Rainwater: alternative or the only drinking water source of coastal belt in Bangladesh?

aminul-islam-sohan

The coastal region of Bangladesh covers 20% of total land of Bangladesh with 711 km long coastline. The coastal zone of Bangladesh consists of Bagerhat,Barguna, Barisal, Bhola, Chandpur, Chittagong, Cox’sBazar, Feni, Gopalganj, Jessore, Jhalkati, Lakshmipur, Narail, Noakhali, Patuakhali, Pirojpur, Satkhira andShariatpur District. The coastal line areas are considered as the most vulnerable area in respect of safe drinking water. Groundwater practice for the coastal area is uncertain. The easily accessed aquifers are extremely saline affected. More than 10 million people are fighting against the same challenge. Though some aquifer depth of 300 to 400 meter is suitable, it is not adequate for the large number of people. Due to the impact of climate change, frequent storm surge events affect sweet water ponds and shallow tube wells.Having surface water without any treatment is not hygienic to drink. Government, local NGOs and international NGOs implemented different types of system for using surface water like pond sand filter (PSF), desalination system, Carocell and so on. As the system needs skilled people to operate, the system becomes inactive after a certain period.  So it is a matter of regret that both options of ground water and surface water are almost inactive to meet the drinking water demand in the coastal area in Bangladesh. Even in the dry season, there is serious scarcity of sweet surface water source. Sometimes they used to go more than 5 km for collecting drinking water only. Most of the coastal villagers are fishermen and farmers. They are not capable of paying for bottled water. Only one option is remaining, that is rainwater. Rainwater harvesting is the most primitive practice in Bangladesh. It is considered as an alternative water source in Bangladesh.

In the monsoon period of June to October, heavy rainfall occurs in Bangladesh. Bangladesh is also a tropical country. The highest rainfall occurs in some coastal district of Bangladesh. The coastal districts receive more than or equal 2700 mm rainfall per year. According to the information of Bangladesh Bureau of Statistics (BBS, 1997) 1.95 – 2.80 m3 of rainwater was available per square meter of catchment area each year for development of rainwater based water supply system. Rainwater harvesting for drinking purpose is common practice in rural area but its access is in limited scale. 36 percent of people in the coastal belt depend on rainwater only because they have no alternative options remaining. However, the protected ponds are replenished by rainwater each year are another significant source of highly saline prone area. However, rainwater water is relatively good. The rain water is free from arsenic contamination, salinity and other harmful infectious organisms and pathogens. Beside this the physical, chemical and bacteriological characteristics of harvested rainwater represent a suitable and acceptable means of potable water. Though it is not free from toxic impurities but it is easily avoidable. But the harvested rainwater quality may be affected due to long time storage. Bacteriological contamination like coliform can happen if the catchment is not properly cleaned. The first run off from the roof should be discarded to prevent entry of impurities from the roof. If the storage tank is clean, the bacteria or parasites carried with the flowing rainwater will tend to die off. Nowadays rain water harvesting refers to both large (community) and small (household) scale. A simple affordable, technically feasible and socially acceptable safe drinking water supply system in thecoastal rural area is very much in demand. In this circumstance, rainwater harvesting system can be considered as a probable solution of the drinking water problem in the arsenic and salinity affected areas.

In the present context, all main water supplies have converted and the alternative option of rainwater has taken place the main option to fulfill the drinking water demand.

 

Aminul Islam Sohan
International Correspondent,Association of Life Science and Engineering Writers (ALSEW)
Lecturer, Department of Civil Engineering, Mogadishu University, Somalia
Email: sohan.bd71@gmail.com

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Hospital Pharmacy in Bangladesh: A New Challenge

Md. Delowar Hossain

Hospital pharmacy play a pivotal role in patient care in  a hospital and this is the department or service in a hospital which is under the direction of a professionally competent, legally qualified pharmacist, and from which all medications are supplied to the nursing units and other services, where  special prescriptions are filled for patients in the hospital, where  prescriptions are filled for ambulatory patients and out-patients, where pharmaceuticals are manufactured in bulk, where narcotic and other prescribed drugs are dispensed, where injectable preparations should be  prepared and sterilized, and where professional supplies (including more specialized medications) are often stocked and dispensed. Hospital pharmacists serve as a link between physicians and patients to promote better patient outcomes. But it is a matter of great regret that in Bangladesh, people are totally unknown to the responsibilities of the hospital pharmacist, even they don’t seek for recruit for the hospital pharmacist in any hospital except a few aristocrat hospitals. Hospital pharmacy service, as a unique department of the hospital, existed in half of the studied hospitals where activities were done by graduate pharmacists and they were also involved in different departments to provide clinical services to the patients. The rest half of the considered healing centers had no clinic drug store benefit. Only a retail drug store inside the hospital was present and there was no diploma or graduate or any pharmacy technician for providing patient care. Hospital pharmacy practice is just started in some private modern hospitals (including Apollo hospital, Square hospital, United hospital and Gastro liver hospital etc. where graduate pharmacist worked in 24 hours successfully and it was proved by the local survey that their quality of treatment and services to the patient is quite appreciable.) in Bangladesh which is inaccessible for the majority of peoples due to high patients cost of these hospitals.

In Bangladesh perspective, for a new pharmacy graduate, industrial pharmacy practices are the major option (more than 95% opportunities for pharmaceutical industries) to build up his or her career, as a result, proper health services are not maintained and job crisis for a graduated pharmacist day by day increases. The educational system of pharmacy is one of the major reasons for bounded pharmacy practices because the courses included in bachelor degree principally emphasize on industrial practices.

Although the pharmacy education started its journey by the hand of the Department of Pharmacy, Dhaka University in 1964. Still now very nearly seven government universities and twenty two private universities offer Bachelor of Pharmacy (Honors) degree. Among these universities only 2-3 universities offer five-year Bachelor of Pharmacy (Honors) professional degree but other remaining universities offers four-year bachelor degree. In the event that we see some developed country in the world their employment locales for graduate drug specialist are not restricted in mechanical drug store practices and real part of drug specialist are included in community, hospital and clinical drug store administrations. For example, USA, Australia, Canada and the Middle East, pharmacy profession is highly patient care oriented, and they have much more opportunities in hospitals, clinics, and community pharmacy sectors. Pharmacy educational systems have to play in these pharmacy practices because they have updated their pharmacy education to 5-year pharmacy professional degree (Pharm. D) and this Doctor of Pharmacy (Pharm. D) course mainly focused on patient care services rather than industrial practices.

Challenges for implementing hospital pharmacy in Bangladesh are absence of talent pool among the qualified pharmacists, lack of government policy towards the hospital pharmacy, business-oriented mentality of the management, doctor dominant medical services, redundant and obsolete curriculum in the universities, no functional pharmacy council and professional bodies run by untrained, inexperienced and politically motivated individuals, non-conforming curriculum related to hospital pharmacy practice, financially more rewarding career in marketing, sales and manufacture, lack of career growth.

Changes we need for the establishment of hospital pharmacy in Bangladesh; those are policy change with respect to the pharmaceutical care (government and management), society for hospital pharmacy in Bangladesh should be established, awareness building among the public towards the quality pharmacy services, curriculum revision in the pharmacy education, sending a limited number of graduate pharmacists overseas for up to three months to receive specific training in clinical pharmacy and hospital pharmacy management.

National Drug Policy 2005 of Bangladesh suggests that medicine distribution and utilization in retail pharmacies and hospitals should be under the supervision of qualified pharmacists. But the reality is that no graduate pharmacist is working in retail pharmacies or government hospitals of Bangladesh except very few tertiary level private hospitals. These one or two hospitals can not improve the overall health care system in Bangladesh. Along with the lack of human resources, the profession seriously lacks government interest. Actually, the first footsteps should come from the government by making it mandatory to have at least a graduate pharmacist in every hospital. In the recent year, the number of the hospital in Bangladesh is more than 2000 (in 2006 it was 1683, 678 were government hospitals and 1005 were non-governmental). In that case, if I consider a simple statistics, that is in every hospital 10 graduate pharmacists are involved (in Apollo hospital it is 24) in patient care system so required the number of pharmacists will be 16830. The challenge of health care system can be faced only by changing the approach to a pharmacists education. Every pharmaceutical institution should focus on the applied and effective knowledge of pharmacy rather than the traditional one.

It is also recommended to the hospital administrators that hospital pharmacy should be launched to ensure patient compliance and therapy outcome and to provide healthcare services of international standard. Pharmacists and pharmacy services are a vital part of a healthcare system. To attain the ideal healthcare service doctor, pharmacist, nurse and other healthcare professionals must work together. Legal reform is needed to achieve the health objectives of the nation to contribute towards attainment of the Sustainable Development Goals (SDG) and to achieve the acceptance of the pharmacy profession as an integral part of a well-structured health care system. The government of Bangladesh should ensure the hospital pharmacy service to all the peoples in order to reduce medication-related errors and to improve patients care and safety.

Md. Delowar Hossain is a Student at Department of Pharmacy in East West University, Bangladesh. He can be reached at dhdipu030@gmail.com 

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Chikungunya, Recent Concern for Us

marufur_rahman_moni

Mosquito-borne viral disease, chikungunya has been re-emerged recently. In 1952, first description about this disease had been found in southern Tanzania. After a long period, it was witnessed again in northeastern Italy in 2007. Since then, these disease has been re-emerged in this century. Recently, Bangladesh has been affected as it is considered a tropical disease. It is thought that it has re-emerged for the viral mutation. Moreover, in the present world, tourism from one country to another has been increased. Thus, this disease gets opportunity to spread and it has already been the major concern for us.

Chikungunya disease has been occurred for virus named “Chikungunya“ which is a single stranded RNA virus transmitted to people through mosquito bites. Two spices of mosquitoes, Aedesaegypti and Aedesalbopictus are responsible for both dengue and chikungunya. But when mosquito feed on already chikungunya infected person, that mosquito has also been infected with this virus. After that, this mosquito can be able to spread the virus by biting a healthy man. It is relief of us that unlike dengue, these viruses don`t cause any death but people in which body have been developed by such kind of virus, suffer painful conditions in the body. In 95% conditions, chikungunya is symptomatic. The common symptoms are joint aches and pains, whereas the others are fiver, depression, rash, eye pain, headache etc.Sometimes, people can be confused about the symptoms seen between dengue and chikungunya. Unlike dengue, rashes are seen on trunk, limbs, face, palms and feet. Moreover, joint pains on hands and feet are also considered as symptoms of chikungunya, whereas muscle pain on the back, arms and legs are the main symptoms of dengue. But the concern for us is that chikungunya is also asymptomatic in 5% conditions. That`s why, it is sometimes very difficult to identify whether this virus grows in the body or not. Although complications of this disease are rare, this virus can cause inflammation of the retina, heart muscle, liver, kidneys, spinal cord, membranes of the brain and adjoining cerebral tissue and also cause bleeding.

There are two types of risk factor of chikungunya, physical and environmental. A research shows that older adults, children under the age of one, pregnant women, people in whom diseases pre-exist have a higher risk of infecting the disease. In addition, the environmental risk factor is exposure of mosquito. Monsoon is the season of spreading this disease as mosquitoes grow up rapidly and increasingly in this season. So, it can bring devastating result on people living in chikungunya prevalent area. For being chikungunya a tropical disease, Bangladesh is also at risk. This disease has already been discovered in Dhaka, Dohar and Nababganj, Rajshahi, Pabna and also in shibganj of Chapainababganj. As it has short case series, this type of fever is common in Bangladesh. But the fact is that awareness about this virus has not built up yet among the people. So, it is evident that chikungunya is concern for us.

Chikungunya fever can be diagnosed by virus isolation, collection of blood samples for serology and so on. But the commonly used test is the Immunoglobulin M antibody ( IgM) test. Chikungunya infected people should take rest. Moreover, infected one should drink water to prevent dehydration. Besides this, for reducing fever and pain, acetaminophen or paracetamol can be taken as medicine. At present, there is no vaccine for prevention or medicine for treatment, however, there has been tried to develop a working vaccine for chikungunya which will produce antibodies against the virus. As vaccines against chikungunya virus are not introduced yet, so reducing the risk of getting bitten by mosquito is the best policy of preventing the disease for us. That`s why, collection of standing water should be avoided. Moreover, insect repellants containing deet, picaridin on skin for protection from mosquitoes must be applied when anyone goes in mosquitoes prevalent areas. At last, the most important thing is that everyone should be aware of this disease which will help us to prevent chikungunya.

Md. Marufur Rahman Moni, is an undergrad student completing his graduation under dept. of pharmacy East West University, Bangladesh. He can be reached at moni007.mrm@yahoo.com

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Chikungunya: The New Threat

Sifat-Sharmin-Shiba

Recently a new type of virus has come out which is often similar to Dengue virus and the name of this virus is-‘Chikungunya’. Everybody thinks these two diseases are one and same in nature,but there is some differences between Chikungunya & Dengue virus in symptoms. Let us know what is Dengue virus. In general It is a mosquito-borne single positive-stranded RNA virus of the family Flaviviridae. Genus-Flavivirus, which causes Dengue fever. Five serotypes of the virus have been found and five of them can cause the full spectrum of disease. Notwithstanding scientists are finding their understanding of dengue virus may be simplistic, as rather than distinct antigenic groups there appears to be a continuum.This same study identified 47 Additionally, coinfection with and lack of rapid tests for zika virus and chikungunya complicate matters in real world infections. Mainly the carrier of dengue fever is-Ades mosquitoes

On the other hand chikungunya is also a mosquitoes transmitted disease. It can be transmitted to people by mosquitoes and also mosquitoes by people. In late 2013, chikungunya virus was found for the first time in the Americas on islands in the Caribbean. Outbreaks have occurred in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans. Currently chikungunya has emerged in an epidemic form in Bangladesh and it has been said by Institute of Epidemiology Disease Control & Research (IEDCR).This  Chikungunya virus is most often spread to people by Aedes aegypti and Aedes albopictus mosquitoes. These are the same mosquitoes that transmit dengue virus. They bite during the day and at night.

Most people infected with chikungunya virus will develop with some symptoms and according to CDC The major symptoms of chikungunya virus are-

  • Basically its begin 3–7 days after being bitten by an infected mosquito.
  • The most common symptoms are fever and joint pain with weakness.
  • Besides that  headache, muscle pain, joint swelling, or rashes are seen.
  • Chikungunya disease does not often result in death, but the symptoms can be severe and disabling.
  • Most patients feel better within a week. But some of them the joint pain may persist for months with nausea or vomiting.
  • People at risk for more severe disease ,especially newborns infected around the time of birth, older adults (≥65 years), and people with medical conditions such as high blood pressure, diabetes, or heart disease.

Sometimes Chikungunya Virus Can Cause Brain Inflammation, Death. Catching the mosquito-borne virus chikungunya usually leads to fever and severe pain, but a new study shows it may also lead to inflammation in the brain, and even death in some people. The symptoms of chikungunya are likely to dengue and zika diseases which spreads by the same mosquitoes and after that it transmitted into chikungunya. if anyone develop this symptoms described above and have visited an area where chikungunya is found then healthcare provider may order blood tests to look for chikungunya or other similar viruses like dengue and Zika as diagnosis.

Till now there is no any vaccine to prevent or no medicine to treat chikungunya virus. During the first week of infection, chikungunya virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.So at first we all have to be safe from ades mosquitoes bites by using mosquitoes repellent. Especially Travelers can protect themselves by preventing mosquito bites. During traveling to countries with chikungunya virus, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens. Also have to suppress the haunt of ades mosquitoes as early as possible. Besides that-

-have to take plenty of water or fluids to prevent dehydration

-have to take medicine such as acetaminophen or paracetamol to reduce fever and pain.

-have to consult with doctor or healthcare provider before taking aspirin or NSAID anti-inflammatory drugs for better health

Moreover with the help of govt. and non-govt organization or media , the drain system should be cleaned to destruct the mosquitoes as far as possible, so that we can get rid of these virus.

Sifat Sharmin Shiba is an undergrad student in Department of Pharmacy East West University, Bangladesh. She can be reached at sifatshiba2015@gmail.com

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Understand nutrient and energy dense food at your daily meal

Md_Tanvir

The world is changing fast. Food habit and food choice are changing even fasterdue to globalization, introduction of different types, taste& region based commercial foods we actually getting out of our mind to select our meal. But, it is high time; we should give a break to our tongue and make our food choice consciously.

For making conscious choice of food for the betterment of our health, we have to understand our food calories. There are several kinds of foods which may yield a lot of calories and god taste but

Is it ok to consume a lot of calories only because it tastes good? Definitely not. So, in this article we will try to understand some basic concept about energy dense food and nutrient dense food to make conscious food choice for better health considering some key definitions and examples regarding Nutrient density and Energy density.

Nutrient denseisa key term in the dietary guidelines. It means, foods that provide lots of nutrition, like vitamins, minerals and other important nutrients. And it also yield with relatively fewer calories. So, you may call it’s kind of a nutrition packed food a more bang for your bucks so to speak that you get lots of, of content without a lot of calories so that’s essentially what it is.

The million dollar question is how we may know if the food is nutrient dense or not. It’s pretty simple.Foods get less nutrient dense by either frying it, which is going to add lots of extra calories without much extra nutrition, or adding extra sugar, or empty calories to food. So we can take sometimes a basically healthy food or a nutrient dense food. And make it less nutrient dense and more energy dense by adding fats, by adding sugar, primarily is the way that, that might happen to a food.

Adequate diets include foods that are nutrient dense. And emphasizing nutrient dense foods is one way that you can assure you’re getting an adequate intake without getting a whole lot of calories. When we emphasize these nutrient dense foods, it doesn’t mean that you eat these exclusively. It just means that they make up the greatest proportion of your food choice. And it is just looking at different foods in terms of their nutritional content, their vitamin, mineral, phytochemical, other food component content versus their calorie intake. Of course, vegetables are going to be on the top. Your leafy greens are some of your most nutrient dense foods. But we also are looking for that in other type vegetables, some of your fruits, berries, beans, legumes.

But at the lower level, we will find refined grains, foods that have a lot of extra sugar added to them. So, foods that may have a little higher fat content are going to fall lower on that nutrient density scale. More likely emphasizing foods that are lower calorie, more nutrition, is going to go a long way to achieving a healthy diet. That concept of energy density that I mentioned is just the number of calories in a gram or a given volume of food. So it’s just a measure of the energy density.

The number of calories in a portion is another way to look at it. Such as- where in 20 grams of potato chips, which is less than an ounce, there’s about 107 calories and so, when we look at that, in terms of calorie content versus weight, the energy density is around 5.4. And we’re going to look at some different foods, and how that energy density might play out. And just kind of show you how fat content, sugar content increases energy density.

Fast foods tend to be typically energy dense, certainly, not all of them. But as a group that’s one challenge with emphasizing a lot of what we would call fast-type foods. They tend to be nutrient poor too, so, you know, you want to emphasize more of these nutrient rich foods. Like vegetables, fruits, whole grains etc. Which don’t tend to be energy dense.

The bottom line is we should make most of our food choices high in nutrient density and low in energy density. High fiber foods tend to be high in nutrient density, low in energy density. High water foods, foods that have a lot of water content, tend to be lower in energy density as well and higher in nutrient density. So, as we have learnt, there were lots of factors that affect us. High fiber, High fat foods, you know, are going to lower the nutrient density, raise the energy density.

MdTanvir Islam is a graduate nutritionist & public health specialist. He has completed his gradation under department of Nutrition and Food Technology of Jessore University of Science & Technology and post-graduation under dept. of Public Health at American International University-Bangladesh (AIUB). He has interest on public health and recent health issues. He can be reached at tetratul@gmail.com

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Stress: The Positive and Negative Outcomes

Sabera

Do you feel tension, nervousness, and butterflies in the stomach or pressure in new conditions? If the answer is yes, then you are stressed! Actually, when the combination of internal and external pressures exceeds the individual’s resource to cope with their situation then it is called stress. However, stress has got some beneficial as well as some harmful effect on health.

Good stress or eustress helps one to grow confidence. In our daily life we face many complications or challenges. In such cases good stress plays a role as a spark to drive one to achieve his goal or to fight for justice or just to improve the quality of life. On the other hand, lack of motivation, unfulfilled dreams often leads to boredom. If one cannot reach his goal that may also create low self esteem. When someone faces a new challenge then the stimulation that the body undergoes also help that person to cope up with that situation. By doing so, one gets the confidence of taking risks, developing communication skill, learning new things etc. In a research it was found that during stress some hormones are released from brain that plays a role in enhancing learning and memory.

On the other hand, too much stress is harmful for humans. When a healthy body becomes stressed then the muscles tense up. Long term stress can promote stress-related disorders. Chronic muscle tension leads to headache and migraine in the area of head, neck and shoulder.

Breathing is also hampered with stress. Patients with asthma or any other lung disease may find it difficult to breathe when they need sufficient oxygen. Again, rapid-breathing or hyperventilation due to stress can cause panic attack also.

Stress increases heart rate and contraction of heart muscles. As a result blood vessels that transport blood to different parts of the body feel much pressure. These effects are enhanced by some hormones such as adrenaline, nor adrenaline and cortisol. If these conditions continue for long time then it may take a toll on body. Long term stressed condition may increase the risk for hypertension, heart attack or stroke. Cholesterol level in blood circulation is also affected due to stress. Stress can also contribute to inflammation in the circulatory system that ties stress to heart attack.

Under stressful condition liver produces more glucose and if the extra glucose is not used or absorbed then people who are prone to develop type 2 diabetes can be affected.

People may eat much more or less food than usual in a stressful situation. Some may also increase use of alcohol in stressed condition. Eating more or using alcohol increase the risk for heartburn, some may develop ulcer or some experience severe pain in stomach even without ulcer. Nausea and vomiting may also be occurred due to stress. Even food digestion is also hampered due to stress. Some may experience diarrhea or constipation.

Human brain can be greatly affected by stress. During stress hormones like cortisol and glucocorticoid are released and these hormones kill brain cells in experimental animals. Again it was found that high level of glucocorticoid can shrink the hippocampus, a part of brain that is responsible for memory. As a result the brain loses its ability to create new connections to new brain cells. Long term exposure to stress hormones reduces one’s ability to concentrate, think ahead or to learn quickly.

Stress also affects reproductive health of both males and females. Stress can affect testosterone production, sperm production and maturation and even cause erectile dysfunction or impotence in males. Some males may also become vulnerable to infection to the testes, urethra and prostate gland. In case of females high levels of stress is often associated with irregular or absent menstruation cycles or changes in the length of cycles. Hormone level of women may also fluctuate due to chronic stress and it may affect health. Anxiety, mood swing or feeling distress is all results of stress.

Stress if balanced with daily life activities can be beneficial. There are several techniques that help to reduce stress. Relaxation is a useful technique that reduces muscle tension and also decreases the incidences of stress related disorders such as migraine and headache. Again relaxation with deep breathing can also help to overcome stress. It was observed that healthy people who have a good amount of sleep and nutritious food are less affected by stress. Positive thinking should be practiced and the goal or target of life should be clear to reach the point of success. Sometimes a friendly talk with someone or a vacation also reduces stress.

Medication is not always a solution. If stress is balanced by doing simple daily exercise or activities then it is very much useful. Life is not always complicated, sometimes it is us to makes it complicated by our thinking negatively and doing unplanned activities. Body and mind also need some recreation to reduce stress.

Sabera Rahman is an undergrad student of Department of Pharmacy, East West University. She has interest on pharmacology and pharmaceutical chemistry. She can be reached at sabera.rahman@ymail.com

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Introvert vs. Extrovert- A personality choice or A Scientific Fact?

Tahiya

In a group of four or five people, there is always a person or two who remain quiet and observe the talkative ones. They are the kind who are called the introverts. On easy terms, an introvert is a person who is shy and likes to be by him/herself most of the times. On the other hand, an outgoing and overtly expressive person is known to be extrovert. It is often thought that being an introvert or an extrovert depends on the person’s choice but it does have some scientific aspects as well.

Studies have showed that there are differencesbetween the brain of an introvert and an extrovert person. These two types of brains respond differently in similar type of stimulations. It has been stated by the researchers that an extrovert brain needs more stimulation for any kind of response than an introvert brain. The extroverts have lower level of “arousal”. On the other hand, an introvert brain is easily over stimulated. This is why, extroverts need risks, adventures, crowd and challenges to control their arousal levels and the opposite happens with the introverts. They need more calm, quiet and secluded situations to lower their arousal level.

It has also been suggested that the sensitivity of neurotransmitters- dopamine and acetylcholine in brain; play an important role in determining a person’s extrovert and introvert nature. Dopamine is a chemical messenger that deals with the activation of pleasure in a person. When dopamine floods the brain, both the introverts and extroverts become more talkative, outgoing and motivated to take challenges in risks in their lives. But the major difference is- an introvert brain requires less amount of dopamine to focus or to attain pleasure than an extrovert brain. This is why, an introvert usually feels more comfortable and peaceful in calmer places or even in a library or in their rooms, spending time all alone. This does not make an introvert person socially awkward or lonely or sad, rather it makes those people have deep thoughts about their lives and situations around them.

An introvert person has friends, crowds, gathering, places to go and has fun just as an extrovert person but they do not require to be within those all the time. An extrovert person has lesser sensitivity towards dopamine and that makes him/her attracted to the high levels of energetic approaches and places. They gain pleasure or enjoyment by being with other people, socializing with new crowds, taking adventures or challenges. This does not make them shallow in comparison to the introverts. They also possess the capability of understanding the meaning of their lives and their surroundings but the ways are different.

Acetylcholine deals with the feeling of pleasure as well. But it makes us feel good when we turn inward. It makes us think deeply and focus on a particular thing for a long time. Acetylcholine makes it easier for an introvert to refrain from external stimulation.When a person is in his/her own comfort zone, enjoying his/her solitude, then he/she enjoys the pleasure of acetylcholine at its best. It does not happen with the extroverts. They need crowded and high energetic environment for the proper utilization of their pleasure waves.

There is a concept about introverts that they really dislike being around other people and dislike other people as a whole. This concept is entirely false. They like partying, having fun, going on adventures etc. as much as the extroverts do but they like their own spaces the most. They like observing a conversation rather than being the conversation initiator. They like being a part of the group but not the center of attention. They like going to crowded places and being by themselves there.

Just like the previous concept, it is also believed that the extroverts cannot spend a single time alone. This is also entirely false. They like gaining pleasure or sadness from practical experiences rather than gaining these feelings from a book or from watching or hearing other people’s experiences. This is why, a group is generally, always combined of people of extrovert and introvert natures. Science is behind every single thing on this planet and a person’s introvert and extrovert behavior is not excluded of it.

Tahiya Islam completed her graduation under Department of Pharmacy, East West University. She is a student correspondent at Association of Life Science and Engineering Writers (ALSEW). Tahiya can be reached at tahiya945@gmail.com

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A Digest of Gestational Diabetes

nandeeta-samad

The current world is witnessing the rising prevalence of Gestational Diabetes, which is also termed as Gestational Diabetes Mellitus (GDM) – a health condition when a women who does not have diabetes but develops increased level of blood sugar during the pregnancy period which usually occurs 24 and 28 weeks of pregnancy and also gestational diabetes increases the risk for developing type II diabetes mellitus in further stages of life. According to Johns Hopkins Medicine, gestational diabetes affects 1 of 10 pregnant women. And also according to University of California San Francisco Medical Center, gestational diabetes occurs in about 7 percent of all pregnancies. And it usually arises in the second half of pregnancy and goes away as soon as the baby is born.

The consequences of Gestational diabetes are somewhat menacing as well. Gestational diabetes induces the risk of giving birth to a large sized baby which may cause complications during delivery.Besides, various symptoms and health hazards are evident in babies whose mother had gestational diabetes. Among the symptoms, increased risk of hypoglycemia (low blood sugar), respiratory distress that creates barrier in entering oxygen to lungs and ultimately into the blood, decreased level of magnesium and calcium, jaundice and also a greater risk of developing diabetes in later stage of baby’s life – are mostly apparent.

Now we need to focus on the effective dietary pattern for the gestational diabetic patients. A gestational diabetic mother should consume starchy carbohydrates like whole grain bread, brown rice, pasta, legumes, beans, oats, potatoes and corns etc. which are high in fiber content and very much significant for digestion. Milk and yoghurt, especially low-fat contained dairy products can be the good choice for these patients and it should be ensured that patients do not choose sweetened dairy products to control their sugar level. Both the starchy carbohydrates and milk products must be consumed optimally so that the fetal needs can be fulfilled and at the same time blood sugar level remains controlled.    Moreover choosing low glycemic index and high fiber rich foods such as- pasta, porridge, beans, lentils, apple, orange, whole grain cereals and bread, bashmati rice etc. contain carbohydrates which are slowly absorbed is beneficial for gestational diabetic patients. Here glycemic index (GI) of a particular food indicates the measure of how quickly sugar (glucose) is released into your bloodstream after the consumption of that food.So that the mentioned foods of low glycemic index will release glucose into the bloodstream more slowly. And most importantly, added sugar should be strongly prohibited and aspartame, acesulfame K, sucralose etc. have got approval as safe during gestational diabetes.

Fruits are also rich in fibers and beneficial to the patient but fruit is also rich in natural sugars. That is why, a single fruit or half of a large sized foods should be taken daily. And as a glass of fruit juice contains more than one fruit pulps so that fruit is more prioritized over the juices. Dark green leafy vegetables and other colored vegetables are encouraged to eat for their fiber content, micronutrient (vitamin and mineral) content and antioxidant properties.

According to an evidence review done by the Academy of Nutrition and Dietetics, increasing protein intake doesn’t appear to have any appreciable impact on how your sugar is digested or absorbed. But still I will prefer optimality always and a person who needs 2,000 calories per day needs about 75 to 100 grams protein per day. High bioavailability protein sources are animal origins like meat, fish, eggs, milk and plant origins like beans, peas and other leguminous seeds are of low bioavailability.

A gestational diabetic patient can divide her diet in 5 times a day- 3 main meals and 2 snacks like mid-morning snacks and mid-afternoon snacks.

Reviewing the current data of International Diabetic Federation (IDF) we find -20.9 million or 16.2% of live births to women in 2015 had some form of hyperglycemia in pregnancy. An estimated 85.1% were due to gestational diabetes, 7.4% due to other types of diabetes first detected in pregnancy and 7.5% due to diabetes detected prior to pregnancy and the greatest increase in the female diabetes population over the next 20 years will be in the Middle East and North Africa Region (96%), followed by the Africa Region (90.4%) and South East Asia (74.4%). Furthermore, IDF says that any unmanaged hyperglycemia in pregnancy can result in birth complications that can affect both mother and child including: increased risk of preeclampsia, obstructed labor due to fetal macrosomia and hypoglycemia at birth for the infant. As all of these prove that the gestational diabetes issue is at present alarming, we can hope that modified diet, safe exercise and only prescribed medication during complications can control the situation from getting worse.

Nandeeta Samad currently pursuing her Master degree under Institute of Nutrition and Food Science, University of Dhaka. She is also an associate Fellow, Royal Commonwealth Society (RCS), Youth Ambassador, ActionAid Bangladesh and Young Fellow, South Asian Youth Society (SAYS). She is from Bangladesh. Mail her at nandeeta6@gmail.com

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