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Malaria during Pregnancy
Pregnancy is the time when you want to ensure your health stays at its peak and there are no complications that could affect the baby. There are certain health conditions that arise despite all the precautions taken, and malaria can be one of them. It is a life-threatening disease that is preventable and curable through sustained medication.
What is Malaria?
Malaria is a lethal disease that is caused by a parasite which infects the female Anopheles mosquitoes. When these mosquitoes feed on humans by biting them, malaria spreads and is thus transmitted into human beings. These malarial parasites have been identified as follows:
Plasmodium Malariae
Plasmodium Ovale
Plasmodium Vivax
Plasmodium Falciparum
While Plasmodium Vivax and Plasmodium Falciparum are the most commonly found, it is the latter that is the deadliest. When a mosquito bites a person with malaria and sucks in blood, the malarial parasites travel from the infected person’s blood to the mosquito. The malarial parasite develops and multiplies within 10 to 14 days of its stay within the mosquito and can be easily passed into a healthy person’s body. The infected person takes 7 to 21 days to become sick but in rare cases, it can take several months for the symptoms to appear.
Malaria And Pregnancy
Here are a few basic facts about malaria during pregnancy that you should be aware of:
During pregnancy, your immunity is low and this makes you a more likely target for malaria. It is necessary to be careful, especially during the second and third trimesters of pregnancy since immunity is at its lowest during these times. Pregnant women are also more likely to face frequent and serious attacks of malaria and have a higher risk of complications too.
If the pregnant woman is already suffering from nutritional anaemia, the malaria-induced anaemia will increase its impact further and also lead to complications that could be fatal for the mother. There are chances of the malarial parasites getting into the placenta and interfering with the oxygen transfer and smooth passage of nutrients from the mother to the foetus. This increases the risk of spontaneous abortion, stillbirth or pre-term birth. In some cases, the woman may even give birth to a baby with low birth-weight.
Causes
Malaria during pregnancy is a major health risk for pregnant women. Various studies have shown that women who live in tropical and developing countries are more prone to malarial infection.
Immunity Loss: Due to the decrease of immunoglobulin synthesis during pregnancy, a woman’s immune systems are at an all-time low and this is one of the primary causes of them contracting malaria during pregnancy.
Placenta: The placenta is a new organ that is growing inside your body when you are pregnant. The malarial infection can break through the immunity protection, and placenta-specific phenotypes are also allowed to multiply.
Weather Conditions: Monsoon provides a fertile breeding ground for mosquitoes to grow and it is generally during this season that the spread of malaria becomes rampant. Humidity, temperature and rainfall can also play a significant role in the spread of malaria.
Signs And Symptoms Of Malaria
The symptoms of malaria, quite similar to those of influenza, are quite difficult to diagnose and make themselves visible more than seven to ten days after the first mosquito bite. The common symptoms include the following:
Headache
High fever
Muscle pain
Nausea
Vomiting
Chills
Sweats
Diarrhoea
Pregnancy can alter these symptoms slightly, where the fever is extremely high or low and the shivering and sweating may be missing. Since the symptoms are similar to that of the flu, a blood test is an assured way of confirming malaria and the type that has affected you. If you have chills and sweating, with high fever, then it is best to speak to your doctor at once to avoid further problems.
Risk Factors Of Malaria In Pregnant Women
Malaria in pregnant women can be contracted if the infected person resides in an area that is unhygienic and dirty. If there are stagnant pools of water or water puddles that haven’t been attended to or cleaned for long, it allows mosquitoes to breed easily.
If the pregnant woman has to undergo any kind of blood transfusion or organ transplant, there is a possibility of infected blood passing the parasite to her. Malaria can also be transmitted from the mother to the infant.
Diagnosis
Malaria during pregnancy is difficult to diagnose since most women are asymptomatic. The peripheral blood samples are unable to detect its infection since the falciparum parasite is isolated in the placenta. The following tests are conducted after collecting blood samples from the patient:
Blood Smear Test: This includes microscopic screening of the blood sample taken from the patient and is a standard test for malaria diagnosis.
RDT-Rapid Diagnostic Test: This test detects the malaria antigens in the blood and is used where microscopy is not available.
Histological Examination: Considered to be the most reliable and more accurate than others, this test for detecting pregnancy malaria involves the examination of tissue samples with the use of a microscope.
Malaria Treatment In Pregnancy
If a pregnant woman contracts malaria, it is necessary to provide quick medical attention to her. There are a number of drugs for treatment of malaria in pregnancy which are safe and do not present any kind of side effects to the mother or the foetus.
During the first trimester, quinine and clindamycin can be administered to the patient if it is a mild form of malaria. Chloroquine is also an effective medicine for uncomplicated pregnancy malaria.
The safest and the most effective treatment for malaria during the second and third trimesters is ACT or Artemisinin Combination Therapy.
The above-mentioned antimalarial treatments in pregnancy are safe, but should be administered to the patient under medical guidance only. The medication will depend upon the type of malaria contracted, your age, the pregnancy stage, and the severity of symptoms. These medicines are generally administered in the form of tablets or capsules and sometimes intravenously too, especially if the patient is at an advanced stage.
Complications Of Malaria During Pregnancy
Malaria can be classified into a complex or an uncomplicated infection. Complex malaria is a serious condition that has the potential to give rise to cerebral malaria, anaemia, ARDS (Acute Respiratory Distress Syndrome) and could even lead to organ damage. Uncomplicated infection of malaria displays symptoms like fever, headache and chills followed by sweating that happens every two days and lasts for eight to ten hours.
Maternal Complications
Expecting mothers face the following complications if they suffer from malaria during pregnancy:
Anaemia: When the malarial parasite infects the pregnant woman’s blood, it causes haemolysis or rupture of red blood cells which creates an additional need for blood supply. This causes anaemia which could lead to haemorrhage and maternal mortality in certain cases.
Renal Failure: Unobserved dehydration during malaria can lead to renal failure, and the patient will have to be put under fluid management and diuretics as a part of its treatment. In certain cases, dialysis may also be required.
Hypoglycaemia: This condition occurs when the blood sugar level reduces drastically and falls below 60 mg/dl. The increased action of the falciparum parasites causes this condition which then leads to the enhanced use of glucose and low glucose production. This symptom is asymptomatic and needs constant monitoring.
Immuno-Suppression: Your body undergoes many hormonal changes during pregnancy which impact the immune system in a big way. Your body produces the immunosuppressive hormone called cortisol which reduces immunity. When cortisol levels rise, the resistance to malaria also decreases and this can lead to many complications like cerebral malaria, pulmonary oedema, hypoglycaemia and hyperpyrexia.
Acute Pulmonary Oedema: Known as the severest form of anaemia, it occurs during the second or third trimester. The falciparum infection causes fluid leakage into the lungs, a condition created by the formation of a membrane in the alveoli.
Complications of the Foetus
When the mother is detected with malaria, the foetus could face a few complications which are listed below:
IUGR or Low birth-weight: The growth of a new organ in the form of the placenta allows the malarial parasites to enter the mother’s immune system and prevent oxygen and nutrient supply to the growing foetus. This leads to infants with low birth-weight and IUGR-Intrauterine growth retardation. There are low chances of survival for infants who are born with weight less than 2.5 kg (5.5 lbs).
Preterm delivery: It is the placenta where the malarial parasites strike and multiply, and it is through this infected passage that antibodies and cytokines are carried, triggering an active response and thus leading to early labour.
Vertical Transmission: The risk of malarial infection can easily pass on from the mother to the baby. If malaria is detected on time and the mother receives proper medication, then the foetus remains safe too. That is the reason most doctors advise blood screening of the baby after birth to ensure it has not been infected.
Side Effects Of Malaria On Pregnancy And Foetus
Malaria in pregnancy increases the risk of neonatal death, low birth-weight babies, miscarriage and stillbirth. Also, the baby itself could be born with malaria which could prove to be fatal.
How To Prevent Malaria In Pregnant Women
Since mosquitoes are the main cause of this disease, it is necessary to keep them at bay when you are pregnant. It is necessary to identify potential mosquito-breeding spots around your home and get them cleaned. Any stagnant water that hasn’t been used for a long time should be emptied, especially during monsoon. All containers like vases, flowerpots and fish bowls should be cleaned and filled with fresh water.
Try to wear light-coloured clothes, since mosquitoes are generally attracted towards dark colours. Wearing full-length garments and long sleeves, especially during the night, is highly recommended. The use of mosquito repellents and nets can also be an effective way of keeping mosquitoes at bay during pregnancy and preventing malarial infections.
If you plan to use chemical-based mosquito repellents, make sure you apply it as per the instructions given. Applying more will not give better protection; in fact, it can expose you to higher chemical levels. It is best to apply a thin layer over your skin and spread it evenly for maximum protection.
Can Malaria Affect The Mother Or Baby?
Malaria during pregnancy can lead to anaemia in the mother and subsequently reduce birth weight of the baby. Low birth weight is a major reason for infant mortality.
Conclusion: World over, major steps are being taken to reduce the occurrence of malaria, and the mortality rate can be seen falling due to these efforts. Scientific advancements have helped prevention of malaria to a large extent. However, we are yet unable to defeat it completely, which is why it is imperative to be on your guard and see the doctor at once in case you suspect any symptoms of the condition. Read more
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5 Simple Solutions to your Toddler’s Bedtime Problems
Got a nocturnal little one at hand? For some babies, sleeping is a huge task, for others it’s a breeze. Every child's sleep patterns vary, but most kids suffer from one or more sleeping issues as they grow up. Are your baby's sleeping issues keeping you up at night? Let's put an end to your exhaustion by getting to the root of the problem.
Crying out for you, scared of the dark or bad dreams, the cause for sleep-time problems varies for different kids - which one does your darling suffer from?
If we had to broadly look for solutions to bed-time problems then there are a variety of things that can promote sound sleep in toddlers. Snuggling, reading to her, a warm bath or lullabies can help lull your baby in to a peaceful sleep. However, if the problems continue, there are ways to tackle them as suggested by experts.
Toddler Sleep Problems & Their Solutions
1. Sleep Problem: Your child takes forever to fall asleep
Reason: Frequent napping during the day or irregular sleep pattern.
Solution: Having a fixed bed-time for your child is key to forming a habit. If you already have set a pattern or routine, a disruption in that pattern can trigger this problem. Try and fill up your toddler's morning time with activities and set nap time for after lunch, not exceeding two hours.
2. Sleep Problem: Bed-time nightmares and other fears
Reason: Toddlers have an active imagination that is constantly alert to newer things. Anything like an argument overheard or a fear inducing sight, may come back to her in the form of a nightmare.
Solution: Try and avoid books or movies with anything remotely fearful during bedtime. The best thing to do when your child is afraid is to soothe her and give her security.
3. Sleep Problem: Your child wakes up too early
Reason: Toddlers may wake up at dawn, or when any light enters the room.
Sleep Solution: Usually if a child wakes up too early, she may fall asleep again or play on her own till she gets tired again. Keeping a few toys around or a favourite stuffed animal might help occupy her when she wakes up.
4. Sleep Problem: Your baby wakes up to feed all night
Reason: Your baby probably has her schedule mixed up, eating all night but not enough in the day and napping longer in the day but not all night.
Sleep Solution: For newborns, feeding all night long is completely normal but once your baby crosses 4 months, she should ideally be feeding much more in the day and sleeping a lot longer in the night. In the case that your baby is doing the opposite, you need to gradually work on shifting the schedule by shortening her naps and feeding her more in the day. You can read more about phasing out night feeding for babies here.
5. Sleep Problem: Your baby falls asleep only when you hold her
Reason: This problem is called parent sleep association where they baby can't sleep unless there is close contact with the parent. In most cases, the mom is the parent in question.
Sleep Solution: If the baby has a stronger association with you in particular, you could try and get your spouse to handle bedtime routines for a while. Sometimes getting someone else to put your baby to sleep can help fix this problem.
We're sure that no matter what the bed-time issue is that your baby and you are facing, she will eventually outgrow it and learn to treasure her sleep time. The best possible solution for bed-time problems to set schedules that encourage activity during the day so that your little one is tired and sleeps soundly. The right diet will also help a great deal in ensuring that all major functions of the body, including rest, function normally. Read more
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How to set a Monthly Household Budget
Managing household expenses is one of the biggest challenges most face these days. The constant price rise has made planning somewhat tricky but very doable. Learn how to do it all by preparing a simple monthly household budget that you and everyone can follow.
Want to prepare a monthly budget to keep a tab on your expenses but don't know where to begin? The task isn't as difficult as it seems. You need to start by finding out the average expense of all family members before you sit down to begin planning.
How to Make a Budget for your Home without Being Miserly
1. Write Down your Expenses
While you may have an approximate idea of how much you need to spend in a month, you may miss out on something or the other. It's always better to jot down all expenses on a day-to-day basis. When the month starts, write down fixed expenses such as house rent, car EMI and so on. Once you're done with those, you can start logging daily expenses.
2. Compare Income and Expenses
If you and your husband have fixed salaries, home budget planning becomes much easier. However, if you're a freelancer or a businesswoman and your net income varies from month to month, take the average of the last five-six months. You can also consider last month's earnings as your income. Now, subtract your expenses from your income to know how much you're likely to save and keep that amount aside.
3. Prioritise your Expenses
If you aren't satisfied with the amount you'd be saving and want to save more, prioritise your expenses. Strike off those that aren't really important and focus on those you and your family actually need. You'd be surprised by how much money's spent on frivolous stuff like dining out frequently and manis and pedis.
4. Plan for Leisure
All work and no play can certainly make one dull. So don't be too harsh on yourself and set some money aside to plan a leisurely trip or a fun activity every month. You work hard your whole life, even one or two days of fun every month will leave you refreshed and ready to face life's hectic demands. This is also an important tool to teach your children the importance of working hard.
5. Do a Reality Check
Just preparing a monthly household budget is of no use if you don't follow it. Keep a tab on your expenses throughout the month and at the end, you'll see if you're treading in the right track. Finally, compare your actual expenses with the budget you had planned. This family budget planning tip is an easy way to see where to cut corners and where you can loosen the purse strings.
With these home budgeting tips, preparing a monthly expense plan shouldn't be difficult. Newly-married couples can follow it as can moms, dads and everyone in between. The best part of setting a budget is that you don't need to forego all luxuries; you just need to pick and choose between them wisely. Read more
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Baked Chicken Parmesan
Oh, how we love this dish – baked chicken Parmesan -- breaded, smothered with ketchup and baked until the cheese gets bubbly and melts into every nook and cranny of the chicken piece. It is undoubtedly a pure comfort food, and is so easy to prepare that it comes together within minutes. Serve it to your family and see them fight over the last drippings.
Serves
Preparation Time
Cooking Time
4 People
10-15 Minutes
30-35 Minutes
Ingredients
For the Sauce
2 medium garlic cloves, peeled and minced
1/4 cup extra virgin olive oil
4 crushed tomatoes
1/2 teaspoon dried basil
1/4 teaspoon dried oregano
1/4 teaspoon sugar
For the Chicken
3 tbsp Dijon mustard
1 tbsp white-wine vinegar
1/2 teaspoon salt
1/2 teaspoon black pepper
4 pieces skinless, boneless chicken breast halves (or deboned thighs)
3/4 cup of bread crumbs
1 cup finely grated Parmesan cheese
50 g unsalted butter, melted
Method
Step 1
For the sauce, take a large saucepan and place it on medium heat. Add oil and garlic, sauté till the garlic starts to sizzle.
Step 2
Next, add the tomatoes, basil, oregano, sugar, salt and pepper. Continue to simmer until the sauce thickens a little and flavors blend in with each other.
Step 3
Now take the chicken pieces and keep it between layers of a plastic wrap. Pound the pieces in such a way that the pieces flatten to even thickness.
Step 4
In another bowl, mix mustard, vinegar, salt and pepper, and coat the chicken pieces evenly.
Step 5
Take one more bowl and mix bread crumbs, grated cheese, pepper, and add butter.
Step 6
After coating the chicken pieces in the mustard mixture, dredge it in the crumb mixture. Make sure the chicken piece gets coated evenly.
Step 7
Press the crumbs gently so that they adhere together and transfer it to a baking sheet.
Step 8
Bake for about 15 minutes or until golden brown.
Step 9
Spoon out a little sauce on each of the pieces and serve it with a side of rice or pasta
Nutritional Information
Calories
507 K cal
Proteins
33.9 g
Fat
29.8 g
Carbohydrates
27.4 g
Cholesterol
97 mg
Sodium
991 mg
Potassium
82 mg
Read more
Ankita Mehta has added a new answer
Guardian of 0 children
4 hours ago
Q. is white discharge in 8th month normal?
Ankita Mehta
Mom of a 8 yr 7 m old girl
4 hours ago
A. hi
yes
but if it is too thick or clear like water,if there other symptoms like itching, irritation, redness,foul smell from vagina, please visit your gynecologist
Dr Vandan H Kumar has added a new answer
Guardian of 0 children
4 hours ago
Q. My son is 5 months old is suffering from cough..what to do?
Dr Vandan H Kumar
Paediatrician
3 hours ago
A. give nasal saline drops every few hourly to the child in the nasal cavity.
try to prevent temperature variations around the child
you can go for indirect steam inhalation which will again help in decreasing both cough and cold
continue the regular diet of the child
if there is no improvement in few days then meet your doctoru
for fever and pain give paracetamol.u
anti-cold medicines at this age have got side effects so can be given only after medical consultation.
POOJA KOTHARI has added a new answer
Expecting Mom due in 6 months
4 hours ago
Q. hi. in Feb my period was last and I did pregnancy test in March its positive results but my belly is not being bigger
POOJA KOTHARI
Mom of a 7 yr 1 m old boy
4 hours ago
A. Typically, your bump becomes noticeable during your second trimester. Between 16-20 weeks, your body will start showing your baby's growth. For some women, their bump may not be noticeable until the end of the second trimester and even into the third trimester. The second trimester starts in the fourth month.
Humara has added a new answer
Guardian of 0 children
2 hours ago
Q. I am 7 weeks pregnant. Before pregnancy I used to take medicine named Cyra 20 mg for acidity. Now since the day when I got to know that I am pregnant I am not taking any medicine for acidity but daily I am suffering from it. After having breakfast it starts. I am not eating any spicy food , oily food etc. Please help on this
Read moreHumara
Mom of a 2 m old girl
8 mins ago
A. dear mom u can take digene syrup or ulgel they as safe my doctor recommended me during pregnancy u can also take biorab dsr in the morning and syrup before meal at least 30 min i was faciny the same issue
Dr Ghouse has added a new answer
Mom of a 1 yr 9 m old child
1 hour ago
Q. hi mam , my baby 1 year and 9 month old just now onwards stop breast feeding .pls suggest formula milk to my baby
Dr Ghouse
Paediatrician
1 hour ago
A. your baby is more than 1 year 9 months of age any milk including buffalo milk cows milk ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Trying To Conceive
1 hour ago
Q. #AskTheExpert hello dr.
baby planning kar rhi kuch tips btayiye conceive ho jaye
Dr Ghouse
Paediatrician
1 hour ago
A. it's a natural process ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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