New York- Covid-19 infection during pregnancy leads to distinct immune changes in mothers and babies, according to a study.
The researchers found that Covid-19 dysregulates maternal immune response, with different immune signatures between mothers with asymptomatic and severe disease.
"We know that pregnancy increases maternal risk for Covid-19, but relatively little is known about the long-term consequences of in-utero exposure for infants," said Jae Jung, Director of the Cleveland Clinic Global Center for Pathogen & Human Health Research.
The study highlights "how important it will be for long-term follow-up after pregnancy to catch and hopefully prevent any unforeseen long-term health conditions related to prenatal infection,"Jung added.
For the study, published in the journal Cell Reports Medicine, the team involved 93 mothers with Covid-19 and 45 of their infant children who were exposed to SARS-CoV-2, the virus that causes Covid-19.
The research team studied immune profiles for more than 1,400 cytokines and other inflammatory proteins collected from peripheral and cord blood samples.
The researchers compared maternal blood specimens collected close to the initial detection of SARS-CoV-2 and at different time points throughout pregnancy and delivery.
They found that compared to mild or moderate disease, pregnant women with severe Covid-19 exhibited significantly more inflammation and elevated levels of a protein called IFNL1 (interferon lambda 1) and the receptor it binds with, IFNLR1, which plays a critical role in protecting against viruses.
"This increase in interferon lambda signaling may help explain why we see relatively little direct transmission of Covid-19 between mother and baby during the period right before or after birth -- what we call vertical transmission," explained Suan-Sin (Jolin) Foo, a research associate in Dr. Jung's lab and co-first author on the paper.
Despite the lack of evidence for robust vertical transmission, the researchers found that SARS-CoV-2 infection alters maternal immunity at delivery and that gestational SARS-CoV-2 exposure alters infant immunity at birth.
At delivery, the women exhibited dysregulated levels of several cytokines that are associated with pregnancy complications, including MMP7, MDK, ESM1, BGN and CD209.
Among infants, prenatal exposure induced the expression of cytokines related to T cells, which are a type of immune cell involved in recognising and attacking specific antigens.
The majority of births within the cohort were healthy, but there was a high incidence of some complications, including preeclampsia and foetal growth restriction.
More research will be necessary to understand the extent to which the observed immune changes are related to these clinical outcomes, the team said.
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Rashes, dry and flaky patches of skin are some of the most prevalent skin issues during winter. As the intake of fluid decreases during the winter, dehydrated skin becomes a battleground for various skin issues. Therefore, it's essential to prepare our skin well ahead of the harsh winters. Homemade DIY treatments might work, but they are not all that helpful in solving all your winter skin problems.
Let's put a focal point on what our skin needs during winters:
In winter, we often feel that our skin does not need exfoliation because we haven't stepped out much. But, in reality, winters give rise to dead skin cells. This in turn clogs the follicles and acts as a barrier to the radiance of the skin. Therefore, exfoliate your skin twice a week to get rid of the dead skin buildup. Exfoliation also helps to boost the effectiveness of serums and moisturisers, thereby helping to maintain the perfect level of hydration.
Look for The Right Moisturizer
Beating the chilly winter air is equally as tough as escaping the summer heat. You have to find the right moisturiser that locks in the essential oils in your skin for a longer period of time. Ensure that you are applying that moisturiser twice a day. If you have extremely dry skin and hands, you can opt for an oil-based moisturiser during the winter. Water-based moisturisers are great for summer, but in winter they are not effective as they dry up your skin too often. You can select from shea butter to rich green tea and even rejuvenating fruit butters for intense hydration.
As hyaluronic acid comes with truck loads of benefits, including skin hydration, anti-wrinkle agency, healing agent, and antioxidant, skincare experts across the globe suggest that hyaluronic acid is the best way to maintain hydration during winter. It is suited for all skin types, and skin experts recommend that one should look out for hyaluronic acid-based products when their skin requires hydration. Profhilo has added a new and popular treatment that has gained popularity in recent times. It works by injecting hyaluronic acid into the skin's layers, resulting in visibly hydrated, healthy, and rejuvenated skin.
DIY Facemask for Winters
Face masks can hydrate your skin, remove the dirt and help in improving the pores of the skin. Applying honey and malai (milk cream) facemask is one of the best natural moisturising creams that you can apply on your skin to make it supple and soft. Honey helps to clear your skin off the bacteria that are responsible for the growth of pimples and acne on your face. Mix a tablespoon each of milk cream and honey in a bowl and mix them well. Apply the mixture on your face and skin and leave it for about 15 minutes before rinsing it off with lukewarm water. Pat dry your skin and see the result. (Dr. Chiranjiv Chabra, Cosmetic Dermatologist, Director Skin Alive Clinics)
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The unprecedented event in the form of a Pandemic has pushed people to work from home. While what seemed like a good break from the traditional 9-5, work from home brought its own challenges. With the increased working hours due to the lack of clear boundary between personal and professional life, work from home did not prove to be a relief like it was supposed to.
According to the CMR study, the average screen time for Indians increased to 25 per cent. And 23 per cent complained about weaker eyesight due to extended work hours. Ayurveda is the ancient Indian science that works on creating a balance and treating the body in a holistic manner. Following are the key Ayurvedic herbs and practices shared by Ritika Krit, Founder, Kamree that one can incorporate in their daily lives to decrease eye strain caused by electronics.
Icing or Sheeta Satmya: Consistent use of electronics produces heat in the eyes and makes eyelids dull and tired. To counter the effects of overwork, soak cotton balls in cool milk or rose water and place it on your eyes for a few minutes. The exercise will give much-awaited relief to the eyes.
Palm Exercise: Palm exercise, known as palming, is an ancient Ayurvedic technique to massage eyes and provide relaxation. Rub your arms together for 10 seconds and place it on your shut eyes in a cupping gesture. Remember not to put pressure on your eyes. Do the techniques 2-3 times as you inhale and exhale slowly. The Ayurvedic exercise provides relief to your eyes and is also helpful for a goodnight's sleep.
Mudras: Mudras are simple hand gestures that are always defined as a healing modality. Most Mudras for better eye vision can be done lying down while breathing normally. Different Mudras have different effects on the body, and when combined with a breathing exercise, they can bring back balance in the body while strengthening all desired parts and healing them holistically.
One of the most common Mudra is Prana Mudra. In order to practice Prana Mudra, keep your spine erect and body relaxed with open palms placed on your lap. Join the tip of your pinky finger to ring the finger to the tip of your thumb and breathe normally for 15 minutes. The Mudra will promote healthy vision and heal irritable eyes.
Herbs for Stronger Eye Vision
Fennel- Rich in Vitamin A and C, fennel is good to strengthen your eye vision. You can either consume it in the form of tea or wash your eyes with fennel water as it cooling for the eyes.
Triphala- Three fruits - Haritaki, Amla, and Bibhitaki make Triphala which balances the energies in the body and is a good source of antioxidants and Vitamin C, which reverses the signs of inflammation and oxidative stress.
The Ginkgo Biloba- Native to China, Ginkgo Biloba is most effective in treating degrading eye vision.
Calendula- Also known as "Pot Marigold," calendula is an anti-inflammatory, antiviral, and antibacterial herb that helps in treating eye conditions such as redness, swelling, mild irritations,
Almonds- The most common ingredient to Indian households, almonds are a good source of Vitamin E, which promotes the growth of healthy tissues and great vision.
Splash water 3-5 times a day to active facial nerves and arteries.
Take a break from electronics during meals.
Practice calmness as anger and frustration can increase the flow of blood, which dilates pupils and causes eye strain. You can also exercise pranayama to bring more peace to your daily life.
Avoid hot water for showers which can cause the imbalance of fire elements in the body. Instead, use lukewarm water whenever necessary.
Wear preventive eyeglasses when using electronics to avoid direct contact with blue light.
Avoid reading or using electronics in a dark room.
Avoid rubbing your eyes harshly. (N. Lothungbeni Humtsoe)
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COPD also known as chronic obstructive pulmonary disorders is a group of lung diseases that blocks airflow and makes it difficult to breathe. The most common of these diseases are emphysema and chronic bronchitis. Many people with COPD have both of these conditions. Emphysema slowly destroys air sacs in your lungs, which interferes with outward airflow. Bronchitis causes inflammation of the bronchi. COPD is a condition in which the disease worsens over time and it makes it difficult even to breathe. Asthma or Bronchitis is a very dangerous condition during pregnancy which causes fatigue, resulting in energy being diverted from the growing foetus.
Asthma can be hard to diagnose. To find out if you have asthma, your doctor takes your health history, does a physical exam and listens to your breathing.. You also may get a lung function test called spirometry. This is a test that checks how well your lungs work. During the test, you take a deep breath and exhale (blow) into a machine called a spirometer. This machine measures the amount of air you breathe in and out. It also measures how fast you can breathe. When you're pregnant, normal changes in your body can make you short of breath. This test can help your doctor know if shortness of breath is a common complication of pregnancy or if it's caused by asthma.
Treatment: Breathing Exercises with COPD
Pursed lip breathing
Pursed Lip Breathing
Pursed lip breathing has a range of benefits:
It's been shown to reduce how hard you have to work to breathe.
It helps release the air trapped in the lungs.
It promotes relaxation.
It reduces shortness of breath.
Practising this technique 4 to 5 times daily can help. Here's how to practice pursed-lip breathing:
While keeping your mouth closed, take a deep breath in through your nose, count to 2. Follow this pattern by repeating in your head "inhale, 1, 2." The breath doesn't have to be deep. A typical inhale will do. Put your lips together as if you're starting to whistle or blow out candles on a birthday cake. This is known as "pursing" your lips. While continuing to keep your lips pursed, slowly breathe out by counting to 4. Don't try to force the air out, but instead breathe out slowly through your mouth.
Tip: Pursed lip breathing is best for performing strenuous activities, such as climbing stairs.
Feeling short of breath can cause anxiety that makes you hold your breath. To prevent this from occurring, you can practice coordinated breathing using these two steps:
Inhale through your nose before beginning an exercise.
While pursuing your lips, breathe out through your mouth during the most strenuous part of the exercise. An example could be when curling upward on a bicep curl.
Tip: Coordinated breathing can be performed when you're exercising or feeling anxious.
Deep breathing prevents air from getting trapped in your lungs, which can cause you to feel short of breath. As a result, you can breathe in the more fresh air.
Here's how to practice deep breathing:
Sit or stand with your elbows slightly back. This allows your chest to expand more fully.
Inhale deeply through your nose.
Hold your breath as you count to 5.
Release the air via a slow, deep exhale, through your nose, until you feel your inhaled air has been released.
Exercise tip: It's best to do this exercise with other daily breathing exercises that can be performed for 10 minutes at a time, 3 to 4 times per day.
When you have COPD, mucus can build up more easily in your lungs. The huffing is a breathing exercise designed to help you cough up mucus effectively without making you feel too tired.
Here's how to practice the huffing:
Place yourself in a comfortable seated position. Inhale through your mouth, slightly deeper than you would when taking a normal breath.
Activate your stomach muscles to blow the air out in three even breaths while making the sounds "ha, ha, ha." Imagine you're blowing onto a mirror to cause it to steam.
Exercise tip: A huff should be less tiring than a traditional cough, and it can keep you from feeling worn out when coughing up mucus.
The diaphragm is an important muscle involved in the work of breathing.
People with COPD tend to rely more on the accessory muscles of the neck, shoulders, and back to breathe, rather than on the diaphragm. Diaphragmatic or abdominal breathing helps to retrain this muscle to work more effectively. Here's how to do it:
While sitting or lying down with your shoulders relaxed, put a hand on your chest and place the other hand on your stomach.
Take a breath in through your nose for 2 seconds, feeling your stomach move outward. You're doing the activity correctly if your stomach moves more than your chest.
Purse your lips and breathe out slowly through your mouth, pressing lightly on your stomach. This will enhance your diaphragm's ability to release air.
Repeat the exercise as you are able to.
Protect Your Lungs during Pregnancy
Since you're essentially breathing for two, take these steps to protect your lung health and your infant's health:
Tell Your Doctor About Any Shortness of Breath- There can be many reasons for shortness of breath in pregnancy. Pregnant women are no strangers to shortness of breath. Early pregnancy hormone surges and, later, the weight and bulk of your expanding womb restrict your breathing. If you're feeling short of breath, and you're worried about it for any reason, let your doctor know.
Ask for A Lung Function Test- While the parameters for the test might change as your pregnancy progresses, the simple, noninvasive lung test called spirometry can help your doctor check on your breathing.
Manage Asthma- Uncontrolled asthma during pregnancy puts both babies and you at risk. If you've been lax about your asthma medications, it's time to update your routine for pregnancy and then stick to it.
Avoid Cigarette Smoke- Don't smoke, ban smoking at home, and avoid all environments where you are exposed to cigarette smoke.(Suryalakshmi Paleri, Executive Physiotherapist, Cloudnine Group Of Hospitals, Bengaluru (Malleshwaram))
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It is very common during the winter and monsoon seasons for us to be more susceptible to various infections. According to Ayurveda, a year is divided into 2 kaalas i.e., Uttaryana and Dakshinayana. Each kaala consists of 3 seasons, and so 6 seasons per year with each season persisting for about 2 months.
Uttaryana Kaala (14 January to 14 July)
Shishir Ritu (Winter) Mid- January to Mid- March
Vasant Ritu (Spring) Mid- March to Mid-May
Grishma Ritu (Summer) Mid- May to Mid- July
Dakshinayana Kaala (14 July to 14 January)
Varsha Ritu (Monsoon) Mid- July to Mid- September
Sharad Ritu (Autumn/ Fall) Mid- September to Mid- November
Hemant Ritu (Late Autumn/Pre-Winter) Mid- November to Mid- January
Out of these 6 seasons, Shishir Ritu (winter) extending from Mid-January to Mid-March is a period that remains cold and windy.
Ritusandhi: 'Ritu' means season and 'Sandhi' means junction. It Is a junctional period consisting of the last 7 days of the previous season and the first 7 days of the next season. During this period, our body is prone to infections.
The common ailments which occur during the winter season are:
Common Cold: A common cold is an upper respiratory tract infection caused mainly by viruses. It mainly affects children, old aged people and other immune-compromised individuals. The symptoms include throat irritation, cough with or without phlegm, running nose, sneezing, watery eyes, headache and a low-grade fever.
Stomach Flu: Stomach flu can spread rapidly during the winter season and is caused by the Norovirus. In this condition, there is an ongoing inflammation of the mucosal lining of the stomach. It can be easily transmitted through food and drinks and through feco-oral contamination. The symptoms include nausea, vomiting, watery diarrhoea and stomach cramps. The person may also feel chills, headaches, fatigue and muscle aches.
Extreme Dry Skin: Dry skin also known as winter skin, is usually worsened during the winter season when the environmental humidity is very low. This is because of the cold and dry air which evaporates the water content of the skin very quickly, making it dry and tight. Skin can be prone to inflammations during this period.
Asthma: Asthma is a condition in which the airway becomes narrow and inflamed, leading to difficulty in breathing, cough and wheezing. For some Individuals, these symptoms may flare up during the winter season. The cold dry air can irritate the airways, producing more mucus and increasing the symptoms. Also, the cold environment can worsen airway constriction.
Flu: Flu is commonly mistaken for a common cold but both are different. It is a common viral infection that can be even life-threatening in highly vulnerable groups. It affects the lungs, throat and nose. Flu commonly affects younger and older populations and also people who have reduced immunity or other underlying chronic conditions. Symptoms include high fever, chills, sore throat, nausea, swollen lymph nodes and headache.
Wellness Tips for Winter Ailments
Practice Good Personal Hygiene: Practising good personal hygiene is one of the most important ways to protect yourself from getting infectious diseases such as stomach flu, common cold and flu. It also helps to prevent the spread of infection from yourself to the next person.
Yogic Kriyas: Practising yogic kriyas such as Jala neti will help to remove the excess mucous from the upper respiratory tract and help in the proper airflow without any obstruction. Thus it also helps in asthmatic conditions and alleviates congestion, allergies and cold. It should be practised under the guidance of a proper Yoga trainer. Care should be taken to blow the nostril properly after the practice to avoid headaches.
Basil: Basil has good antiseptic and antiviral properties and is recommended for viral infections like the common cold and flu. It also helps to liquefy the phlegm and is effective for cough and Asthma. It can be added as a topping to soups and sauces
Turmeric: Turmeric has a great antiviral property and acts effectively against the influenza virus. It is also rich in antioxidants and has an anti-inflammatory property.
Vitamin C Rich Foods: Taking Vitamin C rich food is essential for the repair of the tissues. It helps to improve the production of white blood cells and fights against infection. Vitamin C rich foods include Amla, strawberries, broccoli, Brussel sprouts, pepper, citrus fruits like lemon, orange.
Probiotics: Probiotics reduces the possibility of getting upper respiratory tract infections. They help to keep the immune system healthy. It includes buttermilk, fermented rice water, pickled vegetables, kefir etc.
Stay Hydrated: Having a sufficient amount of warm water will help to maintain the moisture content of the skin.
Hot Soups: Soups are a great diet to be added to our winter menu. This can be further enhanced by using various herbs and spices which are good for winters such as rosemary, oregano, ginger, garlic, pepper, cumin etc.
Exercise: Moderate exercise is extremely important to keep our metabolism high. We can get into cardio or yoga practices that help to elevate the body heat and to improve heart functions so that the circulation can be improved to different parts of the body. (Dr Manoj Kutteri, Wellness Director, Atmantan Wellness Centre)
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Low back pain effects approximately 50 to 80 per cent of pregnant women. There are numerous etiologies for pregnancy-related back pain, such as mechanical effects of gravid uterus, positional stressors, and hormonal effects resulting in pain at pubic symphysis and sacroiliac joint.
Lumbar radiculopathy or true sciatica is rare and accounts only for 1 per cent of low back pain in pregnancy.
What is Sciatica?
Sciatica is also known as lumbo-sacral radicular syndrome defined as a radiating pain along the course of the sciatic nerve. The pain travels from the lower back, buttocks, posterior of the thigh, leg and the foot. It can be a deep, dull pain or a shooting, sharp pain. Sciatic pain can range from mild to severe. It often resolves with treatment.
Causes of Sciatica During Pregnancy
Sciatic pain is typically caused by lumbar spine problems, such as:
A bulging or herniated disc
Spinal narrowing or stenosis,
Osteoarthritis or degenerative disc disease
These situations can put pressure on the sciatic nerve, causing symptoms. Sciatica due to a herniated disc during pregnancy isn't common. But, sciatic-like symptoms are common with low back pain in pregnancy.
Sciatic like symptoms can also be caused by
Muscle tension and unstable joints
Pelvic bone pain
Sacroiliac (SI) joint dysfunction
Pelvic Girdle Pain (pelvic bone pain)
Pelvic Girdle Pain (PGP) describes pain in the joints that make up your pelvic girdle; this includes the symphysis pubis joint (SPJ) at the front and the sacroiliac joints (SIJ) at the back. Majority of pregnancy-related low back pain is PGP and is often misdiagnosed as sciatica.
PGP discomfort is often felt over the pubic bone at the front, below your tummy, or across one side of your lower back, or both sides. At the front, below your tummy, or across one side of your lower back, or both sides. A diagnosis of PGP can be reached based on certain signs and symptoms that you may experience during the pregnancy or afterwards. Having one or more of them may indicate the need for a physiotherapy assessment followed by advice on appropriate management.
You may experience pain in all or some of the areas shaded in the diagrams above. You may also experience the following:
Pain when standing on one leg (e.g. Climbing stairs, dressing, or getting in or out of the bath)
Pain or difficulty moving your legs apart (e.g. Getting in or out of the car)
Clicking or grinding in the pelvic area you may hear or feel this
Limited or painful hip movements (e.g. turning over in bed)
Difficulty lying in some positions (e.g. On your back or side)
Pain during normal activities of daily life
Pain and difficulty during sexual intercourse
With PGP, the degree of discomfort you are feeling may vary from being intermittent and irritating, to being very upsetting.
This is a problem with one of the main stabilizing muscles in the buttocks. This is a common cause of sciatic pain during pregnancy and can present with PGP. This is due to the tightness of the muscle and change in posture in pregnancy.
Piriformis syndrome can be due to both muscle pain from the baby's weight that can also add stress to SI joint because it puts extra pressure on your pelvis and hip joints. Occasionally, the position of your baby can add pressure to your sciatic nerve.
Obesity or weight gain (including weight gained during pregnancy)
Prolonged sitting can also increase risk of developing sciatic pain
Muscle tension and stress to the pelvic joints, sacroiliac joint problem
Symptoms of Sciatic Pain During Pregnancy
Occasional or constant pain in one side of your buttocks or leg
Pain along the sciatic nerve path, from the buttocks down the back of your thigh and to the foot
Sharp, shooting, or burning pain
Numbness, pins and needles, or weakness in the affected leg or foot
Difficulty walking, standing, or sitting
Activities to Avoid
Avoid sitting for long periods
Avoid doing pain exaggerating activity
Do not lift heavy weights often and beyond your ability
Warm packs or cold packs depending on the comfort
Rest from the pain exaggerating activity
Managing weight gain during pregnancy
Sleeping on the side that is not affected
Use a pillow for comfort and support
Stretches (as per recommend by your physiotherapist)
If the symptoms persist it is recommended to consult your Obstetrician and get referred to see a physiotherapist. These sign and symptoms should not be dismissed as normal aches and pain. (Shazia Shadab, Senior Physiotherapist, Cloudnine Group of Hospitals (Jayanagar))(By Shazia Shadab)
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