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
July 4,2020

The Union health ministry on Friday revised the dosage of anti-viral drug remdesivir to be administered to coronavirus patients in the moderate stage of illness from the earlier six days to five days as it issued an updated 'Clinical Management Protocols for COVID-19'.

The drug, administered in the form of injection, should be given at a dose of 200 mg on day one followed by 100 mg daily for four days (total five days), the new treatment protocols stated.

The Health Ministry on June 13 had allowed the use of remdesivir for restricted emergency use in moderate cases under "investigational therapies".

"Under emergency use authorisation, remdesivir may be considered for patients in moderate stage requiring oxygen support," the document stated.

It is not recommended for those with severe renal impairment and high level of liver enzymes, pregnant and lactating women, and those below 12 years, it said.

The ministry also okayed off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in the moderate stage of illness as "investigational therapies".

It also recommended hydroxychloroquine for patients during the early course of the disease and not for critically-ill patients.

On June 27, the ministry had included an inexpensive, widely used steroid dexamethasone in treatment protocols for COVID-19 patients in the moderate to severe stages of their illness among other therapeutic measures.

The ministry advised use of dexamethasone, which is already used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects, as an alternative choice to methylprednisolone for managing moderate to severe cases of coronavirus infection.

India's COVID-19 cases soared by over 20,000 in a day for the first time taking the country's total tally to 6,25,544 on Friday while the death toll climbed to 18,213 with 379 new fatalities, according to the Union Health Ministry data updated at 8 am.

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Agencies
June 21,2020

Lower neighbourhood socioeconomic status and greater household crowding increase the risk of becoming infected with SARS-CoV-2, the virus that causes COVID-19, warn researchers.

"Our study shows that neighbourhood socioeconomic status and household crowding are strongly associated with risk of infection," said study lead author Alexander Melamed from Columbia University in the US.

"This may explain why Black and Hispanic people living in these neighbourhoods are disproportionately at risk for contracting the virus," Melamed added.

For the findings, published in the journal JAMA, the researchers examined the relationships between COVID-19 infection and neighbourhood characteristics in 396 women who gave birth during the peak of the Covid-19 outbreak in New York City. Since March 22, all women admitted to the hospitals for delivery have been tested for the virus, which gave the researchers the opportunity to detect all infections -- including infections with no symptoms -- in a defined population

The strongest predictor of COVID-19 infection among these women was residence in a neighbourhood where households with many people are common.The findings showed that women who lived in a neighbourhood with high household membership were three times more likely to be infected with the virus. Neighbourhood poverty also appeared to be a factor, the researchers said.Women were twice as likely to get COVID-19 if they lived in neighbourhoods with a high poverty rate, although that relationship was not statistically significant due to the small sample size.

The study revealed that there was no association between infection and population density.

"New York City has the highest population density of any city in the US, but our study found that the risks are related more to density in people's domestic environments rather than density in the city or within neighbourhoods," says co-author Cynthia Gyamfi-Bannerman."

The knowledge that SARS-CoV-2 infection rates are higher in disadvantaged neighbourhoods and among people who live in crowded households could help public health officials target preventive measures," the authors wrote.

Recently, another study published in the Journal of the American Planning Association, showed that dense areas were associated with lower COVID-19 death rates.

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News Network
February 22,2020

Feb 22: The subjective feeling of well-being experienced by many people with the practice of meditation is associated with specific changes in the brain, according to a study which may lead to better clinical recommendations of the practice.

The study, published in the journal Brain and Cognition, examined the effects of the technique known as Transcendental Meditation (TM), which consists of the silent repetition of a meaningless sound.

In the study, the researchers from the IMT School for Advanced Studies Lucca in Italy, enrolled 34 healthy young volunteers and divided them in two groups.

They said the first group practised TM 40 minutes per day in two sessions of 20 minutes each, one in the morning and the other in the evening.

The second group, the scientists said, did not change its daily routine.

Using questionnaires, they also measured the anxiety and stress levels of all the participants at the beginning of the study, as well as the subjects' ability to manage stressful situations.

According to the researchers, the participants were also subjected to a functional magnetic resonance imaging (fMRI) brain scan, in order to measure the organ's activity at rest, and changes in the excitation among different cerebral areas.

They repeated the tests after three months, at the end of the study.

According to the study, the levels of anxiety and stress perceived by the subjects who followed the meditation program were significantly reduced in comparison with those of the volunteers who did not practice TM.

"Magnetic resonance imaging also shows that the reduction of anxiety levels is associated with specific changes in the connectivity between different cerebral areas, such as precuneus, left parietal lobe and insula, which all have an important role in the modulation of emotions and inner states," said study co-author Giulia Avvenuti from the IMT School for Advanced Studies Lucca.

"In the control group, instead, none of these changes was observed. The fact that Transcendental Meditation has measurable effects on the 'dialogue' between brain structures involved in the modulation of affective states opens new perspectives for the understanding of brain-mind relationships," said Pietro Pietrini, IMT School's Director, and co-author of the study.

"It also extends the results of recent research suggesting that drugs therapies and psychotherapy leverage on the same biological mechanism," Pietrini said.

According to the researchers, even a few months of practice of TM can have positive effects which can be correlated with measurable changes in the brain.

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