Tag Archives: Blood pressure

Catla Fish


Botanical Name: Catla catla
Family: Cyprinidae
Genus: Catla
Valenciennes, 1844
Species: C. catla
Kingdom: Animalia
Phylum: Chordata
Class: Actinopterygii
Order: Cypriniformes

Synonyms:
*Gibelion catla
*Cyprinus catla

Common Names: Catla, Bahu, Bhokua, or Baudhekera.

Description:
Catla fish known as the major (Indian) carp, is an economically important South Asian freshwater fish in the carp family Cyprinidae. It is commonly found in rivers and lakes in northern India, Nepal, Myanmar, Bangladesh, and Pakistan. In Assam.

Catla is a fish with large and broad head, a large protruding lower jaw, and upturned mouth. It has large, greyish scales on its dorsal side and whitish on its belly.

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Catla is a surface and midwater feeder. Adults feed on zooplankton, but young ones on both zooplankton and phytoplankton. Catla attains sexual maturity at an average age of two years and an average weight of 2 kg.
Aquaculture:
It is one of the most important aquacultured freshwater species in South Asia. It is grown in polyculture ponds with other carp-like fishes, particularly with the roho labeo and mrigal carp. The reported production numbers have increased sharply during the 2000s, and were in 2012 about 2.8 million tonnes per year.

Catla is sold and consumed fresh, locally and regionally. It is transported on ice. Fish of 1–2 kg weight are preferred by the consumers.

Food value & Health benefits :

Research has shown that eating fish and shellfish regularly is beneficial to our bodies in many ways; here are ten great reasons to introduce a little more seafood into your diet.

1. Great for your heart:

It’s no coincidence that fish-eating Inuit populations in the Arctic have low levels of heart disease; seafood is low in saturated fat and high in omega-3, (which can both) protect the heart from disease and lower the amount of cholesterol in the blood. One study has even suggested that an extra portion of fish every week can cut risk of heart disease in half.

2. Clearing the vessels

Eating fish can improve your circulation and reduce the risk of thrombosis. The EPA and DHA – omega-3 oils – in seafood can save your body from having to produce eicosanoids, a hormone-like substance which can make you more likely to suffer from blood clots and inflammation.

3. Joint benefits:

Eating fish as a regular part of a balanced diet has been shown to ease the symptoms of rheumatoid arthritis, a condition which causes the joins to swell up. Recent research has also found a link between omega-3 fats and osteoarthritis, suggesting that eating more seafood could help to prevent the disease.
4. The eyes have it:

Eating oil-rich fish regularly can help to keep the eyes bright and healthy. A recent study has suggested that omega-3 fatty acids can help to protect the eyesight of those suffering from age-related macular degeneration (AMD), a condition which causes the retina to degenerate and the eyesight to become blurred. Fish and shellfish also contain retinol, a form of vitamin A which boosts night vision.

5. Essential nutrients:

Seafood provides the body with many essential nutrients which keep us running smoothly, including iodine, selenium, zinc and potassium. Iodine is important for the thyroid gland, and selenium makes enzymes which can help to protect us from cancer. Fish and shellfish are also excellent sources of many vitamins, including vitamins A and D.

6. Take a deep breath:

A number of studies have indicated that fish and shellfish may help to protect our lungs. Not only can seafood relieve the symptoms of asthma in children, but it has shown signs of preventing it. Eating a lot of fish can also keep your lungs stronger and healthier as you age in comparison to those who don’t eat a lot of fish.

7. Brighten your outlook:

Seafood may also play a large part in preventing depression; research has highlighted links between low omega-3 levels and a higher risk of depression. Seafood could also help us to avoid Seasonal Affective Disorder (SAD) and post-natal depression.

8. Your skin looks great:

Not only does omega-3 help to protect the skin from the harmful effects of the UV damage, but eating lots of fish can also help with the symptoms of skin conditions such as eczema and psoriasis. Fish is also a great source of protein, which is an essential ingredient of collagen, a substance which keeps the skin firm and flexible.

9. Good for down below:

Evidence suggests that a diet rich in fish oils can help to protect us against serious inflammatory bowel diseases (BD) including Crohn’s disease and ulcerative colitis. There is also evidence to suggest that omega-3 could help to slow the progression of inflammatory bowel disease in some sufferers.

10. Boost your brainpower:

The human brain is almost 60% fat, with much of this being omega-3 fat. Probably for this reason, research has indicated that people who eat plenty of seafood are less likely to suffer dementia and memory problems in later life. DHA, an omega-3 fat found in seafood, has also been linked to improvements in children’s concentration, reading skills, behaviour, and Attention Deficit Hyperactivity Disorder (ADHD).

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Catla
http://sunsamayal.com/samayal/index.php/en/??????/health-benefits-and-minerals/2069-catla-fish-health-benefits-and-nutrition-facts.html

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Tilapia


Description:
Tilapia is the common name for nearly a hundred species of cichlid fish from the tilapiine cichlid tribe. Tilapia are mainly freshwater fish inhabiting shallow streams, ponds, rivers and lakes and less commonly found living in brackish water. Historically, they have been of major importance in artisan fishing in Africa and the Middle East, and they are of increasing importance in aquaculture and aquaponics. Tilapia can become problematic invasive species in new warm-water habitats such as Australia, whether deliberately or accidentally introduced, but generally not in temperate climates due to their inability to survive in cold water.

Tilapia is the fourth most consumed fish in the United States dating back to 2002. The popularity of tilapia came about due to its cheap price, easy preparation, and its mild taste.
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Tilapia typically have laterally compressed, deep bodies. Like other cichlids, their lower pharyngeal bones are fused into a single tooth-bearing structure. A complex set of muscles allows the upper and lower pharyngeal bones to be used as a second set of jaws for processing food (cf. morays), allowing a division of labor between the “true jaws” (mandibles) and the “pharyngeal jaws”. This means they are efficient feeders that can capture and process a wide variety of food items. Their mouths are protrusible, usually bordered with wide and often swollen lips. The jaws have conical teeth. Typically tilapia have a long dorsal fin, and a lateral line which often breaks towards the end of the dorsal fin, and starts again two or three rows of scales below. Some Nile tilapia can grow as long as two feet.

Other than their temperature sensitivity, tilapia exist in or can adapt to a very wide range of conditions. One extreme example is the Salton Sea, where tilapia introduced when the water was brackish now live in saltwater so salty that it kills marine fish.

Tilapias are also known to be a mouth breeding species. Mouth breeding means they carry the fertilized eggs and young fish in their mouths for several days after the yolk sac is absorbed.

Species:
Tilapia as a common name has been applied to various cichlids from three distinct genera: Oreochromis, Sarotherodon and Tilapia. The members of the other two genera used to belong to the genus Tilapia but have since been split off into their own genera. However, particular species within are still commonly called “tilapia” regardless of the change in their actual taxonomic nomenclature.

The delimitation of these genera among each other and to other tilapiines requires more research; mtDNA sequences are confounded because at least among the species of any one genus, there is frequent hybridization. The species remaining in Tilapia in particular still seem to be a paraphyletic assemblage.

As Food:
Whole tilapia fish can be processed into skinless, boneless (Pin-Bone Out, or PBO) fillets: the yield is from 30 percent to 37 percent, depending on fillet size and final trim.

Tilapia is one of several commercially important aquaculture species (including trout, barramundi and channel catfish) susceptible to off-flavors. These ‘muddy’ or ‘musty’ flavors are normally caused by geosmin and 2-methylisoborneol, organic products of ubiquitous cyanobacteria that are often present or bloom sporadically in water bodies and soil. These flavours are no indication of freshness or safety of the fish, but they make the product unattractive to consumers. Simple quality control procedures are known to be effective in ensuring the quality of fish entering the market.

In a freshwater soilless pond system the fish will not have these flavors. Fish raised in man-made lakes tend to absorb the flavor of the ground. A concrete pond with plants to clean the water is a much better system. It is also important that the fish only get fed as much food as they can eat. If the food is left over in the tank it will break down in the water leaving a bad odor that leads to an unwanted taste in the fish.[citation needed]

Tilapia have very low levels of mercury, as they are fast-growing, lean and short-lived, with a primarily vegetarian diet, so do not accumulate mercury found in prey. Tilapia are low in saturated fat, calories, carbohydrates and sodium, and are a good protein source. They also contain the micronutrients phosphorus, niacin, selenium, vitamin B12 and potassium.

Multiple studies have evaluated the effects of adding flaxseed derivatives (a vegetable source of omega-3 fatty acids) to the feed of farmed tilapia. These studies have found both the more common omega-3 fatty acid found in the flax, ALA and the two types almost unique to animal sources (DHA and EPA), increased in the fish fed this diet. Guided by these findings, tilapia farming techniques could be adjusted to address the nutritional criticisms directed at the fish while retaining its advantage as an omnivore capable of feeding on economically and environmentally inexpensive vegetable protein. Adequate diets for salmon and other carnivorous fish can alternatively be formulated from protein sources such as soybean, although soy-based diets may also change in the balance between omega-6 and omega-3 fatty acids.

Nutritional Value Of Tilapia:-
Tilapia is highly valued as a seafood source due to its many beneficial qualities, which are attributed to its wealth of nutrients, vitamins, and minerals, including significant amounts of protein, omega-3 fatty acids, selenium, phosphorous, potassium, vitamin B12, niacin, vitamin B6, and pantothenic acid. Below you will find a more details explanation of the health benefits of tilapia.
Health Benefits Of Tilapia:
One of the most notable health benefits of tilapia is its low calorie count, which is ideal for anyone looking to shed a few pounds. With just 145 calories per serving, you can pair tilapia with a wide range of vegetables for a truly low-calorie and fat burning meal.

Tilapia is also a great source of omega-3 fatty acids, which can help you maintain a healthy blood pressure and keep heart disease at bay. This is important because many of us with too much fat on our bodies are highly susceptible to these illnesses.

In addition to being loaded with protein, tilapia has plenty of potassium to help prevent post-workout muscle cramps. Other nutrients tilapia contains in abundance includes vitamin B12, which helps keep you mentally alert; niacin, which is necessary to keep your body functioning at an optimal level, and selenium a nutrient known to decrease your risk against cancer and heart disease.

So in addition to being quite low in calories, the health benefits of tilapia include fat burning, improved heart health and good cholesterol (HDL), and a decreased risk of weight-related illnesses.
Growth and Development: One of the most important aspects of tilapia is its impressive protein content, making up more than 15% of our daily requirement in a single serving. Protein is an essential part of our diet, particularly animal proteins, because they can be enzymatically broken down into composite amino acids and reassembled into usable proteins in the human body. Protein is directly linked to proper growth and development of organs, membranes, cells, and muscles. It is particularly important that children consume adequate amounts of protein to ensure that they develop properly. They also are necessary for muscle growth, cellular repair, and proper metabolic activity of numerous organ systems.

Weight Loss: Unlike many other animal products, fish like tilapia are high in protein but low in calories and fats. This can be a good way to reduce your caloric intake, while still giving your body all of the necessary nutrients it needs to function properly. Fish is often turned to as a dietary option for people trying to lose weight, without starving themselves with crash diets.

Bone Health: One of the most prominent minerals found in tilapia is phosphorous, which is an essential mineral for human health, as it is a vital part of the development and growth of bone matter. It is also a necessary element in the maintenance of the teeth and nails, keeping them strong and durable well into your old age. Phosphorous can help prevent osteoporosis, which is the degradation of bone mineral density often suffered by people as they age.

Prevents Prostate Cancer: Like many types of fish, tilapia has a very high content of selenium. The health benefits of selenium are impressive, and are antioxidant in nature. Studies have directly linked selenium intake to a reduction in the risk of prostate cancer, as well as various heart conditions. Additional research is being done on the impact of tilapia’s selenium on other types of cancer. Antioxidants like selenium are famed for their ability to reduce free radical activity in the body, thereby lowering the chances of oxidative stress on all the organ systems, and the mutation of healthy cells into cancerous ones.

Heart Health: Tilapia is a rich source of omega-3 fatty acids, which have been directly linked to lowering cholesterol levels and triglyceride levels in the human cardiovascular system. Omega-3 fatty acids neutralize the impact of omega-6 fatty acids. There is some controversy about fish in general having high levels of dangerous LDL cholesterol, but studies have shown that the beneficial effects of the omega-3 fatty acids outweigh the risks of omega-6 fatty acids also found in tilapia. Omega-3 fatty acids help to prevent atherosclerosis, heart attacks, and strokes. The potassium found in tilapia is also a vasodilator, and reduces blood pressure, which is an additional boost to heart health.
Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.
Resources:
https://en.wikipedia.org/wiki/Tilapia

Tilapia Nutrition Facts and Unique Health Benefits

8 Amazing Benefits of Tilapia

Normal Blood pressure: How low should a person can go?

A new study suggests greater health benefits with a lower-than-standard number.

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Blood pressure has long been one of the best markers of your health. It is a number you can remember and monitor. High blood pressure (hypertension) is linked to a greater risk of heart attacks and strokes.

About one out of three adults has high blood pressure, which is usually defined as a reading of 140/90 millimeters of mercury (mm Hg) or higher.

The first, or upper, number (systolic pressure) represents the pressure inside the arteries when the heart beats, and the second, or lower, number (diastolic pressure) is the pressure between beats when the heart rests.

Blood pressure rises with age because of increasing stiffness of large arteries, long-term buildup of plaque, and the effects of other diseases involving the heart and blood vessels. Typically, more attention is given to the diastolic reading as a major risk factor for cardiovascular disease.

“In fact, for a long time, some physicians felt that a systolic (upper) number higher than 140 could be tolerated in older people,” says Dr. Paul Huang, a cardiologist with Harvard-affiliated Massachusetts General Hospital. “But both upper and lower numbers are equally important.”

A new number to aim for

While 140/90 continues to be the blood pressure cutoff, a study published in the Nov. 26, 2015 issue of The New England Journal of Medicine shows that lowering pressure to around 120/80 may reap greater benefits.

Researchers examined the initial results from the Systolic Blood Pressure Intervention Trial, or SPRINT, which studied 9,361 adults over age 50 who either had hypertension or were at a high risk for cardiovascular disease.

The subjects were divided into two groups. The first received an intensive treatment to lower blood pressure to less than 120/80. The other group followed a standard treatment to lower it to less than 140/90.

After three years, the researchers found that the group with the target of below 120/80 had a 25% lower risk of heart attack, stroke, or cardiovascular death compared with those with the standard target of less than 140/90. They also had 27% fewer deaths from any cause. (The study was stopped early because the outcome in the intensive treatment group was so much better than in the standard treatment group.)
Ups and downs of lower numbers

This study supports observational studies that have found that lower blood pressure reduces cardiovascular risk.

But what does it take to get to the lower numbers? “On average, the people in the intensive treatment group took three blood pressure medications, while those in the standard treatment group only took two,” says Dr. Huang.

Moreover, the study found that the benefits in reducing heart attacks, strokes, and death were found equally in those older or younger than age 75. “So we can no longer say that a higher blood pressure is okay just because someone’s older,” he says.

But should older men focus on going lower? Is lower than 140/90 good enough, or should you be more aggressive and get that number down as close as possible to 120/80?

“If you currently are on blood pressure medicine, and your pressure is lower than 140/90, you should discuss with your doctor whether you should aim to go even lower,” says Dr. Huang. “There may be additional benefits to further reducing your stroke and heart attack risk.”

Still, there may be some downsides to going lower. For instance, many people may not want to take any additional medication. They may be concerned about battling common side effects, such as extra urination, erection problems, weakness, dizziness, insomnia, constipation, and fatigue. They also may have enough trouble monitoring their current medication without adding more to the mix.

Another potential problem: pressure that drops too low. “This could lead to dizziness and lightheadedness, especially when suddenly rising from a seated position, and increase your risk of falls,” says Dr. Huang.

Also, because the study was stopped early, other possible downsides of the extra medications, such as effects on cognitive function or kidney function, remain unknown.

Monitor your blood pressure:

If anything, this study reinforces the need for men to be more diligent about maintaining a healthy level, says Dr. Huang. He suggests older men follow these basic guidelines:

*Check your pressure every month and alert your doctor to changes. “If the upper number is repeatedly higher than 140, or the lower number higher than 90, let your doctor know,” he says.

*Continue to take your medications as prescribed. “If you suffer from any side effects, talk with your doctor about changing the dosage or drug.”

*Reduce your salt intake. “You do not have to go sodium-free, but be more aware of how much sodium is in the foods you eat,” he says. In general, try to keep your sodium intake below 2,000 milligrams a day. Foods that include the words “smoked,” “processed,” “instant,” or “cured” in the name or on the label are often quite high in sodium.

*Continue to exercise or adopt some kind of workout routine. “Activity and weight loss can help lower and maintain a healthy blood pressure,” says Dr. Huang.

From : Harvard Health Publications
Harvard Medical School

Gossypium herbaceum

Botanical Name : Gossypium herbaceum
Family: Malvaceae
Genus: Gossypium
Species: G. herbaceum
Kingdom: Plantae
Order: Malvales

Common Name:  Levant cotton
Habitat: Gossypium herbaceum is native to Asia Minor, and cultivated in U.S.A. and Egypt, India, Mediterranean.

Description:
Gossypium herbaceum is a biennial or triennial plant with branching stems 2 to 6 feet high, palmate hairy leaves, lobes lanceolate and acute flowers with yellow petals, and a purple spot in centre, leaves of involucre serrate, capsule when ripe splits open and shows a loose white tuft surrounding the seeds and adhering firmly to outer coating; it requires warm weather to ripen its seeds, which they do not do north of Virginia.
Their flowers are small and yellow with a purple center. When ripe and in warm weather, the flower capsule will burst and expose the cotton surrounding the seeds firmly. The cotton produced by this plant is short, about 2 inches (5.1 cm) long and is firmly attached to the seed, which is covered in hairy down. An acre of cotton can be expected to produce about 300 pounds (140 kg)……..CLICK & SEE THE PICTURES

The flowering time ends in September, and a month or so earlier the tops are cut off in order to ripen and send the sap back to the capsules. The pods are about the size of a walnut, and are collected by hand as they ripen;the cotton is also separated by hand and packed in bales. In the Levant the seeds are often used as food. An acre may be expected to produce 240 to 300 lb. of cotton.

The herbaceous part of the plant contains much mucilage and has been utilized as a demulcent. Cotton seeds have been used in the Southern States for intermittent fever with great success. The root and stem-bark deteriorates with age, so only newly harvested material should be used. The root-bark of commerce consists of thin flexible bands of quilled pieces covered with a browny yellow periderm, odour not strong, taste slightly acid.

Part Used in medicines: Bark of root and of other cultivated species.
Constituents: A peculiar acid resin, odourless and insoluble in water, absorbing oxygen when exposed, then changes to a red colour. The bark also contains sugar, gum, tannin, fixed oil, chlorophyll.

Medicinal Uses:
Orally administered ethyl ether and ethanol extracts of Gossypium herbaceum significantly decreased the blood glucose level. Gossypium herbaceum is not only lowered TC, TG, LDL, VLDL levels but also increased level of cardioprotective lipid HDL Therefore, Gossypium herbaceum has potential role to prevent formation of atherosclerosis and coronary heart disease. The study demonstrated that both above given extracts of Gossypium herbaceum could be useful in management of diabetes associated with abnormalities in lipid profiles.

Mainly used as an abortifacient in place of ergot, being not so powerful but safer; it was used largely in this way by the slaves in the south. It not only increases the contractions of the uterus in labour, but also is useful in the treatment of metrorrhagia, specially when dependent on fibroids; useful also as an ecbolic; of value in sexual lassitude. A preparation of cotton seed increases milk of nursing mothers.

Click to see  :  Homeopathic remedies    
Other Uses:
Cotton is usually used as a textile while making clothing and can be made into yarns and sheets of fabric. In the Levant seeds are often used for food. It is utilized so often because of its comfortable, breathable properties. It has been cultivated for women’s menstrual cycle pains and irregular bleeding, and it also has been used after birth to expel placenta afterbirth and to increase lactation. Cotton has been used for gastrointestinal issues also, such as hemorrhages, nausea, and diarrhea, as well as fevers and headaches, especially in the southern United States. Levant cotton seed extract, gossypol, also has a potential use as a male contraceptive but can cause infertility after discontinuing. In lab rat studies, it has been able to stop pregnancies early.
The crushed seeds give a fixed, semi-drying oil used in making soap, etc.
Click & see : Gossypium Herbaceum (Cotton) Seed Oil 

Resources:
https://en.wikipedia.org/wiki/Gossypium_herbaceum
http://www.botanical.com/botanical/mgmh/c/cotto109.html

Complications In Pregnancy

 

Pre-eclampsia, eclampsia or toxemia of pregnancy
Definition:
Pre-eclampsia or preeclampsia (PE) is a disorder of pregnancy characterized by high blood pressure and a large amount of protein in the urine. The disorder usually occurs in the third trimester of pregnancy and gets worse over time. In severe disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. PE increases the risk of poor outcomes for both the mother and the baby. If left untreated, it may result in seizures at which point it is known as eclampsia.

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Toxemia of pregnancy is a severe condition that sometimes occurs in the latter weeks of pregnancy. It is characterized by high blood pressure; swelling of the hands, feet, and face; and an excessive amount of protein in the urine. If the condition is allowed to worsen, the mother may experience convulsions and coma, and the baby may be stillborn.
The term toxemia is actually a misnomer from the days when it was thought that the condition was caused by toxic (poisonous) substances in the blood. The illness is more accurately called preeclampsia before the convulsive stage and eclampsia afterward.

Preeclampsia affects between 2–8% of pregnancies worldwide. Hypertensive disorders of pregnancy are one of the most common causes of death due to pregnancy. They resulted in 29,000 deaths in 2013 – down from 37,000 deaths in 1990. Preeclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse outcomes. Women who have had PE are at increased risk of heart disease later in life. The word eclampsia is from the Greek term for lightning. The first known description of the condition was by Hippocrates in the 5th century BCE

Symptoms:
Swelling (especially in the hands and face) was originally considered an important sign for a diagnosis of preeclampsia. However, because swelling is a common occurrence in pregnancy, its utility as a distinguishing factor in preeclampsia is not great. Pitting edema (unusual swelling, particularly of the hands, feet, or face, notable by leaving an indentation when pressed on) can be significant, and should be reported to a health care provider.

In general, none of the signs of preeclampsia are specific, and even convulsions in pregnancy are more likely to have causes other than eclampsia in modern practice. Further, a symptom such as epigastric pain may be misinterpreted as heartburn. Diagnosis, therefore, depends on finding a coincidence of several preeclamptic features, the final proof being their regression after delivery.

The symptoms of toxemia of pregnancy (which may lead to death if not treated) are divided into three stages, each progressively more serious:
Mild preeclampsia symptoms include edema (puffiness under the skin due to fluid accumulation in the body tissues, often noted around the ankles), mild elevation of blood pressure, and the presence of small amounts of protein in the urine.

Severe preeclampsia symptoms include extreme edema, extreme elevation of blood pressure, the presence of large amounts of protein in the urine, headache, dizziness, double vision, nausea, vomiting, and severe pain in the right upper portion of the abdomen.
Eclampsia symptoms include convulsions and coma.

Risk Factors:
Known risk factors for preeclampsia include:

*Nulliparity (never given birth)
*Older age, and diabetes mellitus
*Kidney disease
*Chronic hypertension
*Prior history of preeclampsia
*Family history of preeclampsia
*Advanced maternal age (>35 years)
*Obesity
*Antiphospholipid antibody syndrome
*Multiple gestation
*Having donated a kidney.
*Having sub-clinical hypothyroidism or thyroid antibodies

It is also more frequent in a women’s first pregnancy and if she is carrying twins. The underlying mechanism involves abnormal formation of blood vessels in the placenta amongst other factors. Most cases are diagnosed before delivery. Rarely, preeclampsia may begin in the period after delivery. While historically both high blood pressure and protein in the urine were required to make the diagnosis, some definitions also include those with hypertension and any associated organ dysfunction. Blood pressure is defined as high when it is greater than 140 mmHg systolic or 90 mmHg diastolic at two separate times, more than four hours apart in a women after twenty weeks of pregnancy. PE is routinely screened for during prenatal care.
Causes:
There is no definitive known cause of preeclampsia, though it is likely related to a number of factors. Some of these factors include:

*Abnormal placentation (formation and development of the placenta)
*Immunologic factors
*Prior or existing maternal pathology – preeclampsia is seen more at a higher incidence in individuals with preexisting hypertension, obesity, antiphospholipid antibody syndrome, and those with history of preeclampsia
*Dietary factors, e.g. calcium supplementation in areas where dietary calcium intake is low has been shown to reduce the risk of preeclampsia.
*Environmental factors, e.g. air pollution
*Those with long term high blood pressure have a risk 7 to 8 times higher than those without.

Physiologically, research has linked preeclampsia to the following physiologic changes: alterations in the interaction between the maternal immune response and the placenta, placental injury, endothelial cell injury, altered vascular reactivity, oxidative stress, imbalance among vasoactive substances, decreased intravascular volume, and disseminated intravascular coagulation.

While the exact cause of preeclampsia remains unclear, there is strong evidence that a major cause predisposing a susceptible woman to preeclampsia is an abnormally implanted placenta. This abnormally implanted placenta is thought to result in poor uterine and placental perfusion, yielding a state of hypoxia and increased oxidative stress and the release of anti-angiogenic proteins into the maternal plasma along with inflammatory mediators. A major consequence of this sequence of events is generalized endothelial dysfunction. The abnormal implantation is thought to stem from the maternal immune system’s response to the placenta and refers to evidence suggesting a lack of established immunological tolerance in pregnancy. Endothelial dysfunction results in hypertension and many of the other symptoms and complications associated with preclampsia.

One theory proposes that certain dietary deficiencies may be the cause of some cases. Also, there is the possibility that some forms of preeclampsia and eclampsia are the result of deficiency of blood flow in the uterus.

Diagnosis:
Pre-eclampsia is diagnosed when a pregnant woman develops:

*Blood pressure >_ 140 mm Hg systolic or  >_  90 mm Hg diastolic on two separate readings taken at least four to six hours apart after 20 weeks gestation in an individual with previously normal blood pressure.
*In a woman with essential hypertension beginning before 20 weeks gestational age, the diagnostic criteria are: an increase in systolic blood pressure (SBP) of   >_ 30mmHg or an increase in diastolic blood pressure (DBP) of   >_15mmHg.
*Proteinuria  >_ 0.3 grams (300 mg) or more of protein in a 24-hour urine sample or a SPOT urinary protein to creatinine ratio  >_ 0.3 or a urine dipstick reading of 1+ or greater (dipstick reading should only be used if other quantitative methods are not available)

Suspicion for preeclampsia should be maintained in any pregnancy complicated by elevated blood pressure, even in the absence of proteinuria. Ten percent of individuals with other signs and symptoms of preeclampsia and 20% of individuals diagnosed with eclampsia show no evidence of proteinuria. In the absence of proteinuria, the presence of new-onset hypertension (elevated blood pressure) and the new onset of one or more of the following is suggestive of the diagnosis of preeclampsia:

*Evidence of kidney dysfunction (oliguria, elevated creatinine levels)
*Impaired liver function (impaired liver function tests)
*Thrombocytopenia (platelet count <100,000/microliter)
*Pulmonary edema
*Ankle edema pitting type
*Cerebral or visual disturbances
*Preeclampsia is a progressive disorder and these signs of organ dysfunction are indicative of severe preeclampsia. A systolic blood pressure ?160 or diastolic blood pressure ?110 and/or proteinuria >5g in a 24-hour period is also indicative of severe preeclampsia. Clinically, individuals with severe preeclampsia may also present epigastric/right upper quadrant abdominal pain, headaches, and vomiting. Severe preeclampsia is a significant risk factor for intrauterine fetal death.

Of note, a rise in baseline blood pressure (BP) of 30 mmHg systolic or 15 mmHg diastolic, while not meeting the absolute criteria of 140/90, is still considered important to note, but is not considered diagnostic.

Predictive tests:
There have been many assessments of tests aimed at predicting preeclampsia, though no single biomarker is likely to be sufficiently predictive of the disorder. Predictive tests that have been assessed include those related to placental perfusion, vascular resistance, kidney dysfunction, endothelial dysfunction, and oxidative stress. Examples of notable tests include:

*Doppler ultrasonography of the uterine arteries to investigate for signs of inadequate placental perfusion. This test has a high negative predictive value among those individuals with a history of prior preeclampsia.
*Elevations in serum uric acid (hyperuricemia) is used by some to “define” preeclampsia,[14] though it has been found to be a poor predictor of the disorder. Elevated levels in the blood (hyperuricemia) are likely due to reduced uric acid clearance secondary to impaired kidney function.
*Angiogenic proteins such as vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) and anti-angiogenic proteins such as soluble fms-like tyrosine kinase-1 (sFlt-1) have shown promise for potential clinical use in diagnosing preeclampsia, though evidence is sufficient to recommend a clinical use for these markers.
*Recent studies have shown that looking for podocytes, specialized cells of the kidney, in the urine has the potential to aid in the prediction of preeclampsia. Studies have demonstrated that finding podocytes in the urine may serve as an early marker of and diagnostic test for preeclampsia. Research is ongoing.

Differential diagnosis:
Pre-eclampsia can mimic and be confused with many other diseases, including chronic hypertension, chronic renal disease, primary seizure disorders, gallbladder and pancreatic disease, immune or thrombotic thrombocytopenic purpura, antiphospholipid syndrome and hemolytic-uremic syndrome. It must be considered a possibility in any pregnant woman beyond 20 weeks of gestation. It is particularly difficult to diagnose when preexisting disease such as hypertension is present. Women with acute fatty liver of pregnancy may also present with elevated blood pressure and protein in the urine, but differs by the extent of liver damage. Other disorders that can cause high blood pressure include thyrotoxicosis, pheochromocytoma, and drug misuse
Treatment:
Preeclampsia and eclampsia cannot be completely cured until the pregnancy is over. Until that time, treatment includes the control of high blood pressure and the intravenous administration of drugs to prevent convulsions. Drugs may also be given to stimulate the production of urine. In some severe cases, early delivery of the baby is needed to ensure the survival of the mother.

Prevention:
Recommendations for prevention include: aspirin in those at high risk, calcium supplementation in areas with low intake, and treatment of prior hypertension with medications. In those with PE delivery of the fetus and placenta is an effective treatment. When delivery becomes recommended depends on how severe the PE and how far along in pregnancy a person is. Blood pressure medication, such as labetalol and methyldopa, may be used to improve the mother’s condition before delivery. Magnesium sulfate may be used to prevent eclampsia in those with severe disease. Bedrest and salt intake have not been found to be useful for either treatment or prevention.

Diet:
Protein or calorie supplementation have no effect on preeclampsia rates, and dietary protein restriction does not appear to increase preeclampsia rates. Further, there is no evidence that changing salt intake has an effect.

Supplementation with antioxidants such as vitamin C and E has no effect on preeclampsia incidence, nor does supplementation with vitamin D. Therefore, supplementation with vitamins C, E, and D is not recommended for reducing the risk of pre-eclampsia.

Calcium supplementation of at least 1 gram per day is recommended during pregnancy as it prevents preeclampsia where dietary calcium intake is low, especially for those at high risk. Low selenium status is associated with higher incidence of preeclampsia.

Aspirin:
Taking aspirin is associated with a 1% to 5% reduction in preeclampsia and a 1% to 5% reduction in premature births in women at high risk. The WHO recommends low-dose aspirin for the prevention of preeclampsia in women at high risk and recommend it be started before 20 weeks of pregnancy. The United States Preventive Services Task Force recommends a low-dose regimen for women at high risk beginning in the 12th week.

Physical activity:
There is insufficient evidence to recommend either exercise or strict bedrest as preventative measures of pre-eclampsia.

Smoking cessation:
In low-risk pregnancies the association between cigarette smoking and a reduced risk of preeclampsia has been consistent and reproducible across epidemiologic studies. High-risk pregnancies (those with pregestational diabetes, chronic hypertension, history of preeclampsia in a previous pregnancy, or multifetal gestation) showed no significant protective effect. The reason for this discrepancy is not definitively known; research supports speculation that the underlying pathology increases the risk of preeclampsia to such a degree that any measurable reduction of risk due to smoking is masked. However, the damaging effects of smoking on overall health and pregnancy outcomes outweighs the benefits in decreasing the incidence of preeclampsia. It is recommended that smoking be stopped prior to, during and after pregnancy

Restriction of salt in the diet may help reduce swelling, it does not prevent the onset of high blood pressure or the appearance of protein in the urine. During prenatal visits, the doctor routinely checks the woman’s weight, blood pressure, and urine. If toxemia is detected early, complications may be reduced.

Resources:
http://health.howstuffworks.com/pregnancy-and-parenting/pregnancy/complications/a-guide-to-pregnancy-complications-ga13.htm
http://en.wikipedia.org/wiki/Pre-eclampsia