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Dr. Afshin Shawn Adhami M.D
how should women facing labor approach their birth plan?
Preparing for the arrival of a child is an exciting time for potential mothers, but there is a lot to consider. Aside from painting the nursery and learning how to change a diaper, pregnant women and their partners need to make decisions on how they want to bring their child into the world. Whether by natural, drug-assisted or surgical means, there are associated risks and benefits across the board, depending on the circumstances. In this feature, we examine different birthing methods and their outcomes.
The 20th century brought childbirth from the home to the hospital, where hi-tech devices and procedures - such as the fetal heart rate monitor, cesarean sections (C-sections) and epidurals - became commonplace. By the late 1970s in the US, home birth rates fell to around 1%.
The rise of the C-section
Fast forward to the present day, and the business of childbirth looks very different from its early origins. The Centers for Disease Control and Prevention (CDC) report that there were over 3.9 million births registered in the US in 2012. Of these, over 2.6 million were delivered vaginally, and nearly 1.3 million were delivered via C-section.
Additionally, the vast majority of these births took place in a hospital; only 1.4% of deliveries occurred elsewhere. Of these, over 65% took place at home and 29% occurred in a birthing center.
In 2009, the total C-section delivery rate reached an all-time high, at 32.9%, which represented a 60% increase from the most recent low in 1996, at 20.7% of all births.
Given this significant spike, the American College of Obstetricians and Gynecologists (ACOG) issued clinical guidelines in February of this year to reduce the occurrence of C-sections that were not medically indicated, as well as labor induction before 39 weeks. These guidelines included initiatives aimed at improving prenatal care, changing hospital policies and educating the public.
C-sections are deemed medically necessary when circumstances make a vaginal birth risky for the mother or baby. For example, physicians or midwives may recommend one when the fetus is in the breech position - when the baby's buttocks or feet are facing the pelvis rather than the head - or when the placenta is covering the cervix - called placenta previa.
We recently reported on a study published in August of this year that suggested breech babies have a higher risk of death from vaginal delivery than C-section.
If you or your loved one are pregnant and having question about methods of delivery, Please feel free to contact us to make a consultation with our specialist.
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12 natural cough remedies tips
Coughs play a role in clearing irritants and infections from the body, but persistent coughing can be annoying. The best treatment for a cough will depend on its underlying cause. There are many possible causes of coughs, including allergies, infections, and acid reflux.
Some natural remedies may help to relieve a cough. However, it is important to remember that the U.S. Food and Drug Administration (FDA) do not monitor herbs and supplements, so people who use them may be at risk of using low-quality products and impurities.
You should also be aware that some herbs and supplements can interfere with medications, which may result in unwanted side effects.
If a cough is severe or persists for more than a few weeks, it is essential to seek medical advice.
1. Honey tea
A popular home remedy for coughs is mixing honey with warm water.
According to some research, honey may relieve coughs.
A study on treatments for nighttime coughing in children compared dark honey with the cough-suppressing medication dextromethorphan and with no treatment.
The researchers reported that honey provided the most significant relief from coughing, followed by dextromethorphan.
Although the benefits of honey over dextromethorphan were small, parents rated honey most favorably of all three interventions.
To use honey to treat a cough, mix 2 teaspoons (tsp) with warm water or an herbal tea. Drink this mixture once or twice a day. Do not give honey to children under 1 year of age.
2. Ginger
Ginger may ease a dry or asthmatic cough, as it has anti-inflammatory properties. It may also relieve nausea and pain. One study suggests that some anti-inflammatory compounds in ginger can relax membranes in the airways, which could reduce coughing. The researchers mainly studied the effects of ginger on human cells and animals, so more research is necessary.Brew up a soothing ginger tea by adding 20–40 grams (g) of fresh ginger slices to a cup of hot water. Allow to steep for a few minutes before drinking. Add honey or lemon juice to improve the taste and further soothe a cough.
Be aware that, in some cases, ginger tea can cause stomach upset or heartburn.
3. Fluids
Staying hydrated is vital for those with a cough or cold. Research indicates that drinking liquids at room temperature can alleviate a cough, runny nose, and sneezing.
However, people with additional symptoms of a cold or flu may benefit from warming up their beverages. The same study reports that hot beverages alleviate even more symptoms, including a sore throat, chills, and fatigue.
The symptom relief was immediate and remained for a continued period after finishing the hot beverage.
Hot beverages that may be comforting include:
* clear broths
* herbal teas
* decaffeinated black tea
* warm water
* warm fruit juices
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Heart disease symptoms in men

Heart disease is one of the most common health problems that men face. By knowing some of the signs and symptoms of heart disease, they may be able to reduce their risk of developing serious complications, such as a heart attack.

Heart disease is a term referring to a range of heart health issues. These include:

coronary artery disease
heart failure
other heart-related irregularities, infections, and birth abnormalities
According to the American Heart Association (AHA), heart disease affects more than 1 in 3 men in the United States.

In some cases, a person may have evident signs of heart disease that are easily recognizable. It is possible, however, to develop heart disease without experiencing any noticeable symptoms.

Are symptoms different in men and women?

Men and women share many of the same symptoms for heart disease and heart attacks.

However, men are more likely to experience the well-known heart attack symptoms such as:

crushing chest pain
squeezing, discomfort, or fullness in the chest
pain in the arm, jaw, or back
shortness of breath
cold sweat
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9 Home remedies for shingles
When adults have extremely itchy or painful lesions across their torso or face, the diagnosis may be shingles. It is essential that people with this condition visit a doctor for treatment, but some home remedies can help to relieve symptoms.
In the United States, there are up to one million estimated cases of shingles every year. Shingles refers to the reactivation of the dormant herpes varicella zoster virus after childhood. Aging, trauma, stress, or another illness can all activate the virus.
The Centers for Disease Control and Prevention (CDC) recommend seeking medical advice as soon as any symptoms appear.
Natural remedies
Some of these remedies may relieve pain and itchiness and improve healing:
1. Essential oils
People have used essential oils as herbal remedies for many years, often for skin conditions.
Some essential oils have properties that may help with skin irritation and healing These oils include:
Chamomile oil, which has anti-inflammatory and antimicrobial properties and can improve ulcers and pressure sores by aiding skin-cell regeneration.
Eucalyptus oil, which has anti-inflammatory properties and can increase the speed at which cancer patients sores heal.
Tea tree oil, which has anti-inflammatory and antimicrobial properties and can promote wound healing.
2. Cold compresses
Holding cool cloths or compresses against the rash site may assist in relieving itchiness and reducing inflammation.
People can lightly soak a natural cotton cloth or towel with cool water and wring it out before placing it on sore, itchy areas. They can then repeat this as necessary.
It is also best not to expose the skin to extreme temperatures, so people should avoid using ice baths or very hot water. Hot water will increase blood flow and potentially slow down the healing of sores, whereas ice will increase skin sensitivity.
3. Witch hazel
Researchers believe that witch hazel is more effective than chamomile for reducing inflammation and itchiness in some individuals.
It is possible to purchase witch hazel in a variety of forms, the most common of which are creams or witch hazel water. Many witch hazel creams are available online (visit
People can apply witch hazel topically to areas of irritation and inflammation to achieve relief.
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Know you brain. Right & Left brain.
7 things you didn't know about your brain
The brain — the central "control unit" of our bodies, repository of memories and emotions. Throughout history, philosophers have believed that the brain may even house that intangible essence that makes us human: the soul. What should we know about our brains?
The main organ of the human nervous system, the brain manages most of our bodies activities and processes information received from both outside and inside the body and is the very seat of our emotions and cognitive abilities, including thought, long- and short-term memory, and decision-making.
The first mention of this organ was recorded in an Ancient Egyptian medical treatise known as the "Edwin Smith surgical papyrus," after the man who discovered this document in the 1800s.
Since then, our understanding of the brain has expanded immeasurably, although still we contend with many mysteries surrounding this key organ.
In this Spotlight, we look at some of the most important facts we have uncovered about the brain — and some aspects that remain to be understood.
1. How big are our brains?
Brain size varies widely, depending largely on age, sex, and overall body mass. However, studies have suggested that the adult male brain weighs, on average, about 1,336 grams, whereas the adult female brain weighs around 1,198 grams.
In terms of dimensions, the human brain isn't the largest. Of all mammals, the sperm whale — an underwater denizen weighing an impressive 35–45 tons — is known to have the biggest brain. But, of all the animals on Earth, human brains have the largest number of neurons, which are specialized cells that store and transmit information by electrical and chemical signals.Traditionally, it has been said that the human brain contains approximately 100 billion neurons, but recent investigations have questioned the veracity of that number. Instead, Brazilian neuroscientist has discovered that the number is closer to 86 billion neurons.
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The vegetarian diet reduces heart disease death risk by 40 percent

The latest in a long line of papers on the many health benefits of reducing meat intake concludes that a plant-based diet is a great news for your heart.
Currently, in the United States, vegetarianism and veganism are steadily becoming more popular.
Touted as a more healthful option, many people are working to reduce their meat intake.
In the past few decades, numerous studies have demonstrated that restricting meat impacts the body in a number of positive ways.
For instance, a plant-based diet has been shown to reduce the risk of obesity, type 2 diabetes, and metabolic syndrome. Vegetarianism and veganism may even protect against certain cancers.
A recent review, now published in the journal Progress in Cardiovascular Disease, focused on the benefits of a plant-based diet on cardiovascular health, specifically.

Plant-based diets and heart health
The researchers — from the Physicians Committee for Responsible Medicine in Washington D.C. — scrutinized reams of recent, relevant studies.
Collating information from a host of clinical trials and observational studies, they found that a plant-based diet was consistently linked with improved measures of heart health.
They concluded, for individuals following a plant-based diet, that:
* Risk of death from cardiovascular disease is reduced by 40 percent.
* Coronary heart disease risk is reduced by 40 percent.
* Blocked arteries are unblocked partially or fully in as many as 91 percents of patients.
* Hypertension risk drops by 34 percent.
Also, total cholesterol and low-density lipoprotein, or "bad," cholesterol levels are much lower in vegetarians compared with non-vegetarians. Moreover, a plant-based diet was shown to be associated with weight loss.

A plant-based diet has the power to not only prevent heart disease but also manage and sometimes even reverse it — something no drug has ever done." Dr. Adhami notes.

Dr. Adhami also notes that more healthful diets and lifestyles lower the risk of heart attack by 81–94 percent, while drugs can only lower this risk by 20–30 percent.

How does vegetarianism protect the heart?
There seem to be many reasons why a plant-based diet is more healthful for the heart than a meat-heavy one. It seems that plants impart some benefits, while meat increases certain risks.
For instance, plants are rich in fiber and phytonutrients, which are known to reduce inflammation and oxidative stress. Also, animal products are often high in fat, cholesterol, heme iron, and environmental pollutants.

However, this is a complex interaction, and there may be many more factors involved that are, as yet, unknown.
Heart disease is responsible for the deaths of more than 600,000 U.S. individuals each year, and it remains the leading cause of death, globally. However, these findings show that if society could be gently nudged toward plant-based diets and away from excessive meat consumption, humanity's heart health could be substantially improved.
As Dr. Adhami notes, with more than a dash of positivity, "Heart disease is the world's leading cause of death. This study proves it doesn't have to be."
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QI deficiency explained in traditional Chinese medicine.
According to Traditional Chinese Medicine (TCM), qi is the vital energy that circulates through the body at all times. Practitioners believe that a qi deficiency is linked to the spleen and that rest and eating certain foods can treat the imbalance.
The concepts of TCM are not based in modern science but have their roots in ancient Chinese practices. TCM includes herbal remedies, acupuncture, and exercises such as tai chi or qigong.
While there is no scientific proof for qi or a deficiency of qi, many people understand these terms as ways to describe issues in the body as a whole — rather than taking the rigorous route that medical science does.
In this article, we will explore what a qi deficiency is, its symptoms and causes, and how it might be treated with rest and diet.
What is a qi deficiency?
According to TCM, qi is life force or vital energy. Everything in the world is made up of qi, including the physical body and the feelings a person has.
Followers and practitioners of TCM believe that to be balanced in life and free from physical or mental health issues, a person must have balanced qi. They suggest that illnesses or other conditions only appear when there is a qi imbalance or deficiency in the body.
The National Center for Complementary and Integrative Health (NCCIH) define qi as a vital energy that flows through the body, helping to maintain a person's health. The NCCIH are interested in the ideas of TCM but do not focus on specific concepts, such as qi. Instead, the NCCIH take a more scientific view, looking at how these practices affect the body and their use in symptom management.
What are the symptoms?
Roughly translated, qi means energy, so, simply put, a qi deficiency means low energy. This low energy can affect the body as whole or just specific organs that cause different symptoms.
A general qi deficiency may cause some overall symptoms of fatigue and illness.
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Symptoms of low vitamin E in your body

Symptoms of deficiency Cause Seeing a doctor Treatments Vitamin E in the diet Complications Takeaway

The body needs vitamin E to function, making it an essential vitamin. It is fat-soluble, meaning that it requires fat from the diet to be properly absorbed. Vitamin E is mainly stored in the liver before being released into the bloodstream for use.
Deficiency is uncommon and typically the result of an underlying condition. Some premature infants also have low levels.
Vitamin E occurs in eight chemical forms. With a blood test, a doctor can learn how much of one form, alpha-tocopherol, a person has. Using this information, they can determine whether a person's overall level of vitamin E.
A normal level is usually with the range of 5.5–17 milligrams per liter (mg/L). The normal range may be different for premature infants and children under 17. Normal ranges can also vary slightly among labs.
When an adult has less than 4 mg/L of vitamin E in their blood, they usually require supplementation.

Signs and symptoms of deficiency
Vitamin E deficiency may cause disorientation and vision problems.
Low levels of vitamin E can lead to:
* Muscle weakness: Vitamin E is essential to the central nervous system. It is among the body's main antioxidants, and a deficiency results in oxidative stress, which can lead to muscle weakness.
* Coordination and walking difficulties: A deficiency can cause certain neurons, called the Purkinje neurons, to break down, harming their ability to transmit signals.
* Numbness and tingling: Damage to nerve fibers can prevent the nerves from transmitting signals correctly, resulting in these sensations, which are also called peripheral neuropathy.
* Vision deterioration: A vitamin E deficiency can weaken light receptors in the retina and other cells in the eye. This can lead to loss of vision over time.
* Immune system problems: Some research suggests that a lack of vitamin E can inhibit the immune cells. Older adults may be particularly at risk.
Muscle weakness and difficulties with coordination are neurological symptoms that indicate damage to the central and peripheral nervous systems.

The peripheral system is the network of nerves located beyond the brain and spinal cord. These neurons pass messages throughout the body.
The central nervous system communicates between the brain and the spinal cord.
The sheaths of neurons are mostly composed of fats. When the body has too little vitamin E, it contains fewer antioxidants that protect these fats, and the function of the nervous system breaks down.

Causes of vitamin E deficiency
Vitamin E deficiency often runs in families.
Learning about family history can make diagnosing certain rare, inherited diseases easier. Two of these diseases, congenital abetalipoproteinemia, and familial isolated vitamin E deficiency are chronic and result in extremely low vitamin E levels.
Medical conditions
Vitamin E deficiency can also result from diseases that severely reduce the absorption of fat. This is because the body requires fat to absorb vitamin E correctly.
Some of these diseases include:
* chronic pancreatitis
* celiac disease
* cholestatic liver disease
* cystic fibrosis.
Deficiency is also common in newborns and babies born prematurely who have lower birth weights and less fat.
Premature infants are at particular risk because an immature digestive tract can interfere with fat and vitamin E absorption.
Vitamin E deficiencies in these infants can also lead to hemolytic anemia, which destroys red blood cells.

When to see a doctor
When a person has no history of the ​genetic disease but experiences any symptoms of a vitamin E deficiency, they should contact a doctor.
An extremely low level of vitamin E in the blood can indicate an underlying health issue. Further testing will help to determine the cause and treatment options.

What are the treatment options?
Newborns and premature babies may be given a vitamin E supplement via a tube in the stomach.
Vitamin E supplementation is often effective.
Newborns and premature babies
Current practice involves providing vitamin E supplementation through a tube in the stomach. When necessary, it can also be administered intravenously.
While one dose can sufficiently raise blood levels of vitamin E, multiple doses may be required.

Children and adults with deficiencies caused by inherited conditions require supplementation with high doses of vitamin E.
Supplementation can stop the progression of the disease. When the deficiency is detected early, it may prevent neurological symptoms.

Vitamin E in the diet
It is highly unlikely that a person has low levels of vitamin E unless they have an underlying chronic disease, a genetic condition, or a diet extremely low in fat. For others, supplementation is usually not necessary.
Vitamin E is plentiful in a wide variety of foods. The body cannot produce it, so it must be obtained from the diet or a supplement.
Foods that contain vitamin E include:
* vegetable oils, such as wheat-germ oil, peanut oil, and olive oil
* nuts, seeds
* whole grains
* milk
* most vegetables, including spinach, Swiss chard, red peppers, and avocados


Taking too many fat-soluble supplements can be dangerous.
A person should not take too many supplements of fat-soluble vitamins, including vitamins A, D, E, and K.
Excessive levels of vitamin E may cause abnormal bleeding, muscle aches, diarrhea, and vomiting. The bleeding can increase the risk of a stroke and early death.
Too much vitamin E can also interact with blood thinners, such as warfarin, and chemotherapy medications.
A person should inform the doctor of all supplements and vitamins they take regularly. Do not exceed the recommended dosage of supplements unless instructed to by a physician.

When an adult has a vitamin E deficiency, a chronic illness or genetic condition is likely responsible.
A person should seek treatment from a specialist and a qualified dietitian who has experience with the illness.
When a diet extremely low in fat is responsible for the deficiency, it can be remedied by adding fats to the diet.
Ongoing vitamin E supplementation will be necessary to halt the progression of illness and prevent complications. When a person is diagnosed early and receives continuous treatment, their outlook is usually good.
Research continues on vitamin E supplementation, toxicity, and safe limits.
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10 Home remedies for Wheezing

Wheezing is a common symptom of various respiratory disorders that cause tightening in the throat. There are several ways a person can stop their wheezing at home without using an inhaler, but these will depend on the cause.

Wheezing happens when the airways are tightened, blocked, or inflamed, making a person's breathing sound like whistling or squeaking. Common causes include a cold, asthma, allergies, or more serious conditions, such as chronic obstructive pulmonary disease.

Steam inhalation is an effective home remedy for wheezing.

The following home treatments for wheezing aim to open up the airways, reduce the irritants or pollution that a person breathes in, or treat the underlying causes of the wheezing.

If a person has asthma or another medical condition that causes wheezing, they should speak to our doctors in the ​clinic and use the medications prescribed for it, such as an asthma inhaler.

Effective home remedies for wheezing include:

1. Steam inhalation

Inhaling warm, moisture-rich air can be very effective for clearing the sinuses and opening up the airways. Peppermint essential oil may have pain-relieving and anti-inflammatory effects. Research suggests that it may relax the muscles of the respiratory system, which could help to relieve wheezing and other respiratory problems.

If a steam bath does not appeal to you, a sauna room or hot shower can also help loosen congestion. Gently tapping on the back or chest and breathing deeply can help the steam work even better.

2. Hot drinks

Warm and hot drinks can help to loosen up the airways and relieve congestion.

Honey is a natural anti-inflammatory and antimicrobial, so adding a teaspoon of honey to a hot drink may further improve a person's symptoms.

A 2017 study found that eating one tablespoon of honey twice a day, along with other treatments, helped to relieve throat congestion.

Some people find that peppermint or other menthol teas work well. A person can try experimenting with different teas to find one that helps.

3. Breathing exercises

Breathing exercises may help with COPD, bronchitis, allergies, and other common causes of wheezing.

A 2009 study found that certain yoga-inspired breathing techniques could help with breathing difficulties related to bronchial asthma, including wheezing.

Breathing exercises often include deep, regular inhalations and exhalations. A doctor or respiratory therapist can help with deciding the most effective breathing techniques.

A person may find that they have trouble breathing during a panic attack. Deep breathing exercises can also assist here. It may help to try slow breathing, focusing on breathing deeply into the stomach, and counting breathes.

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An osteoarthritis is a form of arthritis caused by the inflammation, breakdown, and eventual loss of cartilage in the joints. The cartilage wears down over time.

Also known as degenerative arthritis, degenerative joint disease, and osteoarthrosis, osteoarthritis (OA) is the most common joint disorder in the United States.
It affects around 10 percent of men and 13 percent of women aged over 60 years.
OA is a progressive disease. Symptoms worsen over time.
There is no cure, but treatment can help the individual control pain and swelling and stay mobile and active.

The main symptoms of OA are pain and difficulty moving the affected joints.
The person may feel stiff on waking up in the morning, but this usually improves within 30 minutes of starting to move about.
OA involves:
* bony growths around the edges of joints
* damage and loss of cartilage, the part of the joint that cushions the ends of the bones and allows easy movement of joints
* synovitis, a mild inflammation of the tissues around the joints
Some people have no symptoms. Symptoms may occur in one more joints, and they tend to appear gradually.
The individual may also notice that:
* the affected joints are larger than usual
* pain and stiffness worsen after not moving the joint for a while
* joints feel warm and tender
* there is a loss of muscle bulk
* affected joints have a limited range of movement
A grating or crackling sound or sensation may occur in the affected joint.

OA happens when the body is not able to repair joint tissue in the usual way.
A traumatic injury to a joint, for example, may undermine the body's ability to carry out proper repairs is undermined, so damage to the affected joint persists and worsens, leading to symptoms of OA.
OA can develop as a result of cartilage damage. Cartilage is the protective surface that cushions the ends of bones in joints and allows the joints to move smoothly.
The smooth surface of the cartilage becomes rough, causing irritation. As the cartilage wears down, the bone in the joint rubs against another bone, causing damage and pain.
The bones start protruding, forming bony lumps called osteophytes, and the joints may become knobbly.
As a result, the bones gradually thicken and become broader, and the joints become stiffer, less mobile, and painful.
If fluid accumulates in the joints, they will swell.
Why the repair process breaks down remains unclear, but several contributory factors may be involved, including injury or surgery, overuse, and damage resulting from rheumatoid arthritis (RA).​
It may take several years for OA to appear after an injury.
Secondary OA is a condition that develops because of damage or another condition.
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