Birth Control Pills May Increase Risk Of Stroke: Experts

October 28, 2016

New Delhi, Oct 28: Apart from obesity, birth control pills and additional factors such as smoking, high blood pressure or diabetes may put women at increased risk for the most common type of stroke, health experts suggest.

ipillOral contraceptives increase the risk of ischemic strokes, caused by a blood clot that blocks or plugs a blood vessel in the brain.

"Women who take birth control pills are slightly at higher risk of stroke as a result of the high estradiol content in these contraceptive pills, which also increases the risk of blood clots," Vipul Gupta, Additional Director, Neurointervention Surgery, and Co-Director, Stroke Unit, Artemis Hospital, Gurgaon, said.

"The risk also increases for a woman during pregnancy as the increased blood pressure puts stress on the heart. Also migraine can cause chances of stroke three times up in women," Satnam Singh Chhabra, Head Neuro and Spine Surgeon, Sir Ganga Ram Hospital, added.

Women who smoke are also advised against taking birth control pills as this may increase the risk of a stroke.

Stroke is a serious medical emergency causing premature death and disability. It occurs when blood flow to an area of brain is cut off; brain cells are deprived of oxygen and begin to die.

"A stroke occurs when blood supply to a part of the brain is suddenly cut off. The brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function," Mr Gupta explained.

Apart from the ischemic stroke, there is the hemorrhagic stroke caused by a blood vessel that bursts and bleeds into the brain.

"Rheumatic heart disease and atrial fibrillation in younger females is emerging as major cause of strokes," MG Pillai, Head of the Cardiology Department at Nanavati Super Speciality Hospital, Mumbai, said.

When brain cells die during a stroke, the abilities controlled by that area of the brain such as memory and muscle control are lost.

The treatment for stroke may also depend on its type. An ischemic stroke in many cases can be reversed through medicines but only if it is detected within three hours of its occurrence. Treating a hemorrhagic stroke involves finding the cause of bleeding in the brain and controlling it.

"Depending on the damage and overall health of a patient, one can regain the lost abilities to some extent through rehabilitation and medicines," Satnam Singh Chhabra explained.

Unlike ischemic strokes, hemorrhagic strokes aren't treated with antiplatelet medicines and blood thinners because these medicines can worsen the bleeding.

Advanced scans, such as CT angiography, perfusion imaging and MRI are also done to evaluate the site of blockage and quantify the extent of the brain that can be salvaged.

Gains can happen quickly or over the time depending on various factors like the area of the affected part, how much is affected and the patient's motivation. The most rapid recovery usually occurs during the first three to four months of a stroke.

"The cure for a stroke depends on the amount of area damaged. If the damage is fatal then it may take months to heal and if the damage is normal, the patient may recover within a week or two," Kishan Raj, Consultant Neurologist at IBS Hospital, Faridabad, explained.

According to experts, 80 per cent of all strokes are preventable. This starts with managing key risk factors, including high blood pressure, smoking, atrial fibrillation and physical inactivity.

Strokes are life-changing events that can affect a person both temporarily or permanently.

After a stroke, successful recovery will often involve specific rehabilitative activities such as speech therapy, physical therapy to help a person re-learn movements and coordination along with occupational therapy to help people improve their ability to carry out routine daily activities.

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Agencies
June 23,2020

The record levels of new daily COVID-19 cases are due to the fact that the pandemic is peaking in a number of big countries at the same time and reflect a change in the virus' global activity, the World Health Organisation said.

At a media briefing on Monday, WHO's emergencies chief Dr Michael Ryan said that the numbers are increasing because the epidemic is developing in a number of populous countries at the same time.

Some countries have attributed their increased caseload to more testing, including India and the US But Ryan dismissed that explanation.

We do not believe this is a testing phenomenon, he said, noting that numerous countries have also noted marked increases in hospital admissions and deaths neither of which cannot be explained by increased testing.

There definitely is a shift in that the virus is now very well established, Ryan said. The epidemic is now peaking or moving towards a peak in a number of large countries.

He added the situation was definitely accelerating in a number of countries, including the US and others in South Asia, the Middle East and Africa.

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Dr G K Sudhakar Reddy
August 4,2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of  arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip. 

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology.  Leptin is one of the hormones causing knee osteoarthritis. 

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.    

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor. 

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. 

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. 

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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Agencies
January 4,2020

Washington D.C., Jan 3: A new study has found out that diet significantly affects the mental health and well being of an individual.

The study was published in the journal European Neuropsychopharmacology.

"We have found that there is increasing evidence of a link between a poor diet and the worsening of mood disorders, including anxiety and depression. However, many common beliefs about the health effects of certain foods are not supported by solid evidence," said the lead researcher, Professor Suzanne Dickson.

According to the researchers, the link between diet and mental health can be firmly established in certain cases like that of the ability of a ketogenic diet being helpful for children with epilepsy and the impact of vitamin B12 deficiency on poor memory, depression and fatigue.

"With individual conditions, we often found very mixed evidence. With ADHD for example, we can see an increase in the quantity of refined sugar in the diet seems to increase ADHD and hyperactivity, whereas eating more fresh fruit and vegetables seems to protect against these conditions," said Dickson

But there are comparatively few studies, and many of them don't last long enough to show long-term effects," added Dickson.

The study further concludes that some food items can be associated with treatment and the betterment of certain mental health conditions.

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