with a healthy diet with sufficient hydration.

Chicken pox can have serious complications (usually in immuno-compromised conditions). It can cause varicella encephalitis or varicella pneumonia, both of which are highly fatal and can cause death. You may also need special treatment if the lesions get superinfected with bacteria (happens when the lesions are scratched - infection spreads from dirty nails and hands). Also, pergnant women must be extra careful, because varicella infection has very serious effects on the fetus.

There is a vaccine which has been developed against varicella. Its efficacy is found to be between 70% to 90%.

Stress : Part 2 - The Drama

Like I mentioned earlier, the stress response creates some changes in your body in order to prepare you for ‘fight or flight’.

The hormones released during speed up heart rate, breathing rate (more oxygen), blood pressure, and metabolism.

Blood vessels open wider to let more blood flow to large muscle groups, putting our muscles on alert. Also, increases blood supply to your brain, lungs and heart.

Pupils dilate to improve vision.

The liver releases some of its stored glucose to increase the body's energy.

And sweat is produced to cool the body.

Spleen discharges more RBCs and WBCs into your blood stream which helps increase the oxygen carrying capacity and the ability to fight infections.

Fluid is diverted from non-essential sites (like the mouth). This can result in dry mouth and difficulty in speech. You can also have spasm of your throat muscles – causing difficulty in swallowing.

Blood flow is diverted from the skin to support your heart and muscles. This can result in cold, clammy and sweaty skin. It also reduces blood loss, in case you get a cut or injury during an attack (the blood also becomes stickier for the same reason). The scalp (and also tiny muscles in your skin) tend to tighten and makes it seem that your hair is standing up.

Your digestive system usually shuts down at such a time.

These are the acute changes that take place in your body, in response to acute stress.

Stress plays a significant role in presentation and progress of other health conditions..

~ Sudden stress increases the pumping action and rate of the heart and causes the arteries to constrict, thereby posing a risk for blocking blood flow to the heart.

~ Emotional effects of stress alter the heart rhythms and pose a risk for serious arrythmias in people with existing heart rhythm disturbances.

~ Stress causes blood to become stickier, increasing the likelihood of an artery-clogging blood clot.

~ Stress may signal the body to release fat into the bloodstream, raising blood-cholesterol levels.

Here is what can happen in chronic stress, when you are exposed to stress over long periods of time..

* In women, chronic stress may reduce estrogen levels, which are important for cardiac health.

* Stressful events may cause men and women who have relatively low levels of the neurotransmitter serotonin (and therefore a higher risk for depression or anger) to produce more cytokines, which in high amounts cause inflammation and damage to cells.

* Recent evidence confirms the association between stress and hypertension (high blood pressure). People who regularly experience sudden increases in blood pressure caused by mental stress may, over time, develop injuries in the inner lining of their blood vessels.

* People who are trying to deal with stress often resort to unhealthy habits including high-fat and high-salt diets, tobacco use, alcohol abuse, and a sedentary lifestyle.

* Chronic stress appears to blunt the immune response and increase the risk for infections and may even impair a person's response to immunizations.

* Prolonged stress can disrupt the digestive system, irritating the large intestine and causing diarrhea, constipation, cramping, and bloating. Excessive production of digestive acids in the stomach may cause a painful burning.

* Irritable bowel syndrome (or spastic colon) is strongly related to stress. The large intestine becomes irritated, and its muscular contractions are spastic rather than smooth and wave like. The patient has bloating, cramping and alternating periods of constipation and diarrhea.

* Stress may predispose someone to peptic ulcers or sustain existing ulcers.

* Often stress is related to weight gain and obesity. Many people develop cravings for salt, fat, and sugar to counteract tension and, thus, gain weight (which predisposes to diabetes and heart problems).

* Some people suffer a loss of appetite and lose weight. In rare cases, stress may trigger hyperactivity of the thyroid gland, stimulating appetite but causing the body to burn up calories at a faster than normal rate.

* Anorexia nervosa and bulimia nervosa are eating disorders that are highly associated with adjustment problems in response to stress and emotional issues.

* Chronic stress has been associated with the development of insulin-resistance, a condition in which the body is unable to use insulin effectively to regulate glucose (blood sugar).

* Chronic stress is found to be associated to joint and muscle pain (most common complaint is back pain).

* Tension-type headache episodes are highly associated with stress and stressful events.

* Among the wide range of possible migraine triggers is emotional stress.

* The tensions of unresolved stress frequently cause insomnia (can occur due to both acute and chronic stress).

* Stress can lead to diminished sexual desire and an inability to achieve orgasm in women. Stress response can also cause temporary impotence in men.

* Stress may even affect fertility. Stress hormones have an impact on the hypothalamus gland, which produces reproductive hormones. Severely elevated cortisol levels can even shut down menstruation.

* Maternal stress during pregnancy has been linked to a 50% higher risk for miscarriage. It is also associated with lower birth weights and increased incidence of premature births - infant mortality. Stress may cause physiologic alterations, such as increased adrenal hormone levels or resistance in the arteries, that may interfere with normal blood flow to the placenta.

* Studies indicate that the immediate effect of acute stress impairs short-term memory, particularly verbal memory.

* Studies have strongly associated chronic stress to shrinkage in the hippocampus, the center of memory.

* Unexplained Hair Loss (Alopecia Areata) is hair loss that occurs in localized (or discrete) patches and has been associated with stress.

There can be plenty more conditions which can be similarly associated.

Stress : Part 1 - The Culprits

Stress basically refers to the changes in the body which prepares itself to react to certain cirumstances. It is also referred to as the "fight or flight response". It is termed so, because the reaction of the body prepares you to either fight the stimulus (that caused the stress), or flee from it before it can cause any harm. (This theory is from an example of a person under attack by an animal - like a bear)

Stimuli which cause stress are reffered to as stressors. Stressors can be external (traumatic or psychological) or they may be internal (infections or inflammations). Stress can be classified as Acute (short-term or fight-flight response) or Chronic (long-term) stress. After an acute stress response, the body changes reverse and returns to normal (relaxation response). Chronic stress is a response to on-going long-term stress situations which do not require a fight or flight response (for example, stressful work environment or stress due to marital problems).

In response to an acute stress, the body releases certain hormones and neurotransmitters. Basically, the response to any stress involves the hypothalamic-pituitary-adrenal axis (HPA axis).



A little briefing on what the above three mentioned are:

~ Hypothalamus - is a region in the brain which helps regulate body functions, providing a link between the nervous system and the endocrine system. It secretes releasing hormones (RH) in response to stimuli, which control the release of hormones by the pituitary gland.
~ Pituitary gland - a gland located at the base of the brain which releases hormones (that regualte a wide variety of body functions) in response to RH from hypothalamus.
~ Adrenal gland - gland situated above the kidney, and regulates stress by synthesis and release of catecholamines and corticosteroids.

So basically what happens is, when you are under stress your hypothalamus gets stimulated to secrete Corticotropin-Releasing Factor (CRF). The CRF acts on the pituitary gland and hence Adrenocorticotropic Hormone (ACTH) is realeased. The ACTH stimulates the adrenal glands to release Catecholamines and Corticosteroids (glucocorticoids - cortisol).

All the changes that occur in the body during stress are primarily due to release of catecholamines and cortisol. The major catecholamines are epinephrine, norepinephrine and dopamine. The catecholamine which plays the key role in stress related changes is epinephrine, also known as adrenaline (the stress hormone).

One of the effects of these hormones is on the amygdala - a region of the brain which manages emotions. In this case, it would cause fear. The hormones also signal the hippocampus (the region of the brain which is responsible for long-term memory), to store this experience for further reference. It helps to identify the same experience as one of fear/terror when you come across it again in the future. Also, the frontal brain (the front portion of the brain responsible for short-term memory, concentration, inhibition and rational thinking) is inhibited during a stress response. Hence, it can hinder the ability of a person to make rational/complex decisions and to concentrate (especially during exam stress).

Chronic stress on the other hand has very devastating and harmful effects on the brain and the rest of the body. During chronic stress, the body detects small levels of stress and keeps the nervous system slightly elevated causing release of stress hormones in extra amounts over a prolonged period of time. Studies have shown that chronic stress results in a shrinkage of the hippocampus with reduced blood supply, and hence causes a reduced acticity. Also, it is found that the amygdala increases in size and remains hyperactive, regardless of the stimuli.

The result of a shrunken hippocampus and an enlarged amygdala is not good. The huge amygdala causes anxiety and fear to even very small stimuli. The shrunken and inactive hippocampus makes it diffcult for you to process and recall the intial or the specific stimuli that caused your stress. Hence, the body will remain confused as to the specific cause of stress/fear/anxiety. The result will be that your body will stimulate the amygdala to cause generalized anxiety and fear.

In the next post, I will discuss specific changes in the body in response to stress.