If waking up with blurry vision or experiencing sudden sight loss in one or both eyes. Most individuals may overlook these symptoms as a temporary or trivial issue, but they may be an indicator of a serious condition—a transient ischemic attack (TIA), also referred to as a mini-stroke.

Each year, around 46,000 individuals within the UK have their first TIA. Contrary to its title, a mini-stroke is not something that should be treated lightly. It is a serious warning that a full-scale stroke may be pending. Knowing the symptoms, causes, and prevention of TIA can prompt you into action and save lives.

What is a Transient Ischemic Attack (TIA)?

Transient ischemic attack results when blood flow to the brain is briefly obstructed, most commonly by a blood clot or constricted blood vessels. A TIA, unlike a full stroke, reverses within hours to minutes and does not produce lasting brain damage. But they are a signal of a greater chance of a future stroke—a little more than one in three people who experience a TIA will have a stroke within one year.

Physicians today depend on sophisticated imaging methods such as MRI scans, in addition to clinical evaluations, to decide if a subject has suffered a TIA or a stroke. TIAs, if left untreated, can lead to more serious cerebrovascular phenomena, and therefore early detection and treatment are paramount.

Vision processing engages about one-third of the brain and thus is especially at risk during a TIA. If a clot or interrupted blood supply to the area of the brain that controls vision occurs, people can experience the following brief symptoms:

• Blurry vision in one or both eyes
• Double vision
• Sudden loss of vision in one or both eyes

The nerves that regulate eye movement can also be impaired, causing misalignment and an inability to focus. Although these symptoms can resolve in a few hours, they are not to be taken lightly. Sudden, unexpected visual abnormalities require prompt medical care.

Identifying the Symptoms of a Mini Stroke

Symptoms of TIA tend to resemble those of a full stroke. The acronym FAST can be used to identify major warning signs:

Face: One side of the face may droop, making it difficult to smile.

Arms: The person may struggle to lift and hold both arms due to weakness.

Speech: Slurred or incoherent speech, or difficulty understanding others, may occur.

Time: If any of these symptoms appear, call emergency services immediately.

Other symptoms include:

• Sudden numbness or weakness, especially on one side of the body
• Difficulty articulating words or forming sentences
• Memory loss, confusion, dizziness, or sudden falls
• Severe headaches without a known cause

Because it is not possible to know whether symptoms are due to a TIA or a complete stroke when they first appear, immediate medical help is important. Early treatment can greatly minimize the risk of permanent injury or a subsequent stroke.

What Triggers a TIA?

TIAs result from temporary interruptions in blood flow, usually caused by several factors. Blood clots can develop within brain arteries, obstructing flow and causing fleeting symptoms. In others, clots migrate from elsewhere in the body to the brain, raising the risk for a stroke even further. The narrowing of arteries through plaque buildup also inhibits flow and makes people more vulnerable to TIAs. Trauma to blood vessels can also have an effect on flow, as well as cause these transient ischemic attacks. Treating these causes through changes in lifestyle, medicine, and periodic health check-ups is vital to reducing stroke risk.

How to Lower Your Risk of a TIA or Stroke?

Although some risk factors, including age or family history, cannot be altered, there are a number of changes in lifestyle that can greatly reduce your risk of having a TIA or stroke:

1. Follow a Heart-Healthy Diet

A diet of whole foods, such as vegetables, fruits, lean proteins, and legumes, can help cardiovascular health. Salt reduction can be used to control blood pressure, an important risk factor for stroke.

2. Exercise Regularly

Having a minimum of 150 minutes of moderate exercise weekly can enhance circulation, lower cholesterol levels, and keep one healthy weight, all of which aid in preventing strokes.

3. Quit Smoking

Smoking raises blood clot risk and damage to arteries and is thus a leading cause of strokes. See a doctor to come up with a plan for quitting.

4. Reduce Alcohol Intake

Drinking too much alcohol increases blood pressure and makes blood vessels fragile. Adhere to suggested levels—two drinks a day for men and one drink for women.

5. Control Stress Levels

Chronic stress is associated with hypertension and heart disease. Mindfulness, slow breathing, or doing hobbies can lower health risks associated with stress.

Importance of Immediate Medical Attention

Although symptoms may clear up within hours, a TIA is a warning sign that a full-blown stroke may be lurking ahead. Medical attention enables physicians to assess your risk and prescribe medication such as blood thinners, diet changes, or procedures for clearing out clogged arteries.

If you or a person you know has sudden vision changes, speech difficulty, or weakness in the body on one side, don't dismiss them. Taking prompt action can help avoid a deadly stroke and maybe even save a life.

Semaglutide, a well-known drug for diabetes and weight loss, commonly referred to as Ozempic, has been found to help patients with peripheral artery disease (PAD) walk longer distances. PAD is a circulatory condition where narrowed arteries reduce blood flow to the limbs due to plaque buildup. This condition is particularly common among individuals with diabetes.

A study published in The Lancet demonstrated that administering 1 mg of semaglutide to adults with type 2 diabetes and symptomatic PAD led to a 13% increase in their walking distance compared to those given a placebo. The drug was also associated with an improvement in ankle-brachial indices, a key test that compares blood pressure in the ankle to that in the arm, assessing blood flow in the lower limbs. The results of the STRIDE trial were presented at the American College of Cardiology Annual Meeting on March 29. The research was funded by Novo Nordisk, the manufacturer of Ozempic.

Beyond Blood Sugar Levels

The significance of this study lies in its demonstration of semaglutide's multifaceted protective effects beyond just improving blood sugar levels and aiding weight loss. Previous findings have already established its role in reducing the risk of cardiovascular events, benefiting kidney health, and even helping lower certain addictive behaviors.

Understanding Peripheral Artery Disease (PAD)PAD occurs when arteries narrow, restricting blood flow to the arms and legs. It is one of the most serious complications of diabetes and a leading cause of disability and amputation. More than 230 million people worldwide are affected by PAD, and there are currently no medical treatments available that can prevent or slow down its complications in diabetics.

Experts emphasize that PAD is a persistent and highly debilitating disease for which no current therapies exist. Patients suffering from PAD often experience severe limitations in their ability to function and walk without pain. As the condition progresses, some individuals may require interventions such as revascularization surgery, which aims to restore blood supply to the legs. In extreme cases, limb amputation may become necessary.

Semaglutide As A Potential Solution

Medical professionals point out that functional impairment in individuals with PAD is often overlooked in its early stages despite the severe disability it causes. The findings of the STRIDE trial are particularly promising as they indicate that semaglutide’s benefits on maximum walking distance were noticeable at 26 weeks and continued to improve up to 52 weeks without reaching a plateau. This suggests that semaglutide could be a viable long-term therapy option for PAD patients.

Experts further highlight that amputation is one of the most feared complications of diabetes and is significantly more common in diabetic individuals than in those without the condition. The findings of this study offer a ray of hope in addressing this pressing issue.

Following the trial’s promising results, Novo Nordisk has submitted a label extension application for Ozempic to the US Food and Drug Administration (FDA). If approved, this could mark a major breakthrough in the treatment of PAD, potentially offering a new medical option for millions affected by the disease.

As per the Australian Bureau of Statistics (ABS) National Health Measures Survey, 1 in 15 Australian adults is living with diabetes. The ABS also included the details on the number of Australians who showed signs of kidney disease, vitamin D deficiencies and other potential chronic illnesses.

The survey also noted a total 6.6% of Australians over the age of 18 have diabetes. There is also an increase of 1.5% when compared to a decade ago.

What Is Diabetes?

Diabetes is a long-term condition that happens when there is too much sugar in your bloodstream. This is because your body is unable to process it correctly. When someone is diabetes-free, the pancreas produce a hormone called insulin that helps move sugar into the cells of the body. However, with someone with diabetes, the pancreas either does not make enough insulin or the body does not use it well. This leads to sugar build up in the blood.

Increasing Prevalence of Diabetes

Diabetes has become a significant health challenge in Australia, with the number of diagnosed individuals rising to 1.3 million between 2000 and 2021. Data from the Australian Institute of Health and Welfare (AIHW) shows that men are more likely to have diabetes than women. Additionally, adults living in socioeconomically disadvantaged areas are at a higher risk of developing the condition. These figures highlight the growing burden of diabetes on individuals and healthcare systems nationwide.

Apart from diagnosed cases, an estimated 500,000 Australians may be living with undiagnosed type 2 diabetes. The National Health Measures Survey also found that 2.7% of adults are at high risk of developing diabetes. The prevalence of undiagnosed cases suggests a need for increased awareness, screening, and early intervention to prevent complications.

What Could Be The Risk Factors?

Several health risk factors contribute to diabetes, including a high body mass index (BMI), large waist circumference, smoking, and high blood pressure. Individuals with diabetes are more likely to exhibit multiple risk factors compared to those without the condition. However, data also shows that 88.9% of people with diabetes are non-smokers, and 70.5% maintain normal blood pressure levels. These findings align with the management goals set by the Royal Australian College of General Practitioners.

How Can Diabetes Be Managed?

Lifestyle and dietary changes can significantly reduce the risk of developing type 2 diabetes. Research indicates that up to 58% of cases can be delayed or prevented through healthier choices. However, approximately 42% of cases are linked to genetic factors, making prevention challenging for some individuals. Reducing the stigma around diabetes is essential to encourage at-risk individuals to seek medical advice and support without fear of judgment.

Cholesterol and Vitamin D Deficiency Trends

The AIHW health survey also examined cholesterol levels and vitamin D deficiencies among Australians. Around 30.2% of adults have high cholesterol, with women more likely to be affected than men. Additionally, 17.8% of adults have cholesterol levels close to abnormal.

High-density lipoprotein (HDL), often referred to as "good cholesterol," plays a crucial role in transporting cholesterol to the liver for breakdown. However, 14.9% of Australians have an abnormally low HDL level, increasing their risk of heart disease and stroke.

Seasonal Variations in Vitamin D Levels

Vitamin D deficiency is another widespread health concern, affecting 20.6% of adults. Seasonal variations impact deficiency rates, with 26.1% of adults experiencing low vitamin D levels in winter, compared to 15.5% in summer. Vitamin D is essential for calcium absorption, bone health, and muscle function, and severe deficiencies can lead to brittle bones and other health issues.

Pain is the body’s way of signaling that something is wrong. In most cases, pain fades once the underlying issue heals. However, for millions of people, pain becomes a constant companion, lasting for months or even years. This condition, known as chronic pain, not only affects physical health but also has a profound impact on emotional well-being.

Current studies emphasize the strong link between chronic pain and mental illness such as anxiety and depression. Individuals suffering from long-term pain tend to be stuck in a vicious cycle of fear, stress, and emotional distress. But how does chronic pain actually lead to deteriorating mental health, and how can the cycle be stopped?

For over 45 million Americans, chronic pain is a way of life. Although physical pain is the most visible symptom, its impact reaches far beyond the physical body. Chronic pain is frequently accompanied by psychological distress, as many victims experience anxiety and depression caused by their illness.

As per Dr. Ravi Kesari, a general medicine specialist, "Chronic pain and mental illness tend to exacerbate each other. Patients have disturbed sleep patterns, increased mental tension, and depression-like symptoms. This forms a vicious circle in which pain causes emotional distress, which further increases the perception of pain."

This cycle is especially seen in conditions like:

Fibromyalgia – A syndrome of widespread pain, fatigue, and cognitive difficulty.

Irritable Bowel Syndrome (IBS) – A bowel condition frequently associated with stress and tension.

Lower Back Pain – Prolonged pain in the lower back, often accompanied by decreased mobility and depression.

Migraine and Nerve Pain – Prolonged headaches and nerve pain that interfere with daily functioning.

Research indicates that two-thirds of IBS sufferers experience anxiety symptoms, and 65% of patients with depression exhibit chronic pain symptoms. This commonality indicates that mental illness not only heightens sensitivity to pain but also complicates recovery.

How Stress of Chronic Pain Can Rewires Your Brain?

When a person hurts, the body releases stress chemicals such as cortisol and adrenaline to assist in the regulation of pain. Such hormones are helpful during short-term occurrences, but once pain persists over time, continued exposure to stress hormones alters brain chemistry.

"Chronic pain leads to chronic stress, and that changes the neurochemicals in the brain that control mood, thought processes, and behavior," explains Dr. Kesari. "That's why people with chronic pain tend to be irritable, angry, or drained of emotions."

Chronic exposure to stress hormones can cause:

Heightened anxiety and fear reactions, making people excessively careful about everyday activities.

Depression, as serotonin and dopamine levels decrease—two neurotransmitters that produce happiness and motivation.

Cognitive impairment, including problems concentrating, remembering, or deciding.

Pain, Anxiety, and the Fear of Movement

Another very frequent mental impact of chronic pain is kinesiophobia, or fear of movement. Individuals with chronic pain tend to avoid movement for fear of making their pain worse. This avoidance behavior can cause stiffness in the muscles, loss of mobility, and increased pain over time.

For example, a person with chronic back pain might try to avoid exercising, which would further weaken muscles and worsen their condition. This pattern of avoidance and worsened pain begets a spiraling sense of helplessness that further fuels anxiety and mood shifts.

"Anxiety is an understandable reaction to chronic pain," says Dr. Kesari. "People become concerned about what pain will mean for their lives, so tasks that are minor—such as shopping for groceries or socializing—become overwhelming."

Daily Struggles and Self-Esteem Loss

Chronic pain does not only impact mood; it is able to significantly modify the way an individual perceives himself. Most of those who have chronic pain struggle with simple activities such as exiting bed, dressing up, or personal hygiene. Failing to do so by oneself may cause the individual to feel inadequate, frustrated, and socially withdrawn.

As Dr. Kesari describes, "Patients tend to feel ill at ease in social situations because they view their condition as a restriction. This adds to low self-esteem and exacerbates mental illness such as depression."

Considering the complex connection between chronic pain and mental well-being, both physical and emotional welfare must be treated.

Dr. Kesari stresses, "Healthcare providers need to take a whole-body approach to treating chronic pain. That involves coupling conventional pain management with mental health care to break the cycle between pain and emotional distress."

Some strategies that have been found to be effective are:

Cognitive Behavioral Therapy (CBT) – A type of psychotherapy that enables people to deal with negative thought processes and respond to pain.

Physical Therapy & Movement-Based Practices – Gentle exercise, like tai chi or yoga, decreases pain and alleviates fear of movement.

Medication Management – Painkillers can be beneficial, but only as part of a combination of holistic therapies to prevent dependency.

Stress-Reduction Techniques – Techniques such as meditation, deep breathing, and mindfulness assist in balancing stress hormones.

Social Support & Therapy Groups – Sharing experiences with others who live with chronic pain has been shown to combat the sense of isolation and offer emotional support.

Chronic pain is not merely a physical condition—it has a powerful impact on mental health, causing anxiety, depression, and extreme lifestyle constraints. But knowledge of the interlinkage of pain and emotional health can encourage proactive measures toward improved general well-being.

Dr Ravi Kesari is MBBS, MD- General Medicine at Apollo Spectra Hospital, Bangalore in India