Many of us may have taken ibuprofen, sometimes two pills at once, especially when we are struggling with menstrual cramps. Well, as good these pills may be in treating the pain, they are not recommended for your health, especially if you are someone who consumes it on a daily basis or frequently. Gastroenterologist Trisha Pasricha, MD, writes in The Washington Post about why should you avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and aspirin.

What happens when you consume pain killers?

She writes that NSAIDs are great in treating short term pain. They comprise of a group of drugs that inhibit the production of prostaglandins, which serve as a variety of purposes in the body. Some of which also includes contracting the uterus during menses and regulating blood flow in our vessels.

While one to two doses every now and then is okay, following a regular dosage routine, which could range from several times a month, or twice in an hour or so could lead to health risk. NSAIDs are well known to increase intestinal permeability. This means, these painkillers could damage the lining of your gut.

A 2018 review by Ingvar Bjarnason et. al., also writes about how NSAIDs can reduce the blood flow in the tiny vessels that feeds our guts. It can also disrupt the intestinal cells forming a barrier between the outside world and your insides.

What can be done?

While people with conditions like migraines, chronic back pain or bad period cramps can find NSAIDs to be helpful. It is always advisable to have a chat with your physicians to explore NSAID alternatives.

Pasricha suggests acetaminophen.

However, if someone is in dire need of NSAID, her tip is to take the pill right at the start of your symptoms. She says that the drug can do a far better job at stopping things at the source than chasing after all prostaglandins.

Why is it a concern?

NSAIDs are available as over the counter drug, which means people do not need a prescription for it and can make medical decision about them without the guidance of a physician.

A 2018 study published in the Official Journal of the International Society for Pharmacoepidemiology by David W Kaufman, et.al., found that 15% of adult ibuprofen users in the US have exceeded the maximum recommended daily dose. The study also mentions that more than a third of ibuprofen users were taking other NSAIDs, like aspirin and naproxen, while consuming ibuprofen at the same time. Out of these, 61% did not realise that they were using NSAIDs.

Pasricha talks about how it ruptures the gut wall, as she herself has rushed to the hospital in the middle of the night "far more times than" she can count "to perform an emergency endoscopy on someone who was bleeding profusely from an ulcer caused by NSAID".

Another 2009 study published in the American Journal of Gastroenterology states that as many as 1 in 4 chronic NSAID users will get an ulcer and about 4% will bleed or rupture through the gut wall.

An older study from 2005 titled A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy, found that as 75 percent of people regularly using NSAIDs develop low-grade inflammation in their small bowels. NSAIDs can also lead to development of fatty liver disease. This happens because your gut lining becomes more permeable, more toxins and bacteria from the outside world enters your liver and leads to inflammation.

A 2011 study titled Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials, states that as many as 6% of people taking NSAIDs regularly have found their blood count dropping within a few months of starting the medicines, this suggests that this is due to the small, slow amount of bleeding in the gut overtime.

Hypertension or high blood pressure, a major risk for stroke, is preventable and treatable. Yet it accounts for about 14 per cent of cases of stroke among young adults aged below 45 years.

High blood pressure can be defined as the increasing pressure in blood vessels marked as 140/90 mmHg or higher.

Uncontrolled hypertension can burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

A recent study by the Indian Council of Medical Research (ICMR) found that hypertension (74.5 percent) was the most common risk factor for stroke and related deaths (27.8 percent) and significant disability (about 30 per cent) across India.

“Blood vessel walls can be damaged through uncontrolled high blood pressure, making them prone to blockage or rupture. The good news is that hypertension is preventable through regular monitoring, reduced intake of salt, exercise stress control, and medication when required,” Dr. Rajul Aggarwal, Director - Neurology, Sri Balaji Action Medical Institute, Delhi, told HealthandMe.

How Does Hypertension Increase The Risk Of Stroke?

Chronic high pressure forces the brain to compensate, leading to vessel remodeling, narrowing, and eventually rupture or clotting.

The ICMR study reported that ischemic stroke accounted for 60 percent of cases.

The experts explained that in the case of ischemic stroke, high blood pressure damages artery walls, fostering plaque buildup (atherosclerosis) or allowing clots to form and block blood flow to the brain.

On the other hand, with hemorrhagic Stroke, constant strain caused by high blood pressure weakens artery walls, causing them to burst or leak blood into the brain. This can result in severe damage or life-threatening emergencies.

“When blood pressure stays high for years, it slowly strains the blood vessels -- nothing dramatic at first, which is why people ignore it. The arteries become stiff and fragile, sometimes narrowing, sometimes tearing,” Dr. Gunjan Shah, Interventional Cardiologist, Narayana Hospital, Ahmedabad, told HealthandMe.

"This makes clots or bleeding in the brain more likely, leading to ischemic or hemorrhagic stroke, even in people who otherwise feel perfectly fit and busy with daily life," Dr. Shah added.

Importance of the ‘Golden Hour’ In Stroke Care

In stroke-related cases, the golden hour -- referred to as the critical first 60 minutes after symptom onset -- is very much critical. Early medical treatment during the window can prevent death risk as well as boost health outcomes.

However, the ICMR study, published in the International Journal of Stroke, showed that just 20 percent of patients arrived in the hospital after 24 hours of the onset of symptoms.

Dr. Aggarwal said treatment within the first 60 minutes can significantly reduce the brain damage and improve survival as well.

“In a stroke, time moves very differently. Brain cells begin getting damaged within minutes when blood flow stops. If someone reaches the hospital quickly -- within the golden hour -- we have a real chance to restore circulation and limit disability. Recognising symptoms early and not waiting at home can truly change how well a person recovers,” added Dr Shah.

How Can Hypertension And Stroke Be Prevented?

Hypertension is a modifiable disease, and the risks can be reduced by:

• Cutting down and managing stress
• Checking blood pressure regularly
• Treating high blood pressure
• Eating less salt
• Staying active
• Managing stress
• Sleeping properly
• Avoiding tobacco

Dr Shah said that many young patients delay care because they feel fine, but taking medicines on time and correcting lifestyle early can prevent serious problems later.

Dr Srivanjani Santosh, Pediatrician, Social Activist and First Aid trainer, who had earlier spearheaded the ORS campaigned for eight years, urging FSSAI to ban the misuse of the term 'ORS' on non-WHO=standard sugar drinks, has once again shared an important health video on rabies vaccination. Dr Santosh shared that if any mammal, including dog, cat, horse, cow, buffalo, monkey or bat scratch or bit a person, they must be vaccinated with rabies shot.

She also pointed out something many miss: the location of administering the rabies shot. In her video she urged people to not get the shot administered in buttocks, and to only get it on their shoulders or thighs. She also claimed that many clinics and hospitals, despite knowing this fact, are administering rabies vaccination on buttocks.

Also Read: Hangover Star Ken Jeong's Wife Beats Stage 3 Breast Cancer

Why Does Location Of Administration Matter In Rabies Shot?

The World Health Organization (WHO) strongly recommends that rabies vaccines must be injected into the deltoid region, which is the upper arm or near the shoulder region in adults.

In small children, the WHO notes that deltoid region, as well as anterolateral area of the thigh muscle, which is also the upper thigh works.

WHO notes that like any other injections, rabies vaccine should not be given in the gluteal region, that is the buttocks, because of low absorption due to the presence of adipose or the fat tissue.

This video comes at the time when a case of a Birmingham woman losing all her limbs to dog's lick has made headlines all over the news. Health and Me also reported on the same.

Read: Woman Loses All Her Limbs After Getting Sepsis From Dog Lick

Health and Me spoke to Dr. Rakesh Pandit, Senior Consultant & HOD, Internal Medicine at Aakash Healthcare, who further explained, that as per guidelines by the WHO, the rabies vaccine should not be given in the buttocks as they have a heavy layer of fat. The body might not properly absorb the vaccine if it is injected into this fat instead of the muscle, which could result in a vaccine failure.

"A vaccine failure in case of rabies is like a death sentence because the disease is one hundred percent lethal once it shows the signs. The injection site for the vaccine depends on the patient's age; older children and adults must receive the vaccine in the upper arm or shoulder, while infants and toddlers must receive it in the thigh. The vaccine must also be administered with the right needle length to reach the required depth," he said.

Dr Pandit further elaborated, "The place of administering the vaccine (arm or thigh, subcutaneous or intramuscular) has an effect on the immune response, speed at which the vaccine is absorbed, pain and the risk of side effects." He said, "Some vaccines give best results when given in muscle for better immunity. Other vaccines may need subcutaneous administration. When given at the correct site, the vaccines ensure maximum effect, safety and reduced local reactions like swelling."

Read: 36% Of Rabies Death Comes From India: This Is What You Should Do After A Dog Bite, Explains Doctor

What Should One Keep In Mind While Getting A Rabies Shot?

Dr Mule points out that even when there are minor scratches, without bleeding, you must get a rabies shot. "Rabies can be contracted through broken skin. Such exposures still require medical evaluation and, in most cases, rabies vaccination."

What Should One Do Immediately After Being Bitten Or Scratched?

• Wash the wound immediately for at least 15 minutes with soap and running water
• Apply an antiseptic such as povidone-iodine
• Do not apply home remedies like turmeric, chili or oil
• Seek medical care promptly for rabies vaccination and possible immunoglobin

Dr Mule points out that the rabies vaccine should be started as soon as possible. "Ideally within 24 hours of a bite or scratch. However, even if there is a delay of days or weeks, vaccination should still be started immediately as rabies has a variable incubation period," he says.

The temperature of the vaccine matters. "Rabies vaccines are temperature-sensitive and must be stored between 2°C and 8°C. Exposure to heat or freezing can reduce vaccine potency. Poor cold-chain maintenance is a known reason for vaccine failure in rare cases," points out the doctor.

Dr Mule points out that the vaccine should be given intramuscularly in the deltoid or upper arms for adults, as gluteal or buttock injections could lead to inadequate absorption and reduce effectiveness.

A simple strep throat infection, can trigger sudden skin inflammation, leading to psoriasis, particularly in children and young adults, according to a study.

Researchers from the Karolinska Institutet in Sweden showed that a strep throat infection caused by the Group A Streptococcus (GAS) bacterium, can trigger guttate psoriasis by altering the behavior of key immune cells. Guttate psoriasis is an often sudden-onset form of psoriasis with small, red, "drop-shaped" scaling spots on arms and legs.

While neutrophils -- the most common type of immune cell -- are the first immune cells to respond to GAS infection, the study showed that during a streptococcal infection, the immune cells behavior changes depending on their environment.

Notably, among people with guttate psoriasis, the neutrophils presented with antigens -- fragments of pathogens that signal and guide other immune cells -- get accumulated. Once accumulated, the immune cells activated the T cells, leading to inflammation, explained the researchers in the paper, published in the journal eBioMedicine.

"Doctors have long known that strep throat can precede guttate psoriasis, but the biological explanation has been unclear," said Avinash Padhi, first author of the study and Research Specialist at the Division of Dermatology and Venereology, at Karolinska.

"Our findings suggest a link between infection and skin inflammation through the accumulation of antigen-presenting neutrophils in patients' skin," Padhi added.

How Cells Shape Immune Response

Magdalini Lourda, senior author of the study and senior research specialist at the Department of Laboratory Medicine, noted that the "results challenge the traditional view of neutrophils as simple first-line defenders".

The findings show that the neutrophils play "a wider role in shaping immune responses, which may be important when designing future treatments."

How Was The Study conducted?

To find how neutrophils work in psoriasis, the blood neutrophils from psoriasis patients were compared with those from healthy individuals. Blood neutrophils from patients with severe strep-related lung inflammation were also compared.

What Is Guttate Psoriasis?

Guttate psoriasis is a distinct form of acute-onset psoriasis. It is an inflammatory skin disease characterized by the sudden appearance of red, scaly, and smaller skin lesions widespread over the body.

The condition typically follows an infection, most commonly tonsillitis caused by Group A Streptococcus (GAS). Adolescents and young adults are the most affected. It accounts for about 2 per cent of all cases of psoriasis.

Genetics, environmental triggers, such as an upper respiratory tract infection, and the onset of an inflammatory condition in a distant organ are the major risk factors.

The condition may be diagnosed by skin biopsy, throat swab culture, and blood tests.