Better ways to fall asleep

 Woman trying to sleep

If sleeping pills were the answer for a good night’s sleep, US would be one of the world’s most well-rested nations whereDoctors wrote nearly 60 million prescriptions of sleeping pills in 2012, according to IMS Health, a health care technology and information company. That makes sleeping pills some of the most popular medications around.

Ideally, older people should avoid sleeping pills completely, says Adam Spira, a sleep specialist and assistant professor of mental health at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “It’s easy to take a pill and go to sleep, but it’s a totally shortsighted approach with the potential for negative consequences,” he says.

 Spira notes that the more we learn from research, the more important good sleep appears to be for healthy aging. He speculates that people who get enough sleep may enjoy protection from the diseases that can come with passing years. But he says that instead of taking medications, people struggling with insomnia should find other, better ways to fall asleep.

 Fortunately, there are many other options. For starters, Sateia says, patients and their doctors should try looking at the root of insomnia. Many common, treatable health problems can interfere with sleep. The list includes depression, anxiety, poorly managed pain, restless leg syndrome and sleep apnea.

 Once a person is truly ready for good sleep, Sateia says it’s time to learn the basics of “sleep hygiene.” That means avoiding caffeine in the evening, going easy on alcohol, not napping during the day and keeping the bedroom dark, quiet and cool. But these are just the first steps.

 According to Sateia, far too many doctors and sleepless patients give up if sleep hygiene alone doesn’t solve their insomnia. “Tips for sleep hygiene are plastered all over magazines and newspapers,” he says. “After people try that, they think they’ve tried everything.”

 When all else fails

 To really solve their insomnia, many people need to fundamentally shift their attitude about sleep, Sateia says. As he explains, insomnia is often a self-fulfilling prophecy. “Before their head even hits the pillow, they’ve convinced themselves that they’re not going to be able to sleep,” he says.

 Sateia says those expectations can be turned around with the help of cognitive behavioral therapy (CBT), a type of counseling that combines meditation and relaxation techniques with other proven sleep strategies.

 One of the main goals of cognitive behavioral therapy for insomnia — also called CBT-i — is to reduce the amount of time that people spend awake in bed. That means not using the bed for reading and work, and getting out of bed if it feels like sleep isn’t coming. If they can spend less time struggling for sleep, even hard-core insomniacs can feel more confident when they get under the covers. 

And confidence, Sateia says, can be the best sedative of all. “We believe that everyone should go through a course in cognitive behavioral therapy before trying a sleeping pill,” Sateia says. He adds that qualified practitioners may be difficult to find, especially in small towns. However, he says, new Web-based programs could help more people enjoy the benefits of the therapy. “There are no side effects to CBT-i, and the benefits can last for years,” he says



Four facial pains and what they mean


A. Symptom: Deep, dull headache
Condition: Neck muscle spasms
Caused by: Whiplash (neck injury), poor posture and long hours at computer, physical stress

B. Symptom: Ache at base of skull, neck and face
Condition: Rounded shoulders (slouching)
Caused by: Poor sleeping posture (wrong pillow) and over-exercising upper body at the gym

C. Symptom: Electric shock-like pain in cheeks, near nose and jaw
Condition: Trigeminal Neuralgia (TN)
Caused by: Blood vessel pressing on a nerve inside the skull, multiple sclerosis

D. Symptom: Ache in temples, ear pain, facial soreness, limited range of motion of mouth, clicking and joint noise
Condition: Jaw disorder
Caused by: Grinding of teeth in sleep, cradling phone between neck and shoulder, biting nails, clenching teeth during a task that requires focus

For more details, please read..


How stress can affect a pregnancy


We know that extreme stress is bad for any living creature and that it can lead to disease and health degradation in our bodies. Pregnancy in itself is a stressful time on a woman’s body. The normal physical and hormonal changes can be quite daunting for a first time mom. It can be tough to draw conclusions, however, because pregnant women already experience many of the signs of too much stress, such as fatigue and poor sleeping habits. That’s why it’s important to listen carefully to what your body is telling you and to keep your doctor up to date on what’s going on with you, mentally as well as physically.

 Most people don’t deal well with too much stress, but how does it affect you when you’re expecting a baby? Read on to learn about five ways that stress can affect a pregnancy and get tips on how to keep your own stress levels down

1: Preterm Labor and Premature Birth

There are lots of different reasons why babies are born prematurely, but many researchers believe that women who experience high levels of stress while pregnant are at higher risk for experiencing a preterm birth. Stress normally causes our brains to secrete hormones, such as corticotropin-releasing hormone (CRH) and a study published in the American Journal of Obstetrics and Gynecology in 1999 (and subsequent studies by the same team) revealed that women who delivered prematurely not only had very high levels of CRH early on in pregnancy, but they also reported high levels of stress.

 2: Miscarriage

 There have been numerous studies indicating a link between miscarriage and high levels of stress, especially early in the pregnancy or just before conception. Studies showed that high levels of stress hormone, cortisol, may affect levels of progesterone, which impacts uterine growth and other aspects of pregnancy [source: National Academy of Sciences of the USA]. So, not only should you try to avoid chronic stress while pregnant, but you should also focus on it early in your pregnancy.

 3: Low Birth Weight

 Stress hormones such as epinephrine, norepinephrine and cortisol can all cause blood vessels to constrict, and this potentially includes the blood flow to the baby via the umbilical cord. In this case, the fetus may not be absorbing enough nutrients from the mother’s body. Often, the potential for low birth weight is identified in utero, and your doctor can suggest ways to change the behaviors that may be causing it — such as cutting down on your stress levels.

 4: Increased Risk of Infection

 In addition to directly causing problems during pregnancy, the hormones produced by stress can also weaken your immune system. Chronic stress can result in reduced numbers of cells that fight off viral and bacterial infections. The stress response can also cause the nervous system to secrete substances that bind to white blood cells (which defend the body from disease) and make them less effective. Pregnant women already have lowered immune systems, so stress has even more of an impact on them. This equals an increase in illnesses that your body would normally be able to fight off.

 Often, pregnant women can’t take the same kinds of medications that would normally bring them quick relief when they’re sick, so illnesses can last longer or they’re more likely to have to suffer through some of the symptoms. Many different kinds of ailments can impact your pregnancy, as well. The flu, for example, is more likely to turn into pneumonia when you’re pregnant — just when you already have pressure on your lungs due to your growing belly and need more oxygen to support your baby.

 In addition, you may also be more vulnerable to uterine infections when you have a compromised immune system. These may involve the placenta and amniotic sac and can be extremely dangerous. The baby can also be infected — rarely, he or she may develop sepsis (infection in the bloodstream) or conditions like cerebral palsy.

 5: Increased Risks of Problems Later On

 Many researchers believe that chronic stress during a pregnancy can result in issues that may not manifest until later in life. Stress may affect the development of the baby’s brain when the high levels of hormones cross into the placenta. These problems may be emotional, behavioral or physical. Stress in pregnant women, especially in the first trimester, may result in irritable, anxious babies [source: Medicine Net].

Stress can also cause behavioral problems. And once the baby is born, the child may be more vulnerable to a wide array of stress-related issues [source: MedicineNet]. This can mean learning difficulties and slower development. It may even predispose your baby to diseases such as heart disease, obesity and type II diabetes — the conditions that stress can create or exacerbate in you, as well.

Advice From a 101 Old Doctor!


Dr. Shigeaki Hinohara, Japan, turned 101 on 4th October 2012. 

As a 101 year old Doctor, he was interviewed, and gave his advice for a long and healthy life. 

Shigeaki Hinohara is one of the world’s longest-serving physicians and educators. Hinohara’s magic touch is legendary: Since 1941 he has been healing patients at St. Luke’s International Hospital in Tokyo and teaching at St. Luke’s College of Nursing.

He has published around 15 books since his 75th birthday, including one “Living Long, Living Good” that has sold more than 1.2 million copies. As the founder of the New Elderly Movement, Hinohara encourages others to live a long and happy life, a quest in which no role model is better than the doctor himself.

Doctor Shigeaki Hinohara’s main points for a long and happy life:

Energy comes from feeling good, not from eating well or sleeping a lot. We all remember how as children, when we were having fun, we often forgot to eat or sleep. I believe that we can keep that attitude as adults, too. It’s best not to tire the body with too many rules such as lunchtime and bedtime.

* All people who live long regardless of nationality, race or gender share one thing in common: None are overweight. For breakfast I drink coffee, a glass of milk and some orange juice with a tablespoon of olive oil in it. Olive oil is great for the arteries and keeps my skin healthy. Lunch is milk and a few cookies, or nothing when I am too busy to eat. I never get hungry because I focus on my work. Dinner is veggies, a bit of fish and rice, and, twice a week, 100 grams of lean meat.

* Always plan ahead. My schedule book is already full until 2014, with lectures and my usual hospital work. In 2016 I’ll have some fun, though: I plan to attend the Tokyo Olympics!

* There is no need to ever retire, but if one must, it should be a lot later than 65. The current retirement age was set at 65 half a century ago, when the average life-expectancy in Japan was 68 years and only 125 Japanese were over 100 years old. Today, Japanese women live to be around 86 and men 80, and we have 36,000 centenarians in our country. In 20 years we will have about 50,000 people over the age of 100…

* Share what you know. I give 150 lectures a year, some for 100 elementary-school children, others for 4,500 business people. I usually speak for 60 to 90 minutes, standing, to stay strong.

* When a doctor recommends you take a test or have some surgery, ask whether the doctor would suggest that his or her spouse or children go through such a procedure. Contrary to popular belief, doctors can’t cure everyone. So why cause unnecessary pain with surgery I think music and animal therapy can help more than most doctors imagine.

* To stay healthy, always take the stairs and carry your own stuff. I take two stairs at a time, to get my muscles moving.

* My inspiration is Robert Browning’s poem “Abt Vogler.” My father used to read it to me. It encourages us to make big art, not small scribbles. It says to try to draw a circle so huge that there is no way we can finish it while we are alive. All we see is an arch; the rest is beyond our vision but it is there in the distance.

* Pain is mysterious, and having fun is the best way to forget it. If a child has a toothache, and you start playing a game together, he or she immediately forgets the pain. Hospitals must cater to the basic need of patients: We all want to have fun. At St. Luke’s we have music and animal therapies, and art classes.

* Don’t be crazy about amassing material things. Remember: You don’t know when your number is up, and you can’t take it with you to the next place.

* Hospitals must be designed and prepared for major disasters, and they must accept every patient who appears at their doors. We designed St. Luke’s so we can operate anywhere: in the basement, in the corridors, in the chapel. Most people thought I was crazy to prepare for a catastrophe, but on March 20, 1995, I was unfortunately proven right when members of the Aum Shinrikyu religious cult launched a terrorist attack in the Tokyo subway. We accepted 740 victims and in two hours figured out that it was sarin gas that had hit them. Sadly we lost one person, but we saved 739 lives.

* Science alone can’t cure or help people. Science lumps us all together, but illness is individual. Each person is unique, and diseases are connected to their hearts. To know the illness and help people, we need liberal and visual arts, not just medical ones.

* Life is filled with incidents. On March 31, 1970, when I was 59 years old, I boarded the Yodogo, a flight from Tokyo to Fukuoka. It was a beautiful sunny morning, and as Mount Fuji came into sight, the plane was hijacked by the Japanese Communist League-Red Army Faction. I spent the next four days handcuffed to my seat in 40-degree heat. As a doctor, I looked at it all as an experiment and was amazed at how the body slowed down in a crisis.

* Find a role model and aim to achieve even more than they could ever do. My father went to the United States in 1900 to study at Duke University in North Carolina. He was a pioneer and one of my heroes. Later I found a few more life guides, and when I am stuck, I ask myself how they would deal with the problem.

* It’s wonderful to live long. Until one is 60 years old, it is easy to work for one’s family and to achieve one’s goals. But in our later years, we should strive to contribute to society. Since the age of 65, I have worked as a volunteer. I still put in 18 hours seven days a week and love every minute of it.

Patient Assistance Programs

Commonly referred to as PAPs, Patient Assistance Programs are services offered by pharmaceutical companies for those who cannot afford their medication. Patient assistance programs are available to low-income individuals or families who are under-insured or uninsured and are provided to those who meet the eligibility guidelines. Assistance may range from reduced cost of drugs to free medicine. Each drug that a company offers will have its own unique program and may even have a different eligibility requirement than the other drugs they offer. As there is no unified standard of designation for these programs, you may also see them referred to as medication assistance programs, indigent drug programs, and charitable drug programs.

Patient Assistance Programs are not mandated or managed by the federal government and are offered as a free service by the pharmaceutical industry. Nearly all of the major pharmaceutical companies provide specific programs for their most popular drugs. As each program is different, please take a look through our comprehensive database which allows you to search by drug or company name to find your medicines specific patient assistance program. Each profile will provide you with detailed information on how their specific program can assist you with your medication bill and what requirements are needed to qualify for assistance.

Are there general eligibility requirements?

After properly identifying the pharmaceutical company who offers the medicine you would like assistance with, you can begin the the enrollment process. The initial enrollment process along with detailed company information and eligibility requirements are listed in companies websites.

Once the company receives your enquiry, they will review your eligibility. If you qualify, they will provide you the medication by sending it to your mailing address, your physicians office, or to a local hospital. If you do not qualify, many companies will not provide you any response to your enquiry.

Following are references to some of the PAPs offered in India:




Pregnancy Induced Hypertension


What is it?

  • Pregnancy induced hypertension is a high blood pressure problem caused by pregnancy. It is also called “PIH.” You may have PIH if your blood pressure was normal but began to rise after the 20th week of pregnancy. PIH means more than just having high blood pressure. Many of the organs in your body may be involved with PIH. About 5 to 7 per cent of all women get PIH during pregnancy
  • You may be at a higher risk to get PIH if this is your first pregnancy or if you are pregnant with 2 or more babies. Being less than 20 years old or older than 35 years may put you at higher risk for having PIH. Or you may be more likely to have PIH if you have a mother or sister who has had PIH. PIH can be a very serious problem to you and your baby if it is not treated.

There are 2 levels of PIH

  • High blood pressure and protein in the urine and/or swelling of your face, hands, or feet. This may also be called pre-eclampsia .
  • High blood pressure, protein in the urine, swelling, and convulsions (seizures). This may also be called eclampsia.

What causes PIH? It is not known what causes PIH. But it is known that PIH causes blood vessels to tighten which blocks blood flow. The following are possible causes of PIH.

  • Diet. You may not be getting enough zinc, calcium, protein, or total calories in the food you are eating.
  • Genetic. PIH may have been passed to you from your mother. It is common for daughters and mothers to both have had PIH during their pregnancies.
  • Immune system. Your pregnancy may be causing your immune system not to work correctly.
  • Placenta problems. Its job is to bring food to your baby and take away waste. With PIH your placenta may not be working correctly.

Signs and Symptoms: PIH can be found early during your prenatal visits. The following are signs and symptoms of PIH.

  • Being 20 or more weeks pregnant with a blood pressure that is 140/90 or higher.
  • Blurry vision (cannot see clearly).
  • Breathing problems.
  • Decrease in how much urine you are passing.
  • Feeling very sluggish.
  • Gaining 1.4 kg to 2.3 kg in 1 week (7 days).
  • Having very bad pain over your stomach (belly) or under your ribs.
  • Seeing spots in your eyes or having light flashes before your eyes.
  • Sudden swelling of your face, hands, or feet.
  • Swelling of your ankles or feet that does not go away after resting for 12 hours.
  • Swelling of your face, hands, or feet.
  • Very bad headaches.
  • Vomiting.

Care: You may have any of the following tests or treatments. You may need to go into the hospital so that you and your baby can be more closely watched. It is possible that you may need to deliver your baby early if your blood pressure cannot be controlled. This is especially important if you or your baby is in danger because of your blood pressure.

  • Bed rest.
  • Blood tests.
  • Checking your baby’s heart rate.
  • Checking your reflexes.
  • Checking your temperature, blood pressure, heart rate, and breathing every 4 hours.
  • Checking your weight every day.
  • Having your eyes checked.
  • Medicines.
  • Putting a Foley catheter into your bladder to measure how much urine you make every hour.
  • Ultrasound test to check your baby’s growth and to see how much fluid is around the baby.
  • Urine tests.


Please note that this material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. You are advised to consult your doctor if you notice any of the sign and symptoms mentioned above.


FDA Pregnancy Categories for Drugs


The FDA-assigned pregnancy categories as used in the Drug Formulary are as follows:

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

A dog could be your heart’s best friend


A new report from the American Heart Association states that having a canine companion may help lower my risk of heart disease.

“People who have dogs live longer than people who have cats, and the assumption has been that dogs naturally cause their owners to be more active,” suggests Dr. Thomas Lee, Co-Editor in Chief of the Harvard Heart Letter. “The emotional benefits of having an affectionate creature are also one of the theories for why dog-lovers live longer.”

The evidence reviewed by the AHA indicates that dog owners are more likely to exercise, have a better cholesterol profile, have lower blood pressure, be less vulnerable to the physical effects of stress, and be more likely to survive a heart attack.

The mere act of getting a dog is no substitute for a plan to get regular physical activity, to eat a heart-healthy diet, and to get regular medical care. That said, dogs do seem to be good for your heart in many ways.

“Loneliness can’t be a good thing, either from a cardiovascular or a psychological perspective,” Dr. Lee notes. “I am not going to be prescribing dogs for patients with heart disease, but I certainly won’t discourage them—even if they consider themselves fairly limited by their medical problems.

For more details-