Migraine headaches are one of the most common neurological disorders in the world with an estimated global prevalence of one in seven people.
Despite such high prevalence, migraine continues to be an underdiagnosed and undertreated disease in India, resulting from myths and misconceptions surrounding the illness including incorrect diagnosis. While migraine can be effectively managed, awareness and understanding of migraine, its triggers and potential treatment options remains low.
Evidence shows that migraine reduces family, social, and recreational activities. Many patients have had to give up their careers as they are not able to cope. Personal and family lives also get adversely impacted. There are many cases where recurrent headaches and disability has led to self-harm because of the co-morbid depression that is seen with migraine.
According to Dr. K. Ravishankar, The Headache and Migraine Clinic, Jaslok and Lilavati Hospitals, Mumbai, “Migraine is a chronic, disabling neurological disorder that affects more than 150 million people in India. It is often misdiagnosed as sinus associated headache or as being due to a refractive eye problem or as stress related.”
“Migraine is a treatable disorder, where the headache frequency and severity can be effectively controlled. To achieve that goal, one needs to avoid self-medication with harmful over-the-counter pain-killers and be rightly diagnosed and treated with specific anti-migraine treatment prescribed by consulting doctor,” he added.
Further, talking about the causes and symptoms of migraine, Dr. Harirama K Acharya of Narayana Health City, Bengaluru, said, it is characterised by recurrent attacks of moderate to severe head pain that is throbbing or pulsating and often strikes one side of the head, though both sides may ache.
Other common symptoms are increased sensitivity to light, noise, odours and nausea and vomiting. Routine physical activity, movement, or even coughing or sneezing can worsen the headache.
“An untreated migraine attack usually lasts from 4 to 72 hours. Most people who suffer migraine headaches have a family history of headaches suggesting a strong genetic susceptibility. Migraine in women often relates to changes in hormones. The precise cause of migraine headaches in unclear, but there is general agreement that blood flow changes in the brain are a key factor,” Dr. Harirama K Acharya stated.
Triggers of migraine: A trigger is a condition that acts as a precursor to set off a migraine attack. These triggers can be unique for each patient. Environmental factors appear to play a significant role in triggering a migraine attack however, other things may also act as triggers. Some of the common triggers of migraine are:
• Foods such as aged cheeses, salty or processed foods
• Food additives such as sweetener aspartame and monosodium glutamate (MSG)
• Drinks including alcohol and high caffeine beverages
• Stress at work or home
• Sensory stimuli such as bright lights, sun glare, loud sounds, and strong smells like that of perfume, paint thinner, passive smoking
• Changes in wake-sleep pattern including lack of sleep or too much sleep
• Physical exertion
• Changes in the environment such as change of weather or barometric pressure
• Medications such as oral contraceptives and vasodilators
It is important for patients to seek help from a headache specialist or neurologist and complete their migraine treatment as prescribed by the consulting doctor.
Balanced protein intake better for health
Researchers suggest that excessive consumption of protein for building muscle mass could have a negative impact on the body. However, wide-range of protein is best to maintain balance. Amino acids have long been touted by the fitness and bodybuilding communities for their muscle building benefits. From ultra-bulk protein powders to lean mass-promoting snack bars, there’s no shortage of products available for those seeking a muscle boost.
However, protein’s popularity has also meant that less attention has been paid to researching its potentially negative side-effects.
According to the study published in the Journal of Nature Metabolism, excessive consumption of branched-chain amino acids (BCAAs) may reduce lifespan, negatively impact mood and lead to weight gain.
BCAAs stands for branched-chain amino acids. It’s a group of three essential amino acids: leucine, isoleucine and valine, and are most commonly found in red meat and dairy.
BCAAs great for adding muscle mass, but science says you could pay for it later.
Researchers have investigated the complex role nutrition plays in mediating various aspects of metabolic health, reproduction, appetite and ageing.
“While diets high in protein and low in carbohydrates were shown to be beneficial for reproductive function, they had detrimental effects for health in mid-late life, and also led to a shortened lifespan,” one of the researchers, Dr Samantha Solon explained.
“What this new research has shown is that amino acid balance is important. It’s best to vary sources of protein to ensure you’re getting the best amino acid balance.”
The current research examined the impacts that dietary BCAAs and other essential amino acids such as tryptophan had on the health and body composition of mice.
“Supplementation of BCAAs resulted in high levels of BCAAs in the blood which competed with tryptophan for transport into the brain,” explained one of the researchers, Professor Stephen Simpson.
“Tryptophan is the sole precursor for the hormone serotonin, which is often called the ‘happiness chemical’ for its mood-enhancing effects and its role in promoting sleep. But serotonin does more than this, and therein lay the problem,” he added.
Dietitian and public health nutritionist Dr Rosilene Ribeiro recommend eating a wide range of proteins.
It’s important to vary protein sources in order to get a variety of essential amino acids, through a healthy and balanced diet rich in fibre, vitamins and minerals.
BCAAs are essential amino acids present in protein-containing foods, with red meat and dairy being the richest sources. Chicken, fish and eggs are also nutritious sources of BCAAs.
Vegetarians can find BCAAs in beans, lentils, nuts and soy proteins.
Know the severity of falling sick in the morning
While sickness comes irrespective of the time, the severity of afflictions ranging from allergies to heart attacks differs in the morning from that in the night highlighted a new study. The study was published in the Journal Trends in Immunology which compiled studies, predominantly in mice, that looked at the connection between circadian rhythms and immune responses.
The body reacts to cues such as light and hormones to anticipate recurring rhythms of sleep, metabolism, and other physiological processes. The numbers of white blood cells, in both humans and mice also oscillate in a circadian manner.
Taking into account the above-mentioned facts, researchers in the study found that:
Heart attacks in humans are known to strike most commonly in the morning, and research suggests that morning heart attacks tend to be more severe than at night.
In mice, the numbers of monocytes, a type of white blood cell that fights off bacteria, viruses, and fungi –are elevated in the blood during the day. At night, monocytes are elevated in infarcted heart tissue, resulting in decreased cardiac protection at that time of day relative to morning.
Parasite infections are time-of-day dependent. Mice infected with the gastrointestinal parasite Trichuris muris in the morning have been able to kill worms significantly faster than those infected in the evening.
Allergic symptoms follow a time-of-day dependent rhythmicity, generally worse between midnight and early morning. Hence, the molecular clock can physiologically drive innate immune cell recruitment and the outcomes of asthma in humans, or airway inflammation in mice, the review notes.
“Investigating circadian rhythms in innate and adaptive immunity is a great tool to generally understand the physiological interplay and time-dependent succession of events in generating immune responses,” said senior author Christoph Scheiermann, University of Geneva.
ICMR develops affordable quick test kits for diagnosing genetic bleeding disorders
The Indian Council of Medical Research (ICMR) has developed a cost-effective and rapid point-of-care test kit for diagnosing genetic bleeding disorders such as haemophilia A and Von Willebrand disease (VWD).
Diagnostics which are currently available require special equipment and are expensive.
“Both Haemophilia A and VWD are under diagnosed disorders in our country. There are only handful of comprehensive diagnostic centres for bleeding disorders,” an official at ICMR said.
“Lack of awareness and diagnostic facilities, high cost of tests are some of the factors for under-diagnosis of bleeding disorders in our country,” he said.
According to the ICMR, the kit is the world’s first point-of-care test for specific diagnosis of any common bleeding disorder and costs less than Rs 50 in comparison to existing conventional test that cost around Rs 4,000 to Rs 10,000.
The newly developed kit would help in diagnosis within 30 minutes of blood sample collection. Also, this will be available at any level of health care system including primary health care centres (PHCs) since it does not require any special expertise or infrastructure.
Worldwide, incidence of Haemophilia A is 1 per 10,000 male births and that of VWD is around 1 per cent of the general population.
“In India, there is no epidemiological data. We may have roughly 80,000-1,00,000 severe Haemophilia cases in our country, but the total number registered with Haemophilia Federation India (HFI) is only around 19,000,” the official said.
Patients with severe Haemophilia A or VWD can have life threatening spontaneous or post-traumatic bleeding like brain haemorrhage and gastrointestinal bleeding. In emergency medical setting, it is important to have a quick diagnosis of bleeding disorders for treatment.
This rapid test kit can be used for the diagnosis of menorrhagia cases/ post-partum haemorrhage (PPH), gynecological complications among others.