Marriage is a universal practice in which a bond is formed between two individuals that is social, emotional, cultural, physical, and religious in nature. This marital union lays the foundation for the most basic social institution, the ‘family’ that is designed to rear the next generation with comfort.
Several factors are considered in choosing close or distant relations to form this union.
‘Consanguinity’, the term for cousin marriage (CM) or inter-familial marriages between close relatives, is derived from the Latin words, con – “shared” and sanguis – “blood”. In such marriages, each partner shares genes of a common ancestor such as a grandparent. The practice is prevalent in South Asia and Middle East countries with rates exceeding 40% of all marriages.
It is important to discuss CM in the Pakistani context. Hafeez (2014) reported that around 82.5% Pakistani parents are blood relatives from first, second or third generations. Of these 13% are CMs and close relatives. In Pakistani culture CM is common, legal and even a respectable practice due to socio-cultural and economic reasons.
People accept CM being unaware of its associated health risks to their offspring and consequent hospitalizations, and serious psychological, social and financial hardship that may follow. A study reported that Pakistani respondents did not accept the connection between CM and poor birth outcomes. The disabilities were attributed with the destiny and “will of God”. This article will analyze the issue of CM; describe its causes, consequences, and recommendation using Leininger’s sunrise model.
The sunrise model describes the socio-cultural, economic, religious, educational and political factors that may influence a person’s health. All these factors leading to CM can be found in Pakistan and affect the health of the progeny of a CM couple. Firstly, families think that husband and wife will easily adjust due to familiar relationships; it is considered a means of promoting family ties and transmission of cultural values in the next generation. Moreover, the wife is more likely to be supported by her in-laws in times of need.
Secondly, financial issues, marriage arrangements are made easier to handle, and property is retained in the family. Thirdly, it is thought to be a protective factor against divorce. In Pakistan CM is generally observed in extended families, people of low socioeconomic status, rural background, and low levels of parental education.Additionally, marrying in kin is also considered a part of faith in some religions found in Pakistan. CM is also seen as a way of settling abroad, in developed countries. As Shaw (2014) found, Pakistani families who lived in UK used CM to help their relatives to enjoy the benefits of education, occupation and good living standards because they were committed to their kin living in Pakistan.
It is important to understand that culture and health are interrelated; cultural norms can highly influence a person’s health, behavior and decision making and ultimately determines health outcomes. Studies suggest that CM may have genetically detrimental effects. The mating of genetically related individuals contributes to the transmission of genetic material that is similar in nature and may carry disease traits. It allows less common alleles with recessive traits to become phenotypically expressed.
A study conducted by Zakar, Zakar and Aqil (2014) indicated a strong relationship between first-degree consanguinity and the risk of small size birth and neonatal death. Furthermore, congenital anomalies, and autosomal recessive disorders such as thalassemia, cystic fibrosis, atrial and ventricular septal defects, cleft lip or palate run in families due to CM.
Moreover, CM was not found to protect women from any form of abuse: sexual, physical or psychological. This violates several human rights including a right to respect, freedom of choice and expression.
RECOMMENDATIONS
Leininger (2002) suggested three transcultural care decisions and actions: cultural preservation, negotiation, and restructuring. In tackling the CM issue, negotiation and restructuring can be done at the individual, family and community level, using platforms such as health centers, religious centers, guiding units, and schools to educate people on effects of CM.
CULTURE CARE RESTRUCTURING
A health care professional should be non-judgmental and avoid imposition of his/her own values on others while providing information about CM and its risks. However, restructuring of harmful practice regarding CM in Pakistani society will be based on the scientific facts. People should be informed that the law in many countries does not allow cousin marriages. This law can be adopted in Pakistan; however it is difficult to eradicate this ancient custom completely from the society.
Therefore, premarital and preconception counseling should be arranged to help the couple decide. Premarital screening tests should be arranged for all CM couples in health facilities. If the test is positive, couple should be clearly informed of the consequences. Present policies of premarital screening like thalassemia in Pakistan should be promoted by health professionals. Certain stereotypes and stigmas are attached to premarital screening in Pakistani society.
People refrain from going through the process of premarital screening as they believe that they do not have any disease. Therefore clarifying such myths is necessary to preserve health of offspring. Since Pakistan is predominantly a Muslim country, a hadith related to CM can be used to restructure cultural norms. This hadith encourages marriage outside the kin as Hazrat Muhammad (PBUH) stated that CM causes weakness in off spring.
CULTURE CARE NEGOTIATIONIn case of already present CM, genetic screening can still be suggested to couples while planning for the next pregnancy. If the mother is pregnant, identifying CM through history is important. In the case of CM and existing pregnancy, the mother should be asked to have timely screening for fetal congenital defects through Alpha Fetoprotein blood test, ultrasound and other recommended tests. If positive for these tests, she should be given the choice of legal therapeutic abortion.
Moreover, suggesting effective family planning methods such as intrauterine devices, hormonal injection and pills can be recommended (International Planned Parenthood Federation, 2015). Adoption is another option, which is also a common cultural practice in Pakistani extended families.
Hence, to prevent the negative consequences of CM, health professionals, community workers, schools and non-governmental health agencies in Pakistan can take an active role in educating the public about the implications of CM. In addition, appropriate health policies can be developed so as to avoid poor health outcomes associated with CM.
About the author: Azaina Aijaz is a Year III BScN student at the Aga Khan University, School of Nursing and Midwifery, Pakistan. She has been a recipient of merit scholarship for two consecutive years and expecting to get scholarship for Year III. She is also a member of Sigma Theta Tau International – Honor Society of Nursing, Indianapolis, USA.
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Raisins or Kishmish are teeny tiny little packets of energy. Usually used to garnish sweet dishes and desserts; however, smart people consume them more often and they have good reasons to do so. Although they seem dry and boring, these minions of food are rich in nutrients and minerals, and benefit our body more than we can think.
Here are a few things kishmish can be used for:1. Help Cure AnemiaRaisins are rich in vitamin B-complex and iron. These are important in formation and maturation of the red blood cells. It is highly recommended for women and boys undergoing the growth spurt to make raisins a part of their diet.2. Improved EyesightRaisins are rich in polyphenolic phytonutrients. These chemicals help reduce antioxidants that tend to weaken the eye sight. Vitamin A and carotenoids are also found in raisins. They are well known to combat color-blindness. So if you or someone close to you has weak eyes, let them know that raisins can help them a great deal!3. Keep Cancer at Bay
As mentioned earlier, Polyphenolic phytonutrients are found in raisins. These antioxidants trap the free radicals and kill them; hence preventing cancer. Free radicals are what basically spur the metastasis which causes abnormal growth of cells.4. Help against ConstipationThe fiber in raisins is insoluble; it swells in the presence of water. They have a laxative effect and help against constipation.5. Strong BonesMicro nutrients are the nutrients that are required by the body in a very small amount. One such micro nutrient is Boron. Boron is important for the absorption of calcium. A lot of us take adequate milk and calcium products but they are not properly absorbed; one reason why so many people have low calcium levels. Consuming a bunch of raisins daily with a glass of milk would make it easy for the calcium to be absorbed.6. Ease Dental ProblemsStreptococcus Mutans and Porphyromonas Gingivalis are the two most common bacteria in the oral cavity. They cause dental caries (cavity) and swelling and bleeding in the gums. Raisins have anti bacterial properties that help fight against these pathogens.
Raisins also contain a certain amount of calcium that help strengthen the enamel. When eating raisins, the longer they stick to your teeth, the better, because that ensures extended contact of Oleanolic Acid with the teeth, increasing the preventative powers against bacterial growth. Along with it’s role in maintaining bone health and osteoporosis treatment, the boron present in raisins keep in check the growth of oral germs and also promote strong teeth.7. In PregnancyRaisins’ ability to help with eye sight and bones strength is also important for pregnant women. They help with the baby’s eye sight and make the bones stronger.
Dried grapes have a large amount of glucose content which give a lot of energy. Raisins also help with absorption of vitamins hence it should be taken by pregnant women regularly. Raisins strengthen the immune system that weakens during pregnancy. Add “Kishmish” to your diet and reap it’s many benefits.-
We all know the importance of drinking a minimum of eight glasses of water a day. It is emphasized everywhere, from our homes to our bottles of mineral water. Staying hydrated is one of the foremost requirements for a healthy mind and body. According to research, nearly half of us are not properly hydrated at most times.
Staying hydrated and drinking adequate water is essential for our everyday performance, mood, and the quality of our skin, hair and nails. While eight glasses of water may not seem like a difficult target, it is quite unreachable once you make a conscious effort to actually achieve it.
Let us look at different ways drinking optimum amount of water every day can be made easier.
DRINK A GLASS OF WATER FIRST THING IN THE MORNING
Set your routine as such to drink a glass of water first thing when you wake up in the morning. Yes, also before your cup of tea or coffee. This will restore your fluids lost overnight, and kick-start your early dose of hydration.
RUN A MID-DAY HYDRATION CHECK
One way to check your hydration level is by checking the color of your urine. If it is darker than lemonade, know that you are dehydrated. Among other goals, set a goal to have clear urine by 3pm. It might sound a little weird to have a goal of that sort, but it will be more beneficial – the effects of which will make themselves visible soon after. If your urine isn’t clear at this time, then make sure you drink better and work better at keeping yourself hydrated the rest of the day.
ADD NATURAL FLAVOR TO WATER
Who said water has to be boring and taste the same each time? You always have the option to make water more interesting. Your option include adding a burst of flavor with sliced fruits like lemon, orange, lime, pineapple, berries, grapes and cantaloupe.
ALWAYS KEEP A WATER BOTTLE WITH YOU
Keeping a water bottle with you at all times is a great way to keep reminding yourself to stay hydrated. It depends if a half liter or one liter bottle is more feasible for you to carry. Make sure you keep a count of the number of refills you will be needing. A liter is roughly three ounces. If you weigh 120 pounds, you might have to refill a one-liter bottle two to three times a day.
REPLACE ANY OTHER BEVERAGE WITH WATER (AS MUCH AS YOU CAN)
While sodas, coffee and other beverages can be tempting, remember to remind yourself about the healthier option… which is always water. You do not need to be hard on yourself. Bring about a change slowly and gradually so that it is permanent, rather than an alteration that is difficult to maintain and is short-lived. Cut down the number of sodas to one per day, and for the rest of the times replace it with water. That way you will be saving yourself from about 240 unnecessary calories, extra sugar and also from dehydration offered by some of these drinks.
REMINDER SET-UP
It can be easily forgotten – the task to keep hydrating yourself. In a busy schedule, one only remembers to drink water when thirsty, but by that time they are already dehydrated. An easy way to remind yourself is to set a “hydration reminder” on your phone.
END YOUR DAY WITH WATER
Before sleeping, remember to drink a glass of water. This will help you stay hydrated overnight. If you prefer a hot beverage, have lukewarm water with some lemon.
Digestive problems have been a common trouble. It’s not only bad for the stomach, having a poor digestive system influences the entire body negatively. It starts showing on your skin in the form of acne and wrinkles; and gives your face an un-fresh look. It weakens the bones and muscles; which causes difficulty in movements. Poor digestion also effects the brain and hormones; it effects your mood, concentration levels, sleep patterns and your state of mind. Along with these things, if your digestive system is not working up to the mark, you can have problems in reproductive organs; which include irregular menstruation and low sex drive among other things.
Here are some tips to improve your digestion.1. Fiber
“Fiber is your friend” they say. They are right. “A high-fiber diet helps keep food moving through your digestive tract, making you less likely to get constipated,” says Maria Adams, MS, MPH, RD, a registered dietitian in Marblehead. It also helps prevent diverticulitis, irritable bowel syndrome and other bowel related problems. Fiber makes you full faster and also prevents you from over eating. It gives your brain the signal of ‘fullness’, hence you don’t stuff yourself with unnecessary food.2. BrothGrandma always got us a bowl of warm broth or yakhni every time we fell sick. Broth is loaded with nutrients, amino acid proline and gut soothing gelatin. It soothes the digestive tract and improves absorption of nutrients. That is why it is always good to have some soup as an appetizer before a meal. Also if you add a good amount of vegetables to your soup, you are doing yourself a fovor by having broth and fiber in the same meal!3. Ginger TeaWe often take ginger tea for throat ailments, turns out it’s also great for your tummy. Ginger prevents cramping in the abdomen by relaxing the smooth muscles of your abdomen. Ginger also stimulates saliva, bile and other digestive enzymes to help quicker digestion of food and an increased rate of metabolism.
You can make ginger tea by adding a tea spoon of grated ginger in one cup of water and boil it for a while. You can also make some in bulk and sip it all day.4. Chew ProperlyThe process of digestion starts in our mouth. Mechanical digestion is extremely important for good digestion. One must take a while and chew well on food before swallowing. Don’t gobble your food. This practice should be inculcated in children from childhood.5. Apple Cider VinegarBefore a meal, having one table spoon of apple cider vinegar in a glass of room temperature water increases the acidity slightly; making digestion better. ACV is also great for cutting down fat.6. ProbioticsSounds complicated, but it’s really not. Probiotics are live bacteria and yeasts that are good for your digestive health. These bacteria are important to keep your digestive system working. Yogurt is a great source of probiotics, one of the best! This is why it is recommended to eat yogurt during stomach problems. Sour pickles are also rich in probiotics.
Whenever human body encounters a task or challenge that would take sizeable amount of strength, our body releases certain hormones that heighten our senses to increase efficiency. However, through evolution of humans into hunters and gatherers, this rapid surge in energy and elevated reflexes must be channeled towards real physical exhaustion. Otherwise, the amount of these hormones remains elevated in our bloodstream and that does all sorts of harmful things to our body. The results are catastrophic and they include, sleep deprivation, exhaustion, prone to diseases and the most common, headaches, to name a few.Obviously, this cannot be allowed to continue and we have to make sure that our body doesn’t build up high levels of cortisol (commonly known as stress hormone). But there is one thing most of us don’t know about and that is cortisol can actually result in two different reactions, based entirely on what we do, right after it is dispersed by our adrenal glands. If the outcome of this outburst is something that is related to muscle activity, then this mechanism of our body is the most beneficial to our wellbeing by managing our blood pressure, improving our immune system, converting protein into fuel to provide a surge of energy to tackle the challenge that invoked the release of the hormone.However, if we fail to turn this sudden burst of energy into work done, then the hormones dispersed into our blood stay dormant and build up gradually resulting in chronic diseases, gaining weight (especially around the belly area) and high cholesterol to name a few. Although we cannot monitor the amount of cortisol and adrenaline in our blood by ourselves, we can follow a standard set of activities to make sure that all the systems in our bodies are functioning optimally and nothing causes distress for us in the long run. For that we can indulge in these 5 very easy and healthy activities listed below.1. Increase Your Intake of Vitamin CResearch shows that nothing beats high level of cortisol as effectively as Vitamin C. The Vitamin can be considered an essential part of stress management. For students cramming for exams or any stressful academic feat, a diet constituted of citrus fruits would increase their attention as well as the quality of their work. Along with this, Vitamin C also prevents loss of weight that particularly effect students or people who usually work till late hours.2. Reduce CaffeineYes, your beloved cocoa drink isn’t actually helping you cope with stress. Infact, even a single cup of coffee can raise your cortisol level dramatically. What actually happens for people who drink caffeinated drinks daily, your brain picks up the cues for incoming caffeine and dulls your senses such as making you feel tired and less concentrated to compensate for the incoming boost. This mix up of hormones inside our body is very dangerous for us in the long term, thus, it is highly recommended that you slowly start cutting down on your coffee intake.3. Work Out
For a few poor souls (like me), even thinking about being overweight triggers stress which usually ends up with us being depressed about our weight and appearance. Fear not, because the built up amount of stress hormone in our bodies can be tackled even by varying our breath pattern as in some yoga routines. Exercise is a powerful tool against nasty stress hormones that cause us to gain weight and distort our diets in the first place.
4. Sleep on TimeFor all the tough cookies who feel as if they can easily manage those all-nighters, deprivation of sleep is one of the root causes of high cortisol. It doesn’t matter how we feel when the horizon starts to light up, being awake through the entire night automatically triggers our brain for something very strenuous (attempting to finish the TV season within a week still counts as the bad kind of stress!). After the excessive release of hormones in our bloodstream, the lack of physical activity for as much as 6-7 continuous hours; well by now you can imagine what it would lead to. Our bodies crave for food because naturally the brain assumes that we have done so much work to compensate for the huge amounts of cortisol released which end up causing all sorts of adverse effects on our body.
5. Think Clearly and Positively
Perhaps one of the complex (yet extremely effective) way of coping with stress is to revamp our thought process about certain things that can potentially lead to high stress. For example, when we think about the assignment due next week, we usually care less about it. Continued procrastination causes our brain to kick up the priorities of important tasks which ends up in a muddled mess of priorities when compulsory actions pile up on each other, which further reduces our efficiency and concentration.
We might not admit it but having yellow or pale teeth is one of the nightmares anyone could go through. It’s natural to feel weird and maintain distance with anyone who has yellow or discolored teeth. One of the major reasons why some of us cover our teeth in front of the camera is because we are scared of our discolored teeth being captured in a still. We’ll be made fun of and it will be a topic buzzed about.
Our teeth are the first thing anyone notices about us. You can’t talk to anyone without opening your mouth and revealing your teeth to them. White teeth are a sign of good health and proper hygiene. You may have heard that first impression is the last impression. If you want to have a positive impression that lasts for a while then it’s important to don’t show up teeth which seem like they haven’t been brushed for a while.
Now that we have established that no one wants to have yellow or discolored teeth, it is time to give away five ways to whiten your teeth with natural ingredients. These remedies have been tried and tested over the year and are bound to surprise you with sparkling results. Celebrities nowadays spend heaps of money over dental care and whitening their teeth. You on the other hand can make use of these five ways and save yourself from spending all that cash on a trip to the dentist!
Check out how!
Save Up An Appetite For Strawberries
Yes, strawberries are natural whiteners. Strawberries contain malic acid and Vitamin C, both proved as elements that can bleach away stains and bring back your sparkling smile. All you have to do is eat one whole bowl of strawberries but make sure that you properly chew them so that the strawberries are in complete contact with your teeth. Another way is to mash strawberries into a mixture that can be brushed twice or thrice a week. However chewing them is known to have given a larger chunk of positive results.
The Super Effective Duo Of Baking Soda And Lemon
Although both of these ingredients are known to have positive results on their own but together they can give a mind blowing effect. The end product of using these two ingredients together is a dazzling smile that is bound to skip a few heartbeats. Just use a teaspoon of baking soda and squeeze half a lemon in it. Mix it well till the mixture forms bubbles and then brush it onto your teeth. The only downside of this mixture is that if you leave it for more than a minute then it is acidic enough to erode your teeth’s enamel.
Ever Heard Of Oil Pulling?
This is an ancient Ayurvedic treatment and is basically used for oral health. Although oil pulling itself can whiten your teeth, it is said that using coconut oil can actually speed up the process. Oil pulling has no side effects and you can very easily make a habit out of it. Every morning take a spoonful of coconut oil in your mouth and keep swishing it between your teeth for around 5 to 10 minutes. However, do not swallow it and make sure you rinse your mouth properly with clean water after spitting it out.
Apple Cider Vinegar
Another way to whiten your teeth as if you’ve just gotten some expensive professional treatment done. ACV is known to be a natural whitener and stain remover. Consistency is the key in this remedy. You might not notice anything for a while as the results are not instant but they sure are long lasting.
Simply Brush Your Teeth
This is the most simple and natural way ever. Save your teeth from turning yellow by making a habit of brushing them after you eat or drink every time. Keeping up with your oral hygiene can not only avoid discoloration but also reduce it. Make sure you keep switching your old toothbrush for a new one and limit your daily intake of coffee and tea.
There are so many “when life gives you lemons” quotes and all are valid (Even though we humans are already throwing, squeezing, slicing, peeling and pretty much doing everything to the bright citrus filled fruit). So ladies and gentlemen grab your lemons because it’s time that you are going to find that after making that delicious and much needed lemonade in hot seasons, the amazing sauces for pretty much everything edible, these marvelous yellow spheres still have some use left in them (excellent resilience from something easily produced even in home soil).1. Cleaning Dishes and Tough StainsLemons (both peel and citrus) contain an impressive ability to remove stains, even the ones that are so tough that they make us cringe. Ladies, you can easily clean your dishes, coffee pots, even clothes that have got those nasty tea stains. You can combine the lemon rinds with your everyday detergents to gain that extra strength for those extra resilient stains.2. Deodorize
Lemon peels are strong deodorant agent which can help you rid away of any trapped odor in cutting boards, ovens (along with removing the stains inside oven) and your hands! Rub lemon peels over the surface to remove any lingering odor like the smell of onion or garlic. The magic yellow peels will make your hands and surfaces smelling fresh again.3. Whiten TeethYes folks your organic yellow helps you beat the highly unwanted yellow shade your teeth may acquire! As it turns out, citrus helps retain the strength of our teeth and since lemon peel is such an amazing stain remover, your teeth will instantaneously becoming whiter. Note: Avoid using this remedy frequently because high amount of citrus might damage your enamel and gums.4. FacialsThe inside of lemon peel, when rubbed onto facial skin and allowed to dry over a period of 10-20 minutes, lightens age spots and skin tone altogether and sunburns. You can repeat this remedy everyday till desired results are visible.5. Lemon Zest
Grate lemons for lemon zest which is an amazing ingredient in bringing that zesty flavor in your dishes and sauces. Lemon zest can also be frozen and easily reused. Lemon zest can also be used in smoothies, shakes and tea.6. FragranceNot only will lemon peel allow you to remove all the nasty odor in your utensils and dishes, they can also be used as air fresheners by simply burning the fresh or dried peels along with some wood to produce a characteristically delicious lemon scent all over the place.7. Deter Cats
The citrus found in lemon is an amazing cat repellent (unless you have a cat as pet). For anyone who wishes to ban cats from littering in garden areas or wandering around inside the house tearing apart the flower pots, you can put lemon peels in the soil to repel any unwanted feline visitors.8. Homemade Vitamin C powderHeat dried lemon peels on a piece of paper to 200⁰ C to destroy any live enzymes that may be present and grind the peels to produce your very own homemade Vitamin C powder. You can use this powder to produce variety of facial masks and essence for dishes.9. Removing Rust
The nasty rust marks left in your shower by any metallic can, that rusted due to prolonged exposure to moisture can be removed by first spreading salt all over the rust marks and then rubbing them with a half cut lemon (which still has pulp inside) and rinsing that area thoroughly.10. Ant DeterrentPlacing lemon rinds over by ant burrows and window sills allows your home to be insect free until a more permanent solution is sought.11. Reduce CholesterolAdding lemon zest to your drinks allows you to lower your cholesterol levels and at the same time help you lose weight. A healthy diet maintained with regularly drinking ginger tea with lemon zest added or boiled along with lemon peels, can kick start your fitness train.12. Furniture PolishYou can soften your elbow skin which may have become dry and damaged during the winter by using a half cut lemon with baking soda sprinkled over it; now push your elbow into the lemon as if juicing it for several minutes. After that you can rinse and dry for instantaneous results.
