All posts by Prachi Shah

All, Coronavirus

Masks and Social Distancing After Vaccination

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Why You'll Still Need to Wear a Mask After the COVID-19 Vaccine

Image from prevention.com

Prachi Shah

The COVID-19 pandemic has been ongoing for almost a year. Fortunately, vaccine distribution is underway, which has given many people new hope for the end of the pandemic. However, experts say that even after vaccination, individuals should continue wearing masks in public and social distancing from those outside of their household. 

First, it’s important to understand that no vaccine provides everyone complete immunity.  Studies show that the current vaccines limit infection with symptoms; scientists are unsure of the extent to which it prevents infection altogether. The prevalence of asymptomatic COVID-19 in vaccinated individuals is unknown. We wore masks and kept our distance prior to the vaccine just in case we or someone around us was an asymptomatic carrier, and we don’t yet have the data to know whether or not this risk is reduced. [1]

You may be wondering how a vaccine can reduce symptoms but not prevent infection. Administration of the vaccine is like giving your body a “practice run” of what to do if it encounters the real virus. The body will see the particles of the vaccine and produce proteins known as antibodies, which will tag the particles and mark them for destruction. After destroying the harmless vaccine, the antibodies will remain in the body, where they will be ready to target the real SARS CoV-2 (coronavirus) if and when it enters the body.

The vaccine is administered to muscle tissue, and it produces antibodies that can circulate to the rest of the body through the bloodstream. However, the coronavirus is most easily spread through respiratory droplets and primarily attacks cells in the nose, windpipe, and lungs. The moist environment of the nose and respiratory tract is the perfect place for it to reproduce. In the case of exposure of the respiratory tract to the virus, the antibodies may not have reached all the way to the nose to prevent the initial infection (and subsequent spread via droplets), even though the antibodies will prevent the virus from taking hold deeper in the tissue [2][3].

As with all information regarding this virus and its characteristics, it’s important to note that the available information is changing each day. If it seems like experts are “changing their minds” on a recommendation, it’s likely because new research has come to light that changes our understanding of the virus and therefore changes the best practice. As this virus and vaccine are both so new, it’s safest to err on the side of caution and trust the experts when they advise to keep the mask on for now. 

https://www.npr.org/sections/health-shots/2021/01/12/956051995/why-you-should-still-wear-a-mask-and-avoid-crowds-after-getting-the-covid-19-vac

https://www.nytimes.com/2020/12/08/health/covid-vaccine-mask.html

https://www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-ferocious-rampage-through-body-brain-toes

All, Medicine

Daily Use of Over-the-Counter Pain Medication

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Advil vs. Tylenol. Which to Use, and When - WSJ

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Prachi Shah

Two of the most common medications for alleviation of pain, acetaminophen (Tylenol) and ibuprofen (Advil), are used daily by many people with pain from arthritis, tendinopathy, back pain, and other persistent conditions, but is it safe to use these drugs daily? 

Ibuprofen acts in the body by directly preventing the conversion of arachidonic acid to prostaglandin H-5– an important signal to the brain indicating that there may be damage to the body. Since your brain stops receiving the message indicating damage, you stop feeling pain. Aspirin has a slightly different effect on a molecular level, but the same result. Since prostaglandins play a role in blood coagulation and protecting the digestive tract lining, the regular use of ibuprofen or aspirin can cause irritation of the digestive tract and an increased risk of bleeding. Some people get gastrointestinal symptoms with just one or two doses of ibuprofen or aspirin, but that might not be an indication of damage. 

Acetaminophen is thought to work somewhere in the central nervous system,  interrupting the “pain message”’ closer to the brain, but no exact mechanism has been determined yet. Acetaminophen is digested in the liver, and although the majority of it is digested and excreted normally, a small amount is converted to a toxic byproduct. So, if too much acetaminophen is administered too quickly, the toxic byproduct can build to dangerous levels. There are numerous stories of people inadvertently overdosing on acetaminophen, which can damage the liver to the point that it no longer functions. This also means that acetaminophen in combination with other things that harm the liver, such as excessive alcohol, can be dangerous.

While the use of high doses of ibuprofen and acetaminophen can cause liver and kidney damage, the risk of this is small. These are some of the most widely used and safest medications known. Most pills contain only a fraction of the dose needed to cause damage. For example, a standard ibuprofen tablet contains roughly 200 mg of ibuprofen. A dangerous level in an average adult is upwards of 3,200 mg (or 16 pills) in one day or 800 mg (four pills) at once. 

All medicines merit caution. Experts recommend the following tips for safe pain alleviation:

  1. Make sure to know all the possible sources of acetaminophen ingested in one day. It is a common ingredient in many over-the-counter remedies and has multiple brand names, so it’s important to check the ingredient list before taking multiple medications.
  2. Take  as little as possible, and make sure to check the recommended dosage. The maximum amount of medication that is safe varies by factors such as size, sex, and medical conditions. 
  3. Avoid mixing medications/substances. This includes drinking alcohol while taking these medications, as well as asking a health provider about which over-the-counter medications are safe to take along with prescribed medications. 

Over-the-counter pain relievers, such as acetaminophen, ibuprofen, and aspirin, can be available and affordable treatments to help alleviate simple aches and pains. They can be taken on a daily basis if one is careful. 

https://tuftsjournal.tufts.edu/2008/04/professor/01/

https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/How-Do-Pain-Relievers-Work

https://www.youtube.com/watch?v=9mcuIc5O-DE

https://www.health.harvard.edu/pain/acetaminophen-safety-be-cautious-but-not-afraid

https://www.webmd.com/a-to-z-guides/tylenol-acetaminophen-poisoning#1

https://www.news-medical.net/health/Ibuprofen-Mechanism.aspx

https://adf.org.au/drug-facts/ibuprofen/

https://www.ucihealth.org/blog/2018/03/acetaminophen-liver-failure#:~:text=%E2%80%9CSevere%20damage%20could%20occur%20if,cause%20problems%2C%E2%80%9D%20he%20adds

https://www.healthline.com/health/can-you-overdose-on-ibuprofen#dosage

All, Women's Health

Menstrual Myths

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How to Induce a Period: 13 Natural Methods and Myths

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Prachi Shah

It’s a story passed from word of mouth, across households, generations and countries. Young people, often young women with an important event coming up, are told to eat certain foods to induce or delay their menstrual period in order to make sure that it doesn’t coincide with a birthday, religious occasion, or other event. Plants and herbs such as turmeric, mangoes, pineapple, and papaya have been touted for centuries as natural ways to encourage the early onset of a menstrual period. However, the evidence regarding these herbal treatments, known as emmenagogues, is often strictly anecdotal, and is often contradictory. 

A menstrual period is the culmination of the body’s roughly 28 day reproductive cycle. The cycle begins with the maturation of an ovum, or egg, which is then released into the body. Over the next few weeks, the endometrium (thick lining of the uterus) thickens. The cycle culminates with the shedding of this lining through the vagina, which is known as the menstrual period. The menstrual period is regulated largely by hormones such as estrogen and progesterone, among others. When these hormones are not present in the correct ratios, it can result in irregular periods, which may lead someone to seek out natural remedies to induce it. 

Anecdotes claim that foods such as citrus, berries, spinach, and tomatoes bring on a period through the increased intake of vitamin C (ascorbic acid), based on the rationale that this will have a hormone-like action that induces uterine contraction and a subsequent shedding of uterine lining. There are several hypotheses that need testing in theories like this. Other foods such as turmeric or pineapple supposedly induce periods by affecting levels of estrogen and progesterone (hormones that regulate the menstrual cycle) in the body. Unfortunately, there is little scientific evidence to support these concepts. Additionally, a few of these recommended herbal remedies, such as dong quai and parsley, can be toxic in high quantities or when children are exposed; therefore, they should be used in moderation. 

Aside from eating particular foods, there are some other suggested methods to help relieve irregular or painful periods. Exercise has been proved to help relieve menstrual pain. However, excessive exercise can delay or temporarily stop one’s menstrual cycle as can eating disorders or prolonged stress. People who seek regular periods may choose to participate in light/moderate exercise and relaxation techniques.

At the end of the day, the only reliable, scientifically proven method to fully control one’s period is hormonal birth control, which needs to be prescribed by a medical professional. 

https://www.healthline.com/health/womens-health/induce-period#natural-treatments

https://www.mountsinai.org/health-library/herb/dong-quai

https://www.sciencedirect.com/topics/medicine-and-dentistry/apiol

https://www.sciencedirect.com/topics/neuroscience/abortifacients

https://www.medicalnewstoday.com/articles/324830#inducing-a-period

https://www.sciencedirect.com/science/article/abs/pii/S2095496417603480