Is an interesting plant found in the cold deserts of Himachal. Jammu and Kashmir. This is rich in vitamins and cholesterol bursting properties. Contemporary medicine has now found it useful to treat jaundice, though folk and Tibetan medicine have been using it for generations.
India is the 5th largest producer of this. Scientifically it is known as hippophae rhamnoides in 2007 1.4crores worth of berries were sold which is less that 5% of the regions potential.
It produces orange berries and is also found along the Atlantic coast.
Helps in soil and water conservation, desertification control, land reclamation, erosion and water control and even reforestation.
Seabuck thorn are also excellent nitrogen fixers.
Called 'Chharma' in some native languages, oil from fruits and seeds is used for liver diseases, inflammation, disorders of the gastrointestinal system, including peptic ulcers and gastritis, eczema, canker sores and other ulcerative disorders of mucosal tissues, wounds, inflammation, burns, frostbite, psoriasis, rosacea, lupus erythematosus, and chronic dermatoses. In ophthalmology, berry extracts have been used for keratosis, trachoma, eyelid injuries and conjunctivitis. The sea-buckthorn is also known to kill tiny parasitic mites called Demodex.
Constituents of Sea Buckthorn Fruit (per 100 grams fresh berries)
Vitamin C
200-1,500 mg (typical amount: 600 mg)
Vitamin E (mixed tocopherols)
Up to 180 mg (equal to about 270 IU)
Folic acid
Up to 80 mcg
Carotenoids, including beta carotene, lycopene, zeaxanthine; these contribute the yellow-orange-red colors of the fruit
30-40 mg
Fatty acids (oils); the main unsaturated fatty acids are oleic acid (omega-9), palmitoleic acid (omega-7), palmitic acid and linoleic acid (omega-6), and linolenic acid (omega-3); there are also saturated oils and sterols (mainly β-sitosterol)
6-11% (3-5% in fruit pulp, 8-18% in seed); fatty acid composition and total oil content vary with subspecies
Organic acids other than ascorbic (e.g., quinic acid, malic acid; ingredients similar to those found in cranberries)
Quantity not determined; expressed juice has pH of 2.7-3.3
Flavonoids (e.g., mainly isorhamnetin, quercetin glycosides, and kaempferol; these are the same flavonoids as found in Ginkgo biloba.
100-1,000 mg (0.1% to 1.0%)
Health application of seabuck thorn.
The flavonoids make sea buckthorn an medicinally useful plant. 5 focal area of research are GI disorder, particularly ulcers, internal and topical therapy for skin disorders liver protective agent and a remedy for liver cirrhosis.
HEALTH APPLICATIONS
Sea buckthorn has been shown to have a potent antioxidant activity, mainly attributed to its flavonoids and vitamin C content 2 Both the flavonoids and the oils from sea buckthorn have several potential applications 3 There are five areas of research that have been focal points for their use: as an aid to patients undergoing cancer therapy; a long-term therapy for reduction of cardiovascular risk factors; treatment of gastrointestinal ulcers; internal and topical therapy for a variety of skin disorders; and as a liver protective agent (for chemical toxins) and a remedy for liver cirrhosis.
Cancer therapy: Most of the work done in this area has been with laboratory animals. A group in India headed by HC Geol. (at the Department of Radiation Biology, Institute of Nuclear Medicine and Allied Sciences, in Delhi) has published several reports on the potential of a hippophae extract (an alcohol extract, which would mainly contain the flavonoids) to protect the bone marrow from damage due to radiation; his group also showed that the extract may help faster recovery of bone marrow cells 4 In China, a study was done to demonstrate faster recovery of the hemopoietic system after high dose chemotherapy (with 5-FU) in mice fed the sea buckthorn oil 5 The seed oil has been found to enhance non-specific immunity and to provide anti-tumor effects in preliminary laboratory studies 6,7.
Cardiovascular diseases: In a double-blind clinical trial conducted in China 8 128 patients with ischemic heart disease were given total flavonoids of sea buckthorn at 10 mg each time, three times daily, for 6 weeks. The patients had a decrease in cholesterol level and improved cardiac function; also they had less angina than those receiving the control drug. No harmful effect of sea buckthorn flavonoids was noted in renal functions or hepatic functions. The mechanism of action may include reduced stress of cardiac muscle tissue by regulation of inflammatory mediators 9 In a laboratory animal study, the flavonoids of sea buckthorn were shown to reduce the production of pathogenic thromboses 10 Some simple formulas based on sea buckthorn have been developed recently for treating cardiac disorders. For example, there is a liquid preparation of sea buckthorn flavonoids with carthamus (safflower) and licorice, called Ai Xin Bao (from the Shanxi Ai Xin Biological Technology Development Center), which is intended for use in treatment of coronary heart disease and sequelae of heart attack and stroke, through improving blood circulation and restoring cardiac function.
Gastric ulcers: Hippophae is traditionally used in the treatment of gastric ulcers, and laboratory studies confirm the efficacy of the seed oil for this application 11,12 Its functions may be to normalize output of gastric acid and reduce inflammation by controlling pro-inflammatory mediators.
Liver cirrhosis: A clinical trial demonstrated that sea buckthorn extracts helped normalize liver enzymes, serum bile acids, and immune system markers involved in liver inflammation and degeneration 13 In addition, sea buckthorn oil protects the liver from damaging effects of toxic chemicals, as revealed in laboratory studies 14
Skin: An ingredient of the oil, palmitoleic acid, is a component of skin. It is considered a valuable topical agent in treating burns and healing wounds. This fatty acid can also nourish the skin when taken orally if adequate quantities of sea buckthorn or its oil are consumed; this is a useful method for treating systemic skin diseases, such as atopic dermatitis 15). The only other major plant source of palmitoleic acid is macadamia nuts; the oil is used to nourish the skin. Sea buckthorn oil is already widely used alone or in various preparations topically applied for burns, scalds, ulcerations, and infections. It is an ingredient in sunblock-hippophae oil has UV-blocking activity as well as emollient properties-and it is an aid in promoting regeneration of tissues 16. The fruit
References
1. Journal of science, food and agriculture.
2. Rosch D, et al., Structure-antioxidant efficiency relationships of phenolic compounds and their contribution to the antioxidant activity of sea buckthorn juice, Journal of Agricultural Food Chemistry 2004; 51(15): 4233-4239.
Li TSC and Schroeder WR, Sea buckthorn (Hippophae rhamnoides): A multipurpose plant, Horticultural Technology 1996; 6(4): 370-378.
Agrawala PK and Goel HC, Protective effect of RH-3 with special reference to radiation induced micronuclei in mouse bone marrow, Indian Journal of Experimental Biology 2002 May; 40 (5): 525-530.
Chen Y, et al., Study on the effects of the oil from Hippophae rhamnoides in hematopoiesis, Chinese Herbal Drugs 2003; 26(8): 572-575.
Yu Let et al., Effects of Hippophae rhamnoides juice on immunologic and antitumor functions, 1993 Acta Nutrimenta Sinica 15(3): 280-283.
Zhong Fei, et al., Effects of the total flavonoid of Hippophae rhamnoides on nonspecific immunity in animals, Shanxi Medical Journal 1989; 18(1): 9-10.
Zhang Maoshun, et al., Treatment of ischemic heart diseases with flavonoids of Hippophae rhamnoides, Chinese Journal of Cardiology 1987; 15(2): 97-99.
Xiao Z, et al., The inhibitory effect of total flavonoids of hippophae on the activation of NF-kappa ß by stretching cultured cardiac myocytes, Sichuan University Medical Journal 2003; 34(2): 283-285.
Cheng J, et al., Inhibitory effects of total flavones of Hippophae rhamnoides on thrombosis in mouse femoral artery and in vitro platelet aggregation, Life Sciences 2003; 72(20): 2263-2271.
Zhou Yuanpeng, et al., Study on the effect of hippophae seed oil against gastric ulcer, 1998 Institute of Medical Plants Resource Development, The Chinese Academy of Medical Sciences, Beijing.
Xing J, et al., Effects of sea buckthorn seed and pulp oils on experimental models of gastric ulcer in rats, Fitoterapia 2002; 73(7-8): 644-650.
Gao ZL, et al., Effect of sea buckthorn on liver fibrosis: a clinical study, World Journal of Gastroenterology 2003; 9(7): 1615-1617.
Cheng T, et al., Acute toxicity of flesh oil of Hippophae rhamnoides and its protection against experimental hepatic injury, Journal of Traditional Chinese Medicine 1990; 15(1): 45-47, 64.
Yang Baoru, et al., Effects of dietary supplementation of sea buckthorn oils on fatty acids in patients with atopic dermatitis, 1999 Proceedings of the International Sea Buckthorn Congress, ICRTS, Beijing.
Ianev E, et al., The effect of an extract of sea buckthorn on the healing of experimental skin wounds in rats, Dermatology 1995; 48(3): 30-33.
Wednesday, October 28, 2009
Sunday, October 11, 2009
Ayurveda and lifestyle.
Constitution of the body.
Vata
– air+ space responsible for movement like respiration, circulation and thought. On an emotional level creativity, flexibility m fear and anger.
Pitta:
fire+ water responsible for metabolism including digestion of food, hunger
emotionally courage, anger, ambition, pride.
Kapha
Water+ earth cohesion and body structure govern emotions like love devotion, greed and jealousy.
These doshas are essentially body energies activity, diet and lifestyle effect the doshas.
Pitta increases with hot spicy food, anger and strong summer.
Kapha increases with heavy cold food, inactivity dampness and winter.
Vata increases with dry light food, overwork and autumn winds.
The knowledge of our prakriti helps us to maintain by altering our activity, lifestyle and diet according to our constitution.
Imbalance of these elements leads to ill health. This is called vikriti. Health is restored by balancing the doshas
Guna:
If doshas deals with physical component Guna deals with Psychological constitution..
These are again 3 in classification
Sattva harmony and purity
Rajas agitation and vitality
Tamas darkness and ignorance
These are perceived but are deduced from our actions.
The combination of doshas and gunas give us our individuality. The guna’s can be influenced.
Tamas:
Apathetic, lazy, dishonest, insensitive and prone to addiction. Avoids work, lack of willpower and discipline.
Rajas:
Ambitious, dynamic, and often dominate others. Spire for power, wealth and status. Their positive feature is strength, bravery and leadership.
On the negative aspect it is cruelty, manipulation, egotism, and anger.
Food that encourage Rajas quality are: fried, spicy and greasy food.
Sattva
A person displaying the characteristics of pure Sattva is a saintly figure and they are very few and far between. Sattvic qualities include intelligence, compassion, generosity, and kindness. Sattva -dominant people concern themselves with humanitarian and spiritual activities. They possess mental clarity, humility, enthusiasm, and joy.
The diet that increases Sattva includes fresh fruit and vegetables, grains, nuts and seeds, milk, ghee, and buttermilk. Sattvic food should be freshly cooked and eaten in a peaceful environment. Discipline, cleanliness, spiritually uplifting, and selfless activities—all increase Sattva.
Many of us are a combination of the three and this may fluctuate at different stages of our lives. Pressures of modern life make it difficult to incorporate ideal Sattvic qualities into our lives; but over time, and regardless of physical constitution, if we make efforts to modify our lives appropriately—we will surely experience long-term enhancement of health, happiness and content
Ayurveda is a science that teaches you to live in a natural balance. This natural balance is not only limited to proper internal functioning of your body, but also means a balanced relationship with the Earth and with your fellow human beings.
According to Ayurveda, each one of us is a combination of body, mind, senses, and soul.
However, most of our attempts to become happy and peaceful relate purely to the physical body and to materialistic ends. We strive to achieve physical perfection or to obtain items thought to bring security and pleasure, such as a high-income career, car, house, designer clothing, jewelry, or friends and partners.
We rarely pay attention to our mind or soul, even though they are largely responsible for our health. Our lifestyle and diet, which we think provide happiness and pleasure, may not really be healthy for our mind and soul. That is why, even after achieving material comfort and obtaining good physical health, we are often still not contented.
Fruitlessly, we strive even harder to achieve more physical comforts, and are confused when this does not create a sense of satisfaction. We struggle to obtain transitory physical pleasures, mistaking this for genuine and lasting happiness. In the process, we over-stimulate and disturb our senses, creating physical and psychological imbalances.
This situation is like keeping a beautiful bird (soul) inside an intricate, precious cage (body). Rather than feeding the bird and listening to it sing, all of your energy is devoted to polishing and maintaining the cage. You are so busy looking after the cage (body), that you forget the bird (soul) is inside and don’t even notice when it begins to waste away from neglect.
Why do we persist in following lifestyles or diets that make us unhappy or physically sick? It is because we have not learnt how to tend to our psychological or spiritual needs. It is assumed that if we nurture the physical, the rest takes care of itself. However, despite our best efforts, time, and resources spent meeting all of our physical needs and desires we are unable to achieve lasting contentment and peace. This is because we have ignored our spiritual and psychological health. Overlooking the mind and soul means that the majority of our genuine needs are ignored.
Complete health and genuine contentment are obtainable with Ayurvedic principles as they provide guidance on physical, psychological, and spiritual aspects. Ayurveda teaches you how to live in both society and the natural universe without disturbing the natural balance, and how to live in harmony with each other and the Earth.
Ayurveda describes diet and hygiene, as well as lifestyle, conduct, and attitude that can bring total health. Spiritual growth, mental balance, and the maintenance of physical well being are complementary and equal aims of this science. It is essential to understand both the needs of your mind and soul when attempting to obtain complete health, as they are equal partners with your body in determining your welfare.
An understanding of these aspects can bring happiness and peace. Material things may give temporary happiness to your body or to your mind, but they do not meet the needs of your soul. That may be one of the reasons why there is so much suffering and anguish today, despite the wealth available for material goods and physical pleasure. Diet (food for the body) is only one factor in maintaining health. Spirituality (food for the soul) and mental harmony are equally important.
Ayurveda is the only medical science to have defined “health”. In the Ayurvedic sense, health is not merely being free of physical pain or the symptoms of disease. The mind is a very important consideration in the overall assessment of health. A person can only be said to be healthy when the mind is clear, calm, and contented (balanced), complementing a balanced body.
In many cases, people may not have any physical problems or symptoms of illness, but they are very unhappy or agitated at the psychological level. According to Ayurveda, such people are not healthy. Thousands of people are in this category. They may be disturbed, depressed, irritable, and insecure, suffer from insomnia due to stress, or feel generally unfulfilled and aimless. These types of conditions mainly originate in an unbalanced mind.
Ayurveda propounds the principle of natural balance within the body, and harmony with the environment. We are an integral part of our habitat. Living in harmony with our habitat and nature according to natural principles ensures complete physical health and peace of mind.
Modern life often violates the principles of natural living. Many of us work long hours in offices with artificial light and air conditioning systems. We rush from one mundane task to the next while being bombarded with advertising and constant noise, and absorbing pollution through the air and water. Pure water and air are becoming scarce resources, in an environment that is becoming increasingly toxic to us.
Our lifestyles are often as detrimental to our health as the environment. Many of us don’t have time to prepare breakfast, eat a fast food lunch at our desk, and a pre-prepared dinner in front of the television. Coffee keeps us alert, alcohol “relaxes” us and drugs treat our ailments. When the weekend arrives we are so exhausted that we often don’t even have time to really enjoy it! And then it is Monday again with that familiar feeling of dread - we are back in the race of trying to make enough money to buy processed food, gadgets to save us time, and amusements to distract us from the monotony of our lives. In our efforts to seek pleasure we are working hard to achieve personal suffering and poor health.
So why are people in modern times, with all the conveniences of technology to make life easier, finding that life has lost all joy? It is because we have lost contact with nature – and we often feel empty and unsatisfied, as well as physically sick for reasons we cannot really identify. We are overlooking the fact that we are as much a part of mother Earth as all of the other species.
We are often brought up without a basic education of how the body functions, what is beneficial and detrimental from both the physical and psychological perspectives, how to prevent illness, and how to achieve peace and happiness. This is like buying a brand new car and instead of reading or understanding the manual, just jumping behind the steering wheel and taking off to see how fast it can go.
Without knowledge of how to check your new car’s water, oil, tires, or fuel, it will not be long before the car is not performing at its peak. Sooner or later it will begin rattling and jolting, and eventually the engine will seize up and the car will be useless. It might look almost immaculate on the surface but ignoring the signs of rust, putting in the wrong fuel, and not checking the basic systems will lead to irreversible damage.
The benefits of your car can then no longer be enjoyed unless you spend a lot of money fixing or replacing the parts. The car becomes a liability instead of an asset – it takes up space in your garage, drains your bank account, and doesn’t even take you to your destination safely. It is like a sick body that can no longer enjoy the advantages offered by life.
The human body is a far more complex and valuable vehicle than a car. You may be able to just dump a car when it becomes a liability and buy a new one, but a body is irreplaceable. But many of us seem more concerned with cleaning and checking their car than looking after themselves physically and mentally.
Living naturally according to some simple principles can prevent the need for expensive medical treatment or suffering needlessly from debilitating conditions. Learning to listen to your body and read the signals of distress can help you maintain health, making you more productive in your life as well as contented.
So is this ancient wisdom secret, or only available to a fortunate few? Or are the principles hard to comprehend and difficult to apply? You will be pleasantly surprised to know Ayurveda is easily learnt by anyone, and can be adapted into your life starting from today. It does not require any fancy equipment or expert knowledge, and costs no more (and probably less) than what you already spend on groceries.
Maintaining your health is based on nothing more complex than understanding the characteristics of your body and qualities of the food you eat. Many of the remedies for common ailments can be simply and quickly prepared in your own kitchen with widely available herbs.
Ayurveda’s systematic approach to health includes gentle exercise, and daily practices that vary according to season. The purpose of these living habits is to encourage longevity, vitality, and physical and mental strength. As a bonus it also provides peace of mind and balanced emotions. With such perfect health, you are able to not only work more efficiently, but also able to totally relax when you want to. You become the master of your body and mind, not the slave.
Ayurvedic applications can be used to explain and treat any physical or psychological ailment. There are no side effects or negative environmental impacts from the treatments, and the root cause of illness is treated rather than just the symptoms. All medicinal preparations used (herbs, plants, foods, and minerals) are already found in the natural environment and are inexpensive.
Ayurveda is the instruction manual for the natural living of human beings. Understanding this philosophy of life enables you to become your own “healer”. You learn about your body, how it functions, and how to treat it through diet and herbal remedies. In fact, you also become your own dietician, personal trainer, counselor or psychologist, stylist, and beautician! Ayurveda is a unified system that encompasses all these aspects. The magic of it is that it involves nothing more expensive or complex than adapting your diet and lifestyle routines.
Diet
In Ayurveda, food (ahaara) is the prime preventive medicine. Proper diet and eating habits are considered the source of both physical and mental health. You can not only maximize your health through the application of dietary guidelines, but also treat sickness. Once your understand the properties of various foods and herbs, you can apply these principles to your daily diet as well as on those occasions when you feel unwell.
There are dozens of remedies that can be prepared easily in your own home using common foods and herbs. At home, the pharmacy is really no further than the kitchen cupboard or the refrigerator.
In order to be balanced, cheerful, and calm in disposition, it is essential to emphasize Sattvic food in your lifestyle and minimize rajasic or tamasic foods . Regular use of Sattvic food items helps prevent disease and maintain good physical, mental, and spiritual health. According to Ayurveda, eating Sattvic food and practicing a Sattvic life style is the best preventive medicine.
Sattvic food is fresh, pure, and vegetarian. In terms of nutrition, this includes increasing the amounts of fresh fruits and vegetables, grains, salads, pure fruit juices, herbal teas, water and milk, nuts, seeds, and honey. Food should be eaten freshly prepared. At the same time, foods that are processed, pre-prepared, preserved, fermented, canned and packaged, frozen, micro waved, fried or barbecued, high in sugar or spices, or containing artificial flavors or colors should be minimized. Mushrooms, onions, spices and garlic should be avoided, as they are tamasic and/or rajasic. Consumption of alcohol, caffeine and meat should be moderated or eliminated for the same reason.
Foods that have a naturally sweet taste are sattvic. This does not include refined sugar products, but refers to anything that has a sweet taste without any additives, such as grains (rice, wheat and barley), breads, honey, and fruits. Milk, herbal teas, pure fruit or vegetable juices, and water are also included in this group. Organically grown foods are preferred, as fertilizers, pesticides, chemicals and preservatives are tamasic.
A number of clinical studies in India have demonstrated that increasing sattvic foods increases sattvic qualities. For example, animals fed mostly vegetarian food in laboratories became calm, peaceful and alert. In contrast, those fed stale or frozen foods, meat and other tamasic or rajasic food became violent, restless, and agitated (Joshi 1997:138). The hypothesis that food creates behavioral and mood changes has been replicated in studies in the West, where dietary links to behavior (body-mind) have been observed in controlled studies of children.
Lifestyle
Like sattvic dietary considerations, mind balance and sattvic qualities can be enhanced with activities that are sattvic in nature. These are calming, quiet, inspiring, and mentally invigorating. They may include meditation, yoga or other forms of gentle exercise, listening to peaceful and classical music, enjoying nature and the outdoors, gardening, creative or artistic pursuits, or reading good quality literature. Meditation is calming and helps balance emotions, so passion, anger, fear, and extreme emotions are minimized.
Dealing effectively with stress and anxiety is the role of the mind. Managing stress through classic Ayurvedic concepts like meditation, breathing and relaxation exercises that control and calm the mind, are now accepted as scientifically valid. Such practices stop the flow of hormones associated with stress, lower the heart rate and blood pressure. All of these factors have a significant positive effect on health.
The lifestyle regime proposed in Ayurveda encompasses spiritual and psychological aspects. The guidelines are based on living according to sattvic principles, including adopting personal ethics and a code of morality such as speaking the truth, serving humanity, not exploiting others, respecting elders, and devotion to spiritual growth. Practicing exercise (yoga) and meditation, regulating sleep, and controlling negative emotions (greed, envy, anger and violence) further enhance the mind and body.
The lifestyle routine is based on balance in all things. Eating, sleeping, and sex are undertaken within natural limits; and working, socializing, exercising, and relaxation are engaged in with a balanced attitude. No one activity should be engaged in excessively and one area of life should not be sacrificed for another. Moderation is the key to health and happiness.
Vata
– air+ space responsible for movement like respiration, circulation and thought. On an emotional level creativity, flexibility m fear and anger.
Pitta:
fire+ water responsible for metabolism including digestion of food, hunger
emotionally courage, anger, ambition, pride.
Kapha
Water+ earth cohesion and body structure govern emotions like love devotion, greed and jealousy.
These doshas are essentially body energies activity, diet and lifestyle effect the doshas.
Pitta increases with hot spicy food, anger and strong summer.
Kapha increases with heavy cold food, inactivity dampness and winter.
Vata increases with dry light food, overwork and autumn winds.
The knowledge of our prakriti helps us to maintain by altering our activity, lifestyle and diet according to our constitution.
Imbalance of these elements leads to ill health. This is called vikriti. Health is restored by balancing the doshas
Guna:
If doshas deals with physical component Guna deals with Psychological constitution..
These are again 3 in classification
Sattva harmony and purity
Rajas agitation and vitality
Tamas darkness and ignorance
These are perceived but are deduced from our actions.
The combination of doshas and gunas give us our individuality. The guna’s can be influenced.
Tamas:
Apathetic, lazy, dishonest, insensitive and prone to addiction. Avoids work, lack of willpower and discipline.
Rajas:
Ambitious, dynamic, and often dominate others. Spire for power, wealth and status. Their positive feature is strength, bravery and leadership.
On the negative aspect it is cruelty, manipulation, egotism, and anger.
Food that encourage Rajas quality are: fried, spicy and greasy food.
Sattva
A person displaying the characteristics of pure Sattva is a saintly figure and they are very few and far between. Sattvic qualities include intelligence, compassion, generosity, and kindness. Sattva -dominant people concern themselves with humanitarian and spiritual activities. They possess mental clarity, humility, enthusiasm, and joy.
The diet that increases Sattva includes fresh fruit and vegetables, grains, nuts and seeds, milk, ghee, and buttermilk. Sattvic food should be freshly cooked and eaten in a peaceful environment. Discipline, cleanliness, spiritually uplifting, and selfless activities—all increase Sattva.
Many of us are a combination of the three and this may fluctuate at different stages of our lives. Pressures of modern life make it difficult to incorporate ideal Sattvic qualities into our lives; but over time, and regardless of physical constitution, if we make efforts to modify our lives appropriately—we will surely experience long-term enhancement of health, happiness and content
Ayurveda is a science that teaches you to live in a natural balance. This natural balance is not only limited to proper internal functioning of your body, but also means a balanced relationship with the Earth and with your fellow human beings.
According to Ayurveda, each one of us is a combination of body, mind, senses, and soul.
However, most of our attempts to become happy and peaceful relate purely to the physical body and to materialistic ends. We strive to achieve physical perfection or to obtain items thought to bring security and pleasure, such as a high-income career, car, house, designer clothing, jewelry, or friends and partners.
We rarely pay attention to our mind or soul, even though they are largely responsible for our health. Our lifestyle and diet, which we think provide happiness and pleasure, may not really be healthy for our mind and soul. That is why, even after achieving material comfort and obtaining good physical health, we are often still not contented.
Fruitlessly, we strive even harder to achieve more physical comforts, and are confused when this does not create a sense of satisfaction. We struggle to obtain transitory physical pleasures, mistaking this for genuine and lasting happiness. In the process, we over-stimulate and disturb our senses, creating physical and psychological imbalances.
This situation is like keeping a beautiful bird (soul) inside an intricate, precious cage (body). Rather than feeding the bird and listening to it sing, all of your energy is devoted to polishing and maintaining the cage. You are so busy looking after the cage (body), that you forget the bird (soul) is inside and don’t even notice when it begins to waste away from neglect.
Why do we persist in following lifestyles or diets that make us unhappy or physically sick? It is because we have not learnt how to tend to our psychological or spiritual needs. It is assumed that if we nurture the physical, the rest takes care of itself. However, despite our best efforts, time, and resources spent meeting all of our physical needs and desires we are unable to achieve lasting contentment and peace. This is because we have ignored our spiritual and psychological health. Overlooking the mind and soul means that the majority of our genuine needs are ignored.
Complete health and genuine contentment are obtainable with Ayurvedic principles as they provide guidance on physical, psychological, and spiritual aspects. Ayurveda teaches you how to live in both society and the natural universe without disturbing the natural balance, and how to live in harmony with each other and the Earth.
Ayurveda describes diet and hygiene, as well as lifestyle, conduct, and attitude that can bring total health. Spiritual growth, mental balance, and the maintenance of physical well being are complementary and equal aims of this science. It is essential to understand both the needs of your mind and soul when attempting to obtain complete health, as they are equal partners with your body in determining your welfare.
An understanding of these aspects can bring happiness and peace. Material things may give temporary happiness to your body or to your mind, but they do not meet the needs of your soul. That may be one of the reasons why there is so much suffering and anguish today, despite the wealth available for material goods and physical pleasure. Diet (food for the body) is only one factor in maintaining health. Spirituality (food for the soul) and mental harmony are equally important.
Ayurveda is the only medical science to have defined “health”. In the Ayurvedic sense, health is not merely being free of physical pain or the symptoms of disease. The mind is a very important consideration in the overall assessment of health. A person can only be said to be healthy when the mind is clear, calm, and contented (balanced), complementing a balanced body.
In many cases, people may not have any physical problems or symptoms of illness, but they are very unhappy or agitated at the psychological level. According to Ayurveda, such people are not healthy. Thousands of people are in this category. They may be disturbed, depressed, irritable, and insecure, suffer from insomnia due to stress, or feel generally unfulfilled and aimless. These types of conditions mainly originate in an unbalanced mind.
Ayurveda propounds the principle of natural balance within the body, and harmony with the environment. We are an integral part of our habitat. Living in harmony with our habitat and nature according to natural principles ensures complete physical health and peace of mind.
Modern life often violates the principles of natural living. Many of us work long hours in offices with artificial light and air conditioning systems. We rush from one mundane task to the next while being bombarded with advertising and constant noise, and absorbing pollution through the air and water. Pure water and air are becoming scarce resources, in an environment that is becoming increasingly toxic to us.
Our lifestyles are often as detrimental to our health as the environment. Many of us don’t have time to prepare breakfast, eat a fast food lunch at our desk, and a pre-prepared dinner in front of the television. Coffee keeps us alert, alcohol “relaxes” us and drugs treat our ailments. When the weekend arrives we are so exhausted that we often don’t even have time to really enjoy it! And then it is Monday again with that familiar feeling of dread - we are back in the race of trying to make enough money to buy processed food, gadgets to save us time, and amusements to distract us from the monotony of our lives. In our efforts to seek pleasure we are working hard to achieve personal suffering and poor health.
So why are people in modern times, with all the conveniences of technology to make life easier, finding that life has lost all joy? It is because we have lost contact with nature – and we often feel empty and unsatisfied, as well as physically sick for reasons we cannot really identify. We are overlooking the fact that we are as much a part of mother Earth as all of the other species.
We are often brought up without a basic education of how the body functions, what is beneficial and detrimental from both the physical and psychological perspectives, how to prevent illness, and how to achieve peace and happiness. This is like buying a brand new car and instead of reading or understanding the manual, just jumping behind the steering wheel and taking off to see how fast it can go.
Without knowledge of how to check your new car’s water, oil, tires, or fuel, it will not be long before the car is not performing at its peak. Sooner or later it will begin rattling and jolting, and eventually the engine will seize up and the car will be useless. It might look almost immaculate on the surface but ignoring the signs of rust, putting in the wrong fuel, and not checking the basic systems will lead to irreversible damage.
The benefits of your car can then no longer be enjoyed unless you spend a lot of money fixing or replacing the parts. The car becomes a liability instead of an asset – it takes up space in your garage, drains your bank account, and doesn’t even take you to your destination safely. It is like a sick body that can no longer enjoy the advantages offered by life.
The human body is a far more complex and valuable vehicle than a car. You may be able to just dump a car when it becomes a liability and buy a new one, but a body is irreplaceable. But many of us seem more concerned with cleaning and checking their car than looking after themselves physically and mentally.
Living naturally according to some simple principles can prevent the need for expensive medical treatment or suffering needlessly from debilitating conditions. Learning to listen to your body and read the signals of distress can help you maintain health, making you more productive in your life as well as contented.
So is this ancient wisdom secret, or only available to a fortunate few? Or are the principles hard to comprehend and difficult to apply? You will be pleasantly surprised to know Ayurveda is easily learnt by anyone, and can be adapted into your life starting from today. It does not require any fancy equipment or expert knowledge, and costs no more (and probably less) than what you already spend on groceries.
Maintaining your health is based on nothing more complex than understanding the characteristics of your body and qualities of the food you eat. Many of the remedies for common ailments can be simply and quickly prepared in your own kitchen with widely available herbs.
Ayurveda’s systematic approach to health includes gentle exercise, and daily practices that vary according to season. The purpose of these living habits is to encourage longevity, vitality, and physical and mental strength. As a bonus it also provides peace of mind and balanced emotions. With such perfect health, you are able to not only work more efficiently, but also able to totally relax when you want to. You become the master of your body and mind, not the slave.
Ayurvedic applications can be used to explain and treat any physical or psychological ailment. There are no side effects or negative environmental impacts from the treatments, and the root cause of illness is treated rather than just the symptoms. All medicinal preparations used (herbs, plants, foods, and minerals) are already found in the natural environment and are inexpensive.
Ayurveda is the instruction manual for the natural living of human beings. Understanding this philosophy of life enables you to become your own “healer”. You learn about your body, how it functions, and how to treat it through diet and herbal remedies. In fact, you also become your own dietician, personal trainer, counselor or psychologist, stylist, and beautician! Ayurveda is a unified system that encompasses all these aspects. The magic of it is that it involves nothing more expensive or complex than adapting your diet and lifestyle routines.
Diet
In Ayurveda, food (ahaara) is the prime preventive medicine. Proper diet and eating habits are considered the source of both physical and mental health. You can not only maximize your health through the application of dietary guidelines, but also treat sickness. Once your understand the properties of various foods and herbs, you can apply these principles to your daily diet as well as on those occasions when you feel unwell.
There are dozens of remedies that can be prepared easily in your own home using common foods and herbs. At home, the pharmacy is really no further than the kitchen cupboard or the refrigerator.
In order to be balanced, cheerful, and calm in disposition, it is essential to emphasize Sattvic food in your lifestyle and minimize rajasic or tamasic foods . Regular use of Sattvic food items helps prevent disease and maintain good physical, mental, and spiritual health. According to Ayurveda, eating Sattvic food and practicing a Sattvic life style is the best preventive medicine.
Sattvic food is fresh, pure, and vegetarian. In terms of nutrition, this includes increasing the amounts of fresh fruits and vegetables, grains, salads, pure fruit juices, herbal teas, water and milk, nuts, seeds, and honey. Food should be eaten freshly prepared. At the same time, foods that are processed, pre-prepared, preserved, fermented, canned and packaged, frozen, micro waved, fried or barbecued, high in sugar or spices, or containing artificial flavors or colors should be minimized. Mushrooms, onions, spices and garlic should be avoided, as they are tamasic and/or rajasic. Consumption of alcohol, caffeine and meat should be moderated or eliminated for the same reason.
Foods that have a naturally sweet taste are sattvic. This does not include refined sugar products, but refers to anything that has a sweet taste without any additives, such as grains (rice, wheat and barley), breads, honey, and fruits. Milk, herbal teas, pure fruit or vegetable juices, and water are also included in this group. Organically grown foods are preferred, as fertilizers, pesticides, chemicals and preservatives are tamasic.
A number of clinical studies in India have demonstrated that increasing sattvic foods increases sattvic qualities. For example, animals fed mostly vegetarian food in laboratories became calm, peaceful and alert. In contrast, those fed stale or frozen foods, meat and other tamasic or rajasic food became violent, restless, and agitated (Joshi 1997:138). The hypothesis that food creates behavioral and mood changes has been replicated in studies in the West, where dietary links to behavior (body-mind) have been observed in controlled studies of children.
Lifestyle
Like sattvic dietary considerations, mind balance and sattvic qualities can be enhanced with activities that are sattvic in nature. These are calming, quiet, inspiring, and mentally invigorating. They may include meditation, yoga or other forms of gentle exercise, listening to peaceful and classical music, enjoying nature and the outdoors, gardening, creative or artistic pursuits, or reading good quality literature. Meditation is calming and helps balance emotions, so passion, anger, fear, and extreme emotions are minimized.
Dealing effectively with stress and anxiety is the role of the mind. Managing stress through classic Ayurvedic concepts like meditation, breathing and relaxation exercises that control and calm the mind, are now accepted as scientifically valid. Such practices stop the flow of hormones associated with stress, lower the heart rate and blood pressure. All of these factors have a significant positive effect on health.
The lifestyle regime proposed in Ayurveda encompasses spiritual and psychological aspects. The guidelines are based on living according to sattvic principles, including adopting personal ethics and a code of morality such as speaking the truth, serving humanity, not exploiting others, respecting elders, and devotion to spiritual growth. Practicing exercise (yoga) and meditation, regulating sleep, and controlling negative emotions (greed, envy, anger and violence) further enhance the mind and body.
The lifestyle routine is based on balance in all things. Eating, sleeping, and sex are undertaken within natural limits; and working, socializing, exercising, and relaxation are engaged in with a balanced attitude. No one activity should be engaged in excessively and one area of life should not be sacrificed for another. Moderation is the key to health and happiness.
Sunday, October 4, 2009
Ayurveda is a 5000 yr. old universal truth
.
It believes that diseases are caused when man tries to out do nature since the natural state is health and imbalance is ill health. Ayurveda focuses on bringing back health or rather maintaining balance.
Ayu is health.
Veda is knowledge.
So Ayurveda is knowledge of life. The dissatisfaction and malaise we feel in life is essentially due to our distance from nature. Ayurveda nullifies this using diet, exercise meditation and activities that nourish us.
Ayurveda works on body mind and soul principle.
Branches in Ayurveda.
Kaya chikitsa internal medicine
Shalakya tantra ENT and Ophthalmology
Shalya tantra surgery
Agada tantra toxicology
Bhuta vidya psychiatry
Kaumara vidya pediatrics
Vajikarna reproduction and procreation
Rasayana rejuvenation.
Ayurveda essentially has two arms.
· Maintenance of health
· Cure disease.
Health is maintained by specific diet and nutrition, life style and stabilizing techniques.
Curative aspect deals with body mind and soul. Which makes man a purusha. The cause diagnosis remedies and therapies to cure and prevent relapse of illness. The treatment is not suppression but elimination of cause of symptoms. Hence physical psychological and emotional components are important.
As per the Hindu thinking earth and everything on it is the combination of 5 basic elements. Prithvi, jala, akasha, Agni, and vayu.
These term s are used to classify and recognize various objects like:
Agni fire combustible, warm, hot
Jalap water moist cool
Prithvi earth heavy, solid, and stable.
These are not established in a laboratory but by what the 5 basic senses perceive. This may sound a little simplistic but to this basic classification, the age, environment season growth spurt all contribute.
E.g.: when perceived through the physiologic cycle we have:
Childhood growth focus water and earth
Adult activity focus Agni (fire)
Old age weakening space and air.
Just as the macrocosm is made of 5 elements the human body is made of 5 elements making it the microcosm. The elements present themselves as:
Space akasha nose, mouth, and other body orifices.
Air vayu lung, stomach, and other viscera
Fire Agni metabolism, vision, intelligence
Water jala plasma, mucous, saliva etc. body fluid
Earth prithvi muscle, skin.fat.
Health in terms of Ayurveda becomes the balance of these elements.
Imbalance is set right by using minerals, herbs or herbo-mineral components. Excess of one element is nullified by taking the opposite element like excess of water is nullified by using the opposite i.e. fire.
The five elements present themselves in the macrocosm as,
· With reference of season – e.g.—summer is essentially fire
· With reference to geography—e.g.—marshy land becomes water dominated, while mountains represent the wind component.
· With reference to emotions – e.g. – love would be watery and anger fiery.
It believes that diseases are caused when man tries to out do nature since the natural state is health and imbalance is ill health. Ayurveda focuses on bringing back health or rather maintaining balance.
Ayu is health.
Veda is knowledge.
So Ayurveda is knowledge of life. The dissatisfaction and malaise we feel in life is essentially due to our distance from nature. Ayurveda nullifies this using diet, exercise meditation and activities that nourish us.
Ayurveda works on body mind and soul principle.
Branches in Ayurveda.
Kaya chikitsa internal medicine
Shalakya tantra ENT and Ophthalmology
Shalya tantra surgery
Agada tantra toxicology
Bhuta vidya psychiatry
Kaumara vidya pediatrics
Vajikarna reproduction and procreation
Rasayana rejuvenation.
Ayurveda essentially has two arms.
· Maintenance of health
· Cure disease.
Health is maintained by specific diet and nutrition, life style and stabilizing techniques.
Curative aspect deals with body mind and soul. Which makes man a purusha. The cause diagnosis remedies and therapies to cure and prevent relapse of illness. The treatment is not suppression but elimination of cause of symptoms. Hence physical psychological and emotional components are important.
As per the Hindu thinking earth and everything on it is the combination of 5 basic elements. Prithvi, jala, akasha, Agni, and vayu.
These term s are used to classify and recognize various objects like:
Agni fire combustible, warm, hot
Jalap water moist cool
Prithvi earth heavy, solid, and stable.
These are not established in a laboratory but by what the 5 basic senses perceive. This may sound a little simplistic but to this basic classification, the age, environment season growth spurt all contribute.
E.g.: when perceived through the physiologic cycle we have:
Childhood growth focus water and earth
Adult activity focus Agni (fire)
Old age weakening space and air.
Just as the macrocosm is made of 5 elements the human body is made of 5 elements making it the microcosm. The elements present themselves as:
Space akasha nose, mouth, and other body orifices.
Air vayu lung, stomach, and other viscera
Fire Agni metabolism, vision, intelligence
Water jala plasma, mucous, saliva etc. body fluid
Earth prithvi muscle, skin.fat.
Health in terms of Ayurveda becomes the balance of these elements.
Imbalance is set right by using minerals, herbs or herbo-mineral components. Excess of one element is nullified by taking the opposite element like excess of water is nullified by using the opposite i.e. fire.
The five elements present themselves in the macrocosm as,
· With reference of season – e.g.—summer is essentially fire
· With reference to geography—e.g.—marshy land becomes water dominated, while mountains represent the wind component.
· With reference to emotions – e.g. – love would be watery and anger fiery.
Sunday, September 27, 2009
Ayurveda -- an introduction.
September 19-20-21 was a educational weekend at the science center. With the inauguration of Exhibition of Medicinal Plants By Vaidya Choodamani Raghuveer alias Pramod P. Bhide, from Ratnagiri, , Shri Vishwanath Joshi, Director Goa Science Centre, , Shri Arjun Halarnkar, Project Manager, International Centre Goa,The exercise was to introduce the public to the concepts of Ayurveda and to reach out the people. We also looked at presenting Ayurveda as an career opportunity and give the glimpse of the college to the students. Of 11th and 12th standard.
The sessions commenced on 19th with the key note talk by sri Rajendra Kerkar an environmental educationist. Followed by a birds view of the growth of the Ayurvedic college at Shiroda, presented by Dr.Neelesh Korde.
On 20th was an open house the argumentative Indian made his presence felt, it was an interactive sessions between the various streams of medicine with Vaidya Bhide and Dr.Suraj Kanekar chairing the sessions
Dada vaidya, has the unique privilege of being the only Hindu vaidya who was honored by the Portuguese his statue wascarved at Portugal and place at Ponda for the gentleman in dhoti and non presumptuous herbs had cured the viceroy’s son who was declared incurable by the Portuguese doctors. This historic event was discussed in totality by and goans were made aware of their unique heritage by Dr.Prajal sakhardande and Vaidya Jayant Gosai from Sattara. This event also commemorated dada vaidya’s 150th birth anniversary .A book on Ayurveda and milestone's in it journey was released to commemorate the event.Raj vaidya the grandson on Dada vaidya graced the occasionfuture was the focus of 21st we had an career option presentation by the college for 11th and 12th standard students.
Dr.Anura Bhale made the public aware of what was prakriti, what was dosha and what role it played on the people’s health. She also did prakriti pareekshan or examination of those who were interested and counseled them on balancing their food and exercise regime.
The session concluded with the Art of Living practitioners giving their input on Ayurveda and health.
The high lights of the three days, were the presence of the ethnic folk healer Ram Shanker Gavalikar who learnt the art of finding medicinal roots and herbs in the forest and using them for treatment from his mother and grandmother.
Dr.Archana Gaonkar had contributed 3 precious days from clinic to render free consultation for the participants.
Dr.Anura Bhale made the public aware of what was prakriti, what was dosha and what role it played on the people’s health. She also did prakriti pareekshan or examination of those who were interested and counseled them on balancing their food and exercise regime.
The session concluded with the Art of Living practitioners giving their input on Ayurveda and health.
The high lights of the three days, were the presence of the ethnic folk healer Ram Shanker Gavalikar who learnt the art of finding medicinal roots and herbs in the forest and using them for treatment from his mother and grandmother.
Dr.Archana Gaonkar had contributed 3 precious days from clinic to render free consultation for the participants.
Wednesday, September 23, 2009
Naati madhu
Or folk medicine
These are medications handed by folk healers using available herbs. They are not aware of how the disease emerges or how the medication exactly works, but they are aware of the symptoms and what cures the symptoms.
It is learnt partly as hand me downs and partly by observing nature.
Some popular Naati medicines are:
· Delayed menstruation the root of the coconut tree is made to paste with cows milk this should be taken twice ad ay. Till periods begin.
· Excessive bleeding the root of hibiscus and the root of lotus are blended in equal quantity and dispensed through cow’s milk as vehicle.
· White discharge: is handled by pounding root of cotton trees and mixing it with the extract with honey and taking it in.
These are medications handed by folk healers using available herbs. They are not aware of how the disease emerges or how the medication exactly works, but they are aware of the symptoms and what cures the symptoms.
It is learnt partly as hand me downs and partly by observing nature.
Some popular Naati medicines are:
· Delayed menstruation the root of the coconut tree is made to paste with cows milk this should be taken twice ad ay. Till periods begin.
· Excessive bleeding the root of hibiscus and the root of lotus are blended in equal quantity and dispensed through cow’s milk as vehicle.
· White discharge: is handled by pounding root of cotton trees and mixing it with the extract with honey and taking it in.
Thursday, September 3, 2009
chikungunya.
Why am I talking about Chikungunya when Swineflu is in fashion?
Well a friend of mine has returned from Kerala, she was saying that the minute people turn with febrile symptoms, the doctors hand out pills, on the assumption of Chikungunya as it is still rampant there.
“Without a blood test?” --- Without a blood test. Why would it be important for a blood test after all paracetamol that is prescribed for Chikungunya is a relatively harmless drug that it is vended over the counter without prescription? Multivitamins can’t do much damage either. Fluid intake and rest are prescribed in all febrile conditions.
In a way this is a good thing to do, because people once infected by Chikungunya seem to develop a more serious condition called the tomato fever. What happens here, is there are tomato like rashes emerging on the hands and legs. The skin becomes hypersensitive, these tomato like rashes have fluids oozing out of them.
To the date 28.000 cases have been registered. The general profile of the disease is not known.
But what is scary is the differential diagnosis of Chikungunya is dengue. While Chikungunya is crippling dengue is fatal.
Chikungunya Vs Dengue:
vector:
Dengue Aedes aeaypti
Chikungunya Aedes aeaypti and aedes albopictus.
Clinical features:
Dengue normal fever(DNF) high fever abrupt onset sever headache, pain behind the eyes, muscles bone joints, nausea, vomiting and rashes.
Dengue hemorrhagic (DHF) just like DNF but hemorrhage is also seen. Hemorrhage when there is bleeding.
Chikungunya sudden onset, of fever, headache, chills, nausea, vomiting, sometimes joint pain and rashes are also seen.
Incubation:
Dengue 3- 5days.
Chikungunya 3-7 days.
This is why it is very easy to miss the diagnosis particularly when so much of hype is going around.
Laboratory tests:
Are important in diagnosis and treatment plan. The tests done are:
· Antibody test for IgM and IgG
· Total blood and platelet count
· White blood count.
Clinical features with IgM and IgG or both decrease WBC and platelet count usually confirms dengue. Normal or hemorrhagic.
Presence of IgG and isolation of virus by genetic coding is diagnostic of Chikungunya.
Dengue requires hospitalization ASAP there is a fear of the patient bleeding into a hemorrhagic shock,
While Chikungunya is usually self limiting, lot of fluids, rest, and paracetmol helps in relief from symptoms. Though joint pain persists for a long time.
References:
Kerala department of preventive health.
WHO Chikungunya awareness program.
Center for disease control.
Well a friend of mine has returned from Kerala, she was saying that the minute people turn with febrile symptoms, the doctors hand out pills, on the assumption of Chikungunya as it is still rampant there.
“Without a blood test?” --- Without a blood test. Why would it be important for a blood test after all paracetamol that is prescribed for Chikungunya is a relatively harmless drug that it is vended over the counter without prescription? Multivitamins can’t do much damage either. Fluid intake and rest are prescribed in all febrile conditions.
In a way this is a good thing to do, because people once infected by Chikungunya seem to develop a more serious condition called the tomato fever. What happens here, is there are tomato like rashes emerging on the hands and legs. The skin becomes hypersensitive, these tomato like rashes have fluids oozing out of them.
To the date 28.000 cases have been registered. The general profile of the disease is not known.
But what is scary is the differential diagnosis of Chikungunya is dengue. While Chikungunya is crippling dengue is fatal.
Chikungunya Vs Dengue:
vector:
Dengue Aedes aeaypti
Chikungunya Aedes aeaypti and aedes albopictus.
Clinical features:
Dengue normal fever(DNF) high fever abrupt onset sever headache, pain behind the eyes, muscles bone joints, nausea, vomiting and rashes.
Dengue hemorrhagic (DHF) just like DNF but hemorrhage is also seen. Hemorrhage when there is bleeding.
Chikungunya sudden onset, of fever, headache, chills, nausea, vomiting, sometimes joint pain and rashes are also seen.
Incubation:
Dengue 3- 5days.
Chikungunya 3-7 days.
This is why it is very easy to miss the diagnosis particularly when so much of hype is going around.
Laboratory tests:
Are important in diagnosis and treatment plan. The tests done are:
· Antibody test for IgM and IgG
· Total blood and platelet count
· White blood count.
Clinical features with IgM and IgG or both decrease WBC and platelet count usually confirms dengue. Normal or hemorrhagic.
Presence of IgG and isolation of virus by genetic coding is diagnostic of Chikungunya.
Dengue requires hospitalization ASAP there is a fear of the patient bleeding into a hemorrhagic shock,
While Chikungunya is usually self limiting, lot of fluids, rest, and paracetmol helps in relief from symptoms. Though joint pain persists for a long time.
References:
Kerala department of preventive health.
WHO Chikungunya awareness program.
Center for disease control.
Saturday, August 22, 2009
inhaled insulin
The inhalation of insulin into the lungs offers a new method of insulin treatment delivery for people with diabetes.
The same features that make the lung so well suited for gas exchange also make it an ideal organ for absorption of small molecules into the bloodstream. The pulmonary alveolar surface area of the lung is 130 m2, the size of a tennis court, and the pulmonary capillary surface area is nearly as large at 115 m2. With each breath, air flows into nearly 300 million alveoli. Moreover, the alveolar lining cell is just 1 to 2 mcm from the pulmonary capillary lumen, a distance that favors rapid uptake into the bloodstream.
Absorption of a molecule across the alveolar-capillary interface is inversely related to its molecular mass. Small peptides, such as insulin (approximately 6000 Daltons) are readily absorbed across the very thin, vesiculated, permeable membrane. Molecules that make it to the alveolar level have longer residence time there, because mucociliary mechanisms at this level are minimal.
There are several factors affecting lower respiratory deposition of an aerosol or dry powder formulation. One of these is particle size. Particles greater than 5 mcm in diameter impact and are deposited in the pharynx and large airways. Particles 1 to 3 mcm generally reach the lower airways and alveoli. Particle velocity also affects deposition. Flow rates > 35 L/min or < 10 L/min will favor upper airway impaction, while flow rates of 15 to 25 L/min are ideal for lower airway deposition. Even under the best of circumstances, however, only the minority of an aerosol or dry powder usually makes it deep into the lungs
Inhaled Human Insulin
There are several forms of inhaled insulin, either approved or in development. The only inhaled insulin that is approved is Exubera® (insulin human [rDNA origin]) Inhalation Powder. Other forms in development include AERx (NovoNordisk), AIR (Lilly), Spiro (Dura), Technosphere Insulin (MannKind), and Aerodose (Aerogen). Some are not powder but aerosol. Their excipients and medication delivery systems also differ.
Exubera is a dry powder insulin contained in small blisters of 1 mg and 3 mg potency. After the blister is inserted into the base of the inhaler, a vacuum is established by cocking the lever at the base, allowing aerosolization of the powder. The aerosolized particles are then inhaled.[21]
Each actuation of the Exubera inhaler produces 200 mL of a homogeneous powder. This powder contains human (rDNA origin) insulin, and the excipients sodium citrate, glycine, sodium hydroxide (to maintain pH), and mannitol. None of these are known to be immunogenic. Mannitol has been clinically used as an agent in bronchoprovocation testing, but its concentration in Exubera is lower than the lowest dose used in such testing.
There are several forms of inhaled insulin, either approved or in development. The only inhaled insulin that is approved is Exubera® (insulin human [rDNA origin]) Inhalation Powder. Other forms in development include AERx (NovoNordisk), AIR (Lilly), Spiro (Dura), Technosphere Insulin (MannKind), and Aerodose (Aerogen). Some are not powder but aerosol. Their excipients and medication delivery systems also differ.
There are several forms of inhaled insulin, either approved or in development. The only inhaled insulin that is approved is Exubera® (insulin human [rDNA origin]) Inhalation Powder. Other forms in development include AERx (NovoNordisk), AIR (Lilly), Spiro (Dura), Technosphere Insulin (MannKind), and Aerodose (Aerogen). Some are not powder but aerosol. Their excipients and medication delivery systems also differ.
Exubera is a dry powder insulin contained in small blisters of 1 mg and 3 mg potency. After the blister is inserted into the base of the inhaler, a vacuum is established by cocking the lever at the base, allowing aerosolization of the powder. The aerosolized particles are then inhaled.[21]
Each actuation of the Exubera inhaler produces 200 mL of a homogeneous powder. This powder contains human (rDNA origin) insulin, and the excipients sodium citrate, glycine, sodium hydroxide (to maintain pH), and mannitol. None of these are known to be immunogenic. Mannitol has been clinically used as an agent in bronchoprovocation testing, but its concentration in Exubera is lower than the lowest dose used in such testing.
The dose of Exubera that reaches the alveolar level is the "fine particle dose," which consists of particles 3.3 mcm in diameter or smaller. The "fill mass" is the amount of insulin plus excipient in the individual insulin blister. In the case of a 1-mg Exubera blister, there is 0.7 mg of excipient and 1 mg of insulin; on actuation of the inhaler, 0.53 mg of insulin is emitted, of which 0.4 mg is less than 3.3 mcm in diameter. Thus, of the 1-mg insulin in the blister, 0.4 mg or 40% is deposited at the alveolar level. A 3-mg Exubera blister creates a 1.0 mg fine particle dose; hence, 33% is deposited in the alveoli. This explains why 3 1-mg blisters deliver more insulin (1.2 mg) than 1 3-mg blister, which delivers only 1 mg to the alveoli.[21]
Most of the insulin that reaches the distal lung is absorbed. There is no evidence of insulin accumulation in the alveoli. The insulin that is not absorbed undergoes metabolic degradation or slow mucociliary clearance
Smoking.
Insulin absorption studies have looked at the maximum concentration of serum insulin after a dose of insulin (Cmax) as well as the area under the serum insulin vs. time curve (AUC) following that dose. Such studies have shown that active smoking increases absorption of inhaled insulin 2- to 5-fold. The mechanism by which smoking affects inhaled insulin absorption is still unknown. The absorption of subcutaneous insulin is not affected by smoking.[22]
Cessation of smoking is accompanied by a reduction in absorption of inhaled insulin toward normal in as little as days. After a week of abstinence from smoking, inhaled insulin absorption decreases toward normal by as much as 50%. Resumption of smoking for just 3 days increases absorption of the peptide toward levels seen during chronic smoking.[22]
Because of the wide variations in absorption of inhaled insulin observed with smoking, cigarette smoking within the past 6 months has been a contraindication to inhaled insulin use in Phase 2 and 3 studies, and remains a contraindication to use of inhaled insulin.[21]
Passive smoking has been examined experimentally, in a study in which subjects were exposed to smoke in a smoking chamber for 2 hours at concentrations mimicking those found in a smoky bar. Contrary to active smoking, passive smoking appears to decrease inhaled insulin absorption by as much as 20% to 30%.[23] It is not clear how long this effect lasts after subjects are removed from the smoky environment. It is likewise unclear why passive smoking and active smoking have opposite effects on the absorption of inhaled insulin.
Asthma, Chronic Obstructive Pulmonary Disease, and Their Treatment.
Studies have shown that insulin absorption, as measured by area under the curve (AUC) and maximum concentration (Cmax), is 20% to 50% lower in mild to moderate asthmatics than in normals.[23]
In contradistinction to asthmatics, a small cohort of patients with chronic bronchitis and emphysema having a predicted baseline forced expiratory volume in 1 second (FEV1) of 35% to 40% were tested and found to have rates of absorption for inhaled insulin that were 2-fold higher than those of subjects without chronic obstructive pulmonary disease (COPD).[23] Although both asthma and COPD are characterized by small airway inflammation, it is not known why inhaled insulin absorption is affected in opposite ways by these disorders.
In patients with mild (FEV180% or more) or moderate (FEV180% or less) asthma, the administration of albuterol 30 minutes before taking inhaled insulin resulted in a 25% to 50% increase in systemic insulin absorption compared with administration of inhaled insulin alone. (Data on file) Inhaled fluticasone appears to have no effect on inhaled insulin absorption, but other medications used for asthma and COPD have not been systematically
This slide summarizes how respiratory factors affect inhaled insulin absorption.
Other Factors Affecting Absorption. In clinical studies of Exubera, episodes of viral upper respiratory infection, laryngitis, and acute bronchitis had no discernible effect in either direction on inhaled insulin absorption. There were not enough cases of pneumonia in phase 2/3 studies to be able to comment on the effects of a more severe infection on inhaled
Respiratory Tract Effects of Inhaled Insulin
Symptoms, Adverse Events. Respiratory safety of inhaled insulin has been a concern for several reasons:
1. It is a novel drug substance with novel excipients that is being inhaled.
2. Its administration is chronic.
3. Insulin is a polypeptide with potential for immune response in the lung.
4. Insulin has growth-promoting properties.
Consequently, respiratory side effects have been looked at closely in phase 2/3 studies.
In some studies, cough has been reported in 22% to 30% of patients with diabetes on Exubera compared with 4% to 10% of patients with diabetes on comparator treatment. (Data on file) The cough tended to occur within seconds to minutes after Exubera inhalation, and was generally rated as mild. The cough was rarely productive and rarely occurred
at night. Cough prevalence was greatest in the first month of use, then decreased by 20% to 40% over the next 3 months, and remained constant thereafter. In clinical studies, only 1.2% of patients discontinued Exubera because of cough. Patients who cough while on Exubera do not, on average, have any change in pulmonary function tests (PFTs) that distinguishes them from those who do not cough. Finally, such patients destined to cough cannot be reliably determined beforehand—they have the same mean pretreatment FEV1 as those patients who do not cough.
Shown here are respiratory adverse events reported in >1% of patients receiving inhaled insulin or a comparator drug (oral medications or subcutaneous insulin) in phase 2/3 studies.[21] Dyspnea has been reported by 4% of patients on Exubera and by 1% to 3% of patients on comparator agents. Nearly all cases were reported as mild or moderate; discontinuation of Exubera due to dyspnea was uncommon (0.4%). In clinical studies, patients with dyspnea were more likely to have a reduction in their pulmonary function, whether they were treated with Exubera or a comparator drug. Additionally, on occasion, the cause of dyspnea was another disease process, unrelated to either the Exubera or the comparator treatment.
Chest pain has been reported in 4.7% of patients on Exubera and in 3.2% of patients treated with subcutaneous insulin or oral antidiabetes medications. Of these patients, 90% rated the pain as mild or moderate. There were no differences in the incidence of angina (1%) and myocardial infarction (1%) between those patients treated with Exubera versus other agents.
Other symptoms reported more often in Exubera-treated patients than in comparator-treated patients include:
1. Increased sputum in 3% to 4% (vs. 1% of comparator patients)
2. Epistaxis in 1.2% (vs. 0.4-0.8%)
3. Voice alteration in 1.3% of patients with type 2 diabetes (vs. 0-0.3%)
4. Dry mouth in 2.4% (vs. 0.8%)[21]
Effects on Pulmonary Function. More than 43,000 PFTs have been performed in over 4600 adult subjects taking inhaled insulin. Spirometry, with measurement of FEV1 and forced vital capacity (FVC), has been used to look for the effects of inhaled insulin on airflow and airway function. Lung volumes, and especially carbon monoxide diffusing capacity of the lung (DLCO), have been used to look for any effect of inhaled insulin on pulmonary
The same features that make the lung so well suited for gas exchange also make it an ideal organ for absorption of small molecules into the bloodstream. The pulmonary alveolar surface area of the lung is 130 m2, the size of a tennis court, and the pulmonary capillary surface area is nearly as large at 115 m2. With each breath, air flows into nearly 300 million alveoli. Moreover, the alveolar lining cell is just 1 to 2 mcm from the pulmonary capillary lumen, a distance that favors rapid uptake into the bloodstream.
Absorption of a molecule across the alveolar-capillary interface is inversely related to its molecular mass. Small peptides, such as insulin (approximately 6000 Daltons) are readily absorbed across the very thin, vesiculated, permeable membrane. Molecules that make it to the alveolar level have longer residence time there, because mucociliary mechanisms at this level are minimal.
There are several factors affecting lower respiratory deposition of an aerosol or dry powder formulation. One of these is particle size. Particles greater than 5 mcm in diameter impact and are deposited in the pharynx and large airways. Particles 1 to 3 mcm generally reach the lower airways and alveoli. Particle velocity also affects deposition. Flow rates > 35 L/min or < 10 L/min will favor upper airway impaction, while flow rates of 15 to 25 L/min are ideal for lower airway deposition. Even under the best of circumstances, however, only the minority of an aerosol or dry powder usually makes it deep into the lungs
Inhaled Human Insulin
There are several forms of inhaled insulin, either approved or in development. The only inhaled insulin that is approved is Exubera® (insulin human [rDNA origin]) Inhalation Powder. Other forms in development include AERx (NovoNordisk), AIR (Lilly), Spiro (Dura), Technosphere Insulin (MannKind), and Aerodose (Aerogen). Some are not powder but aerosol. Their excipients and medication delivery systems also differ.
Exubera is a dry powder insulin contained in small blisters of 1 mg and 3 mg potency. After the blister is inserted into the base of the inhaler, a vacuum is established by cocking the lever at the base, allowing aerosolization of the powder. The aerosolized particles are then inhaled.[21]
Each actuation of the Exubera inhaler produces 200 mL of a homogeneous powder. This powder contains human (rDNA origin) insulin, and the excipients sodium citrate, glycine, sodium hydroxide (to maintain pH), and mannitol. None of these are known to be immunogenic. Mannitol has been clinically used as an agent in bronchoprovocation testing, but its concentration in Exubera is lower than the lowest dose used in such testing.
There are several forms of inhaled insulin, either approved or in development. The only inhaled insulin that is approved is Exubera® (insulin human [rDNA origin]) Inhalation Powder. Other forms in development include AERx (NovoNordisk), AIR (Lilly), Spiro (Dura), Technosphere Insulin (MannKind), and Aerodose (Aerogen). Some are not powder but aerosol. Their excipients and medication delivery systems also differ.
There are several forms of inhaled insulin, either approved or in development. The only inhaled insulin that is approved is Exubera® (insulin human [rDNA origin]) Inhalation Powder. Other forms in development include AERx (NovoNordisk), AIR (Lilly), Spiro (Dura), Technosphere Insulin (MannKind), and Aerodose (Aerogen). Some are not powder but aerosol. Their excipients and medication delivery systems also differ.
Exubera is a dry powder insulin contained in small blisters of 1 mg and 3 mg potency. After the blister is inserted into the base of the inhaler, a vacuum is established by cocking the lever at the base, allowing aerosolization of the powder. The aerosolized particles are then inhaled.[21]
Each actuation of the Exubera inhaler produces 200 mL of a homogeneous powder. This powder contains human (rDNA origin) insulin, and the excipients sodium citrate, glycine, sodium hydroxide (to maintain pH), and mannitol. None of these are known to be immunogenic. Mannitol has been clinically used as an agent in bronchoprovocation testing, but its concentration in Exubera is lower than the lowest dose used in such testing.
The dose of Exubera that reaches the alveolar level is the "fine particle dose," which consists of particles 3.3 mcm in diameter or smaller. The "fill mass" is the amount of insulin plus excipient in the individual insulin blister. In the case of a 1-mg Exubera blister, there is 0.7 mg of excipient and 1 mg of insulin; on actuation of the inhaler, 0.53 mg of insulin is emitted, of which 0.4 mg is less than 3.3 mcm in diameter. Thus, of the 1-mg insulin in the blister, 0.4 mg or 40% is deposited at the alveolar level. A 3-mg Exubera blister creates a 1.0 mg fine particle dose; hence, 33% is deposited in the alveoli. This explains why 3 1-mg blisters deliver more insulin (1.2 mg) than 1 3-mg blister, which delivers only 1 mg to the alveoli.[21]
Most of the insulin that reaches the distal lung is absorbed. There is no evidence of insulin accumulation in the alveoli. The insulin that is not absorbed undergoes metabolic degradation or slow mucociliary clearance
Smoking.
Insulin absorption studies have looked at the maximum concentration of serum insulin after a dose of insulin (Cmax) as well as the area under the serum insulin vs. time curve (AUC) following that dose. Such studies have shown that active smoking increases absorption of inhaled insulin 2- to 5-fold. The mechanism by which smoking affects inhaled insulin absorption is still unknown. The absorption of subcutaneous insulin is not affected by smoking.[22]
Cessation of smoking is accompanied by a reduction in absorption of inhaled insulin toward normal in as little as days. After a week of abstinence from smoking, inhaled insulin absorption decreases toward normal by as much as 50%. Resumption of smoking for just 3 days increases absorption of the peptide toward levels seen during chronic smoking.[22]
Because of the wide variations in absorption of inhaled insulin observed with smoking, cigarette smoking within the past 6 months has been a contraindication to inhaled insulin use in Phase 2 and 3 studies, and remains a contraindication to use of inhaled insulin.[21]
Passive smoking has been examined experimentally, in a study in which subjects were exposed to smoke in a smoking chamber for 2 hours at concentrations mimicking those found in a smoky bar. Contrary to active smoking, passive smoking appears to decrease inhaled insulin absorption by as much as 20% to 30%.[23] It is not clear how long this effect lasts after subjects are removed from the smoky environment. It is likewise unclear why passive smoking and active smoking have opposite effects on the absorption of inhaled insulin.
Asthma, Chronic Obstructive Pulmonary Disease, and Their Treatment.
Studies have shown that insulin absorption, as measured by area under the curve (AUC) and maximum concentration (Cmax), is 20% to 50% lower in mild to moderate asthmatics than in normals.[23]
In contradistinction to asthmatics, a small cohort of patients with chronic bronchitis and emphysema having a predicted baseline forced expiratory volume in 1 second (FEV1) of 35% to 40% were tested and found to have rates of absorption for inhaled insulin that were 2-fold higher than those of subjects without chronic obstructive pulmonary disease (COPD).[23] Although both asthma and COPD are characterized by small airway inflammation, it is not known why inhaled insulin absorption is affected in opposite ways by these disorders.
In patients with mild (FEV180% or more) or moderate (FEV180% or less) asthma, the administration of albuterol 30 minutes before taking inhaled insulin resulted in a 25% to 50% increase in systemic insulin absorption compared with administration of inhaled insulin alone. (Data on file) Inhaled fluticasone appears to have no effect on inhaled insulin absorption, but other medications used for asthma and COPD have not been systematically
This slide summarizes how respiratory factors affect inhaled insulin absorption.
Other Factors Affecting Absorption. In clinical studies of Exubera, episodes of viral upper respiratory infection, laryngitis, and acute bronchitis had no discernible effect in either direction on inhaled insulin absorption. There were not enough cases of pneumonia in phase 2/3 studies to be able to comment on the effects of a more severe infection on inhaled
Respiratory Tract Effects of Inhaled Insulin
Symptoms, Adverse Events. Respiratory safety of inhaled insulin has been a concern for several reasons:
1. It is a novel drug substance with novel excipients that is being inhaled.
2. Its administration is chronic.
3. Insulin is a polypeptide with potential for immune response in the lung.
4. Insulin has growth-promoting properties.
Consequently, respiratory side effects have been looked at closely in phase 2/3 studies.
In some studies, cough has been reported in 22% to 30% of patients with diabetes on Exubera compared with 4% to 10% of patients with diabetes on comparator treatment. (Data on file) The cough tended to occur within seconds to minutes after Exubera inhalation, and was generally rated as mild. The cough was rarely productive and rarely occurred
at night. Cough prevalence was greatest in the first month of use, then decreased by 20% to 40% over the next 3 months, and remained constant thereafter. In clinical studies, only 1.2% of patients discontinued Exubera because of cough. Patients who cough while on Exubera do not, on average, have any change in pulmonary function tests (PFTs) that distinguishes them from those who do not cough. Finally, such patients destined to cough cannot be reliably determined beforehand—they have the same mean pretreatment FEV1 as those patients who do not cough.
Shown here are respiratory adverse events reported in >1% of patients receiving inhaled insulin or a comparator drug (oral medications or subcutaneous insulin) in phase 2/3 studies.[21] Dyspnea has been reported by 4% of patients on Exubera and by 1% to 3% of patients on comparator agents. Nearly all cases were reported as mild or moderate; discontinuation of Exubera due to dyspnea was uncommon (0.4%). In clinical studies, patients with dyspnea were more likely to have a reduction in their pulmonary function, whether they were treated with Exubera or a comparator drug. Additionally, on occasion, the cause of dyspnea was another disease process, unrelated to either the Exubera or the comparator treatment.
Chest pain has been reported in 4.7% of patients on Exubera and in 3.2% of patients treated with subcutaneous insulin or oral antidiabetes medications. Of these patients, 90% rated the pain as mild or moderate. There were no differences in the incidence of angina (1%) and myocardial infarction (1%) between those patients treated with Exubera versus other agents.
Other symptoms reported more often in Exubera-treated patients than in comparator-treated patients include:
1. Increased sputum in 3% to 4% (vs. 1% of comparator patients)
2. Epistaxis in 1.2% (vs. 0.4-0.8%)
3. Voice alteration in 1.3% of patients with type 2 diabetes (vs. 0-0.3%)
4. Dry mouth in 2.4% (vs. 0.8%)[21]
Effects on Pulmonary Function. More than 43,000 PFTs have been performed in over 4600 adult subjects taking inhaled insulin. Spirometry, with measurement of FEV1 and forced vital capacity (FVC), has been used to look for the effects of inhaled insulin on airflow and airway function. Lung volumes, and especially carbon monoxide diffusing capacity of the lung (DLCO), have been used to look for any effect of inhaled insulin on pulmonary
Tuesday, August 18, 2009
foot care for a diabetic-- a ready reckoner
Diabetes mellitus is a metabolic disorder of the pancreatic cells. This is a combination of hereditary factors and lifestyle disturbance.
The general symptoms being Polydipsia(extreme thirst), polyuria (lot of urination) polyphagia increasing need to munch or eat, there are chances of loss of peripheral vision, breathe smells of acetone, weight loss, hyperventilation when it comes to breathing, nausea, vomiting , abdominal pain, glycosuria (sugar in the urine)
What happens here the hormone insulin which regulates the uptake of glucose by the cells reduces in levels, which means the glucose required for cells is reduced.
Diabetic neuropathy is one of the complication diabetes, there is abnormally decreased sensation starting from the feet, and then moves on to the other nerves, it referred to as stocking and glove pattern. If this combines with the damaged blood vessels then we could land with a diabetic foot. This manifests as skin infection, ulcers and may move on gangrene when we are left with no option but to go in for a surgery. In fact diabetic gangrene amputation accounts for the largest non traumatic cause for amputation.
Some common diabetic foot problems
Corns
callus
Ingrown toes
Planter warts
Blisters
Bunion
Hammertoes
Dry cracked skin
Athletes feet
This condition can be avoided by taking proper care of the feet.
The feet have to be checked every day including between the toes.
even if you feel the slightest decrease in sensation to your feet talk to your diabetologist
Cracks, corns, callus of the feet should be brought to the attention of the doctor and not neglected or self medicated.
a moisturising cream can be used on the legs but please avoid using it between the toes it can cause fungal infection
clip your nails following the curve of the nail than straight across, if need be take someone’s help
wash and dry your feet particularly between the toes regularly do it as an evening ritual this will help to gauze the sensation too
never walk barefoot , wear a foot wear even at home
wear comfortable socks when wearing shoes
buying comfortable shoes
Buy a pair that will accommodate abnormalities like bunions or collapsed tarsal plates.
have broad fronts that allow movement and breathing of toes
pick low heels to prevent embarrassing the toes
Have good lace guard or Velcro so that the inner surface does not bruise the skin.
Diabetic foot ulcers are caused by narrowing of the blood vessels and decreased sensation due to peripheral neuropathy, the wound tends to get aggressively infected and necrotic due to the presence of higher blood sugar
For whatever reasons if the foot ulcer does develop then the following care should be taken.
Ulcer should be covered with a dressing
A nurse of a podiatrist should handle the re-dressing till healing is complete
Depending on the size of the ulcer it might require padding to take the pressure off.
Special footwear maybe required to keep the pressure minimum
Antibiotics may be required to keep the infection in control.
If there is cellulites then the puss may have to be drained.
In very severe cases widening of the arteries may be needed.
in all the foot care is essential in a diabetic to prevent amputation of the feet due to development of a diabetic ulcer which in turn is a result of thickened arteries and peripheral neuropathy or loss of sensation in the feet.
Monday, August 17, 2009
Medical ethics
Principles of medical ethicsa physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
A physician shall support access to medical care for all people.
Yet there is an area of grey, decisions and situations demand certain thinking. Hence an entire area of medical ethics and jurisprudence.
Definition:
Is a field of applied science, the study of moral value, judgement as applied to the medicine. As a scholarly discipline, medical ethics encompasses in its practical application in clinical as well as work on its history, philosophy, theology and sociology.
The branch of ethics that examines questions of moral right and wrong arising in the contest of practise of medicine.
History
The field is indebted to the Muslim physician though the antiquity is from the Hippocrates oath. Thomas Percival (1740-1804) used the term medical ethics when he wrote about medical jurisprudence. Eventually it re-invented itself to bioethics.
It was pioneered by Rabbi Immanuel Jacob in 1950. Since this is based on the rabbinic law of halalhah it deeply based in the Jewish faith.
Scope:
Is based on the 4 principles
Autonomy
Beneficence
Nonmaleficience
Justice
Autonomy sanctity of human life is of infinite value.
The religious precept to preserve health is not optional but is mandatory. A patient’s consent is required to perform live saving surgery,
Duty of procreate—abortions, contraception, sterilization are only allowed under emergencies that is to save the mother’s life. Mother’s life more relevant until child birth after which the child is considered as life.
Sanctity of marriage bond precludes any generation of human life outside it. This includes donor insemination or fertilization.
Duty to alleviate pain. It is mandatory to secure relief from pain a person does not own his body, he is only the custodian, cosmetic operations are allowed to promote legitimate end like marriage or employment prospects.
Respect for the dead autopsies is done only if findings can save another human life. Minimum organ transplants are allowed. The cadaver has to be interred with as many organs intact as possible.
Islamic ethics.
Are based on the Koran
Human life is valuable.
A physician takes an oath to protect life at all stages. And rescue it from death, malady, pain and anxiety. To all the way an instrument to Allah’s mercy extending medical care to near and far, virtuous and sinner and friend an enemy.
Contemporary ethics.
Autonomy is the right of an individual to self determination
Beneficence in medical terms means taking action to serve the best interest of the patients there are scholars who feel this claims only a focus on medicine then this takes precedence over autonomy. Cosmetic surgery, contraception, and euthanasia fall beyond its purview.
Non malefiecence is the concept of do no harm it more important not to harm the patient than do them good.
Justice is the patients right to dignity.
Informed consent is when the doctor explains the pros and cons of the patient, his current health scenario and the consequences of treatment. An informed patient then takes his decision.
Confidentiality between the doctor and patient this is privileged information. The doctor can refuse to disclose it even under an oath.
A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
A physician shall support access to medical care for all people.
Yet there is an area of grey, decisions and situations demand certain thinking. Hence an entire area of medical ethics and jurisprudence.
Definition:
Is a field of applied science, the study of moral value, judgement as applied to the medicine. As a scholarly discipline, medical ethics encompasses in its practical application in clinical as well as work on its history, philosophy, theology and sociology.
The branch of ethics that examines questions of moral right and wrong arising in the contest of practise of medicine.
History
The field is indebted to the Muslim physician though the antiquity is from the Hippocrates oath. Thomas Percival (1740-1804) used the term medical ethics when he wrote about medical jurisprudence. Eventually it re-invented itself to bioethics.
It was pioneered by Rabbi Immanuel Jacob in 1950. Since this is based on the rabbinic law of halalhah it deeply based in the Jewish faith.
Scope:
Is based on the 4 principles
Autonomy
Beneficence
Nonmaleficience
Justice
Autonomy sanctity of human life is of infinite value.
The religious precept to preserve health is not optional but is mandatory. A patient’s consent is required to perform live saving surgery,
Duty of procreate—abortions, contraception, sterilization are only allowed under emergencies that is to save the mother’s life. Mother’s life more relevant until child birth after which the child is considered as life.
Sanctity of marriage bond precludes any generation of human life outside it. This includes donor insemination or fertilization.
Duty to alleviate pain. It is mandatory to secure relief from pain a person does not own his body, he is only the custodian, cosmetic operations are allowed to promote legitimate end like marriage or employment prospects.
Respect for the dead autopsies is done only if findings can save another human life. Minimum organ transplants are allowed. The cadaver has to be interred with as many organs intact as possible.
Islamic ethics.
Are based on the Koran
Human life is valuable.
A physician takes an oath to protect life at all stages. And rescue it from death, malady, pain and anxiety. To all the way an instrument to Allah’s mercy extending medical care to near and far, virtuous and sinner and friend an enemy.
Contemporary ethics.
Autonomy is the right of an individual to self determination
Beneficence in medical terms means taking action to serve the best interest of the patients there are scholars who feel this claims only a focus on medicine then this takes precedence over autonomy. Cosmetic surgery, contraception, and euthanasia fall beyond its purview.
Non malefiecence is the concept of do no harm it more important not to harm the patient than do them good.
Justice is the patients right to dignity.
Informed consent is when the doctor explains the pros and cons of the patient, his current health scenario and the consequences of treatment. An informed patient then takes his decision.
Confidentiality between the doctor and patient this is privileged information. The doctor can refuse to disclose it even under an oath.
Saturday, August 15, 2009
Cancer Update from Johns Hopkins
AFTER YEARS OF TELLING PEOPLE CHEMOTHERAPY IS THE ONLY WAY TO TRY (TRY THE KEYWORD) AND ELIMINATE CANCER, JOHNS HOPKINS IS FINALLY STARTING TO TELL YOU THERE IS AN ALTERNATIVE WAY .
1. Every person has cancer cells in the body. These cancer cells do not show up in the standard Tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.
2. Cancer cells occur between 6 to more than 10 times in a person's life time.
3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.
4.. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle (lack of sleep) factors.
5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.
6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinaltract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.
7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.
8... Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.
9 When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.....
10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.
11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.
CANCER CELLS FEED ON:
A. Sugar is a cancer-feeder... By cutting off sugar it cuts off one important food supply to the cancer cells. Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but only in very small amounts. Table salt has a chemical added to make it white in color. Better alternative is Bragg's aminos or sea salt.
B. Milk causes the body to produce mucus, especially in the gastro-intestinaltract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soya milk cancer cells are being starved.
C. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.
D. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment... About 20% can be from cooked food including beans.. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells. To obtain live enzymes for building healthy cells, try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).
E.. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties... Water -- best to drink purified water, or filtered, to avoid known toxins and heavy metals in tapwater.. Distilled water is acidic, avoid it. 12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines become putrified and leads to more toxic buildup. 13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body's killer cells to destroy the cancer cells. 14. Some supplements build up the immune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs, etc.) to enable the body's own killer cells to destroy cancer cells.. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells... 15. Cancer is a disease of the mind, body, and spirit.. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, unforgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life. 16. Cancer cells cannot thrive in an oxygenated environment.. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.
(PLEASE FORWARD IT TO PEOPLE YOU CARE ABOUT) CANCER UPDATE FROM JOHNS HOPKINS HOSPITAL
1. No plastic containers in micro.
2. No water bottles in freezer.
3. No plastic wrap in microwave...
Johns Hopkins has recently sent this out in its newsletters.. This information is being circulated at Walter Reed Army Medical Center as well.Dioxin chemicals causes cancer, especially breast cancer.Dioxins are highly poisonous to the cells of our bodies..Don't freeze your plastic bottles with water in them as this releases dioxins from the plastic. Recently, Dr. Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us. He said that we should not be heating our food in the microwave using plastic containers.This especially applies to foods that contain fat. He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body. Instead, he recommends using glass, such as CorningWare, Pyrex or ceramic containers for heating food. You get the same results, only without the dioxin. So such things as TV dinners, instant and soups, etc.., should be removed from the container and heated in something else.Paper isn't bad but you don't know what is in the paper. It's just safer to use tempered glass, Corning Ware, etc... He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons. Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nuked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food. Cover food with a paper towel instead.
1. Every person has cancer cells in the body. These cancer cells do not show up in the standard Tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.
2. Cancer cells occur between 6 to more than 10 times in a person's life time.
3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.
4.. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle (lack of sleep) factors.
5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.
6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinaltract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.
7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.
8... Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.
9 When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.....
10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.
11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.
CANCER CELLS FEED ON:
A. Sugar is a cancer-feeder... By cutting off sugar it cuts off one important food supply to the cancer cells. Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but only in very small amounts. Table salt has a chemical added to make it white in color. Better alternative is Bragg's aminos or sea salt.
B. Milk causes the body to produce mucus, especially in the gastro-intestinaltract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soya milk cancer cells are being starved.
C. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.
D. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment... About 20% can be from cooked food including beans.. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells. To obtain live enzymes for building healthy cells, try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).
E.. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties... Water -- best to drink purified water, or filtered, to avoid known toxins and heavy metals in tapwater.. Distilled water is acidic, avoid it. 12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines become putrified and leads to more toxic buildup. 13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body's killer cells to destroy the cancer cells. 14. Some supplements build up the immune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs, etc.) to enable the body's own killer cells to destroy cancer cells.. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells... 15. Cancer is a disease of the mind, body, and spirit.. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, unforgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life. 16. Cancer cells cannot thrive in an oxygenated environment.. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.
(PLEASE FORWARD IT TO PEOPLE YOU CARE ABOUT) CANCER UPDATE FROM JOHNS HOPKINS HOSPITAL
1. No plastic containers in micro.
2. No water bottles in freezer.
3. No plastic wrap in microwave...
Johns Hopkins has recently sent this out in its newsletters.. This information is being circulated at Walter Reed Army Medical Center as well.Dioxin chemicals causes cancer, especially breast cancer.Dioxins are highly poisonous to the cells of our bodies..Don't freeze your plastic bottles with water in them as this releases dioxins from the plastic. Recently, Dr. Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us. He said that we should not be heating our food in the microwave using plastic containers.This especially applies to foods that contain fat. He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body. Instead, he recommends using glass, such as CorningWare, Pyrex or ceramic containers for heating food. You get the same results, only without the dioxin. So such things as TV dinners, instant and soups, etc.., should be removed from the container and heated in something else.Paper isn't bad but you don't know what is in the paper. It's just safer to use tempered glass, Corning Ware, etc... He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons. Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nuked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food. Cover food with a paper towel instead.
Wednesday, August 5, 2009
ADIPONECTINE AND DIABETES
~JClinical Endocrinol Metab.2008 27,(Epub ahead of print.)
ABSTRACT
Adiponectine is protein produced by and secreted exclusively by adipocytes. It regulates the metabolism of lipids and glucose. It influences the body response to insulin. It has antiflammatory action on the cells lining the walls of the blood vessels. Increase in Adiponectine decreases risks of heart attacks. The article looks t\at the tests and the conclusion drawn by various researching bodies.
INTRODUCTION
Decreased, Adiponectine levels particularly the heavy molecular weight (HMW) is not only an early indicator of gestation diabetes(GDM) with a potential to progressive diabetes mellitus. higher levels of Adiponectine particularly HMW is associated with type1 diabetes mellitus(T1DM) , and type 2 diabetes mellitus(T2DM) though relation was found between severity of retinopathy and nephropathy but not neuropathy.
Diabetes mellitus:
Diabetes Mellitus (DM) Better known just as "diabetes" -- a chronic disease associated with abnormally high levels of the sugar glucose in the blood. Diabetes is due to one of two mechanisms:(1) Inadequate production of insulin (which is made by the pancreas and lowers blood glucose) or(2) Inadequate sensitivity of cells to the action of insulin.The two main types of diabetes correspond to these two mechanisms and are called insulin dependent (type 1) and non-insulin dependent (type 2) diabetes.. Gestation diabetes mellitus(GDM) is a condition seen in women during pregnancy where there is frank hyperglycemia and glycosuria.
Adiponectine:
Orthologs
Human
Mouse
Entrez
9370
11450
Ensembl
ENSG00000181092
ENSMUSG00000022878
Uniprot
Q15848
Q6GTX4
Refseq
NM_004797 (mRNA)NP_004788 (protein)
NM_009605 (mRNA)NP_033735 (protein)
Location
Chr 3: 188.04 - 188.06 Mb
Chr 16: 23.06 - 23.07 Mb
Symbols--ADIPOQ,ACDC,ACrP30,APM-1 APM1,GBP28,
History -- Adiponectine first characterized in mice as a transcript the human analogue was found in adipose and was found to decrease obesity despite of being created by the adipose cell. The cell was localized to chromosome 3p27 region affecting susceptibility to T2DM and obesity.
Function:
It regulates the metabolism of lipids and glucose.
It influences the body response to insulin
It has antiflammatory action on the cells lining the walls of the blood vessel
Increase Adiponectine decrease risks of heart attacks.
Association of diabetes mellitus and Adiponectine
T1DM is associated with higher levels than healthy subjects. Increase is associated with HMW sub form and is unaffected by gender and diabetic kidney disease.—
T2DM shows higher HMW Adiponectine this is also associated with renal insufficiency
A correlation to HMW Adiponectine was found between severity of retinopathy and nephropathy but not with neuropathy in T2DM
HMW Adiponectine was an independent risk factor for progressive T2DM particularly the HMW isoform
HMW Adiponectine is decreased in GDM deficiency of HMW may indicate an early event in natural T2DM.
RESEARCH
Adiponectine and T1DM
In type 1 diabetes there is no insulin or not enough of it.
T1DM is per se associated with higher Adiponectine level as compared to healthy individuals—a study conducted by Tarnow I,Rosssing P, Parving HH, Flybjerg A. at the medical research laboratories Clinical Institute,Aaarlus university hospital, steno diabetes center Gentofle, department. Of endocrinology, Righshospital University of Copenhagen
Aim: to investigate the distribution of the three molecular subforms of Adiponectine in well characterized group of T1DM with varying degrees of nephropathy and healthy control patients.
The presentation of Adiponectine was seen in 3 isoform.
High molecular weight(HMW) which was a primary active form
Medium molecular weight (MMW) a subforms
Low molecular weight(LMW) an unresolved molecular form
Study-207 patients were studied. The patient distribution was thus.
58 with normal albuminuria
46 with micro albuminuria
46 with macro albuminuria
57 matched control.
A fast protein liquid chromatography was done and results measured with immunoflorometric assay. the results observed where:
The relative concentration of total Adiponectine and all subforms were higher in T1DM that healthy controls.
Relative fractions when up regulated where.
P<0.001 in HMW subforms
P<0.001 in MMW subforms
P<0.05 in LMW subforms.
Levels of total and HMW were unaffected by nephropathy status defined by albumin excretion rate
Unaffected by gender
Unaffected by kidney; disease.
ADIPONECTIN AND T2DM
In type 2 diabetes, there is generally enough insulin but the cells upon it should act are not normally sensitive to its action
The serum HMW Adiponectin concentrations are higher in T2DM with nephropathy and lese levels are also associated with renal insufficiency---is the conclusion drawn by a study conducted by Komba H, Igaki N, Goto S, Yokota K, Doi H, Take moto T, Kohmo , Hirosue Y at the department of internal medicine Takasago Municipal hospital, Japan(hkomba@med.kobe-u.ac.jp )
Aim: was to study if the HMW complex of Adiponectin is associated with renal insufficiency in T2DM
Method: a total of 179 T2DM patients were selected from the outpatient. These patients where then divided to 4 groups depending on the albumin: creatine ratio (n).
Normal albuminuria n=86
Micro albuminuria n=44
Macro albuminuria n= 23
Hemodialysis n=26
This was then specifically assayed for HMW Adiponectin with a commercially available enzyme-linked immunosorbent assay kit.
Results:
Patient condition
Adiponectin level microgms/ml
hemodialysis
17.1+/-8.2
Macroalbuminuria
14.3+/-8.7
Microalbuminuria
10.8+/-7.0
Glomerular filtration rate related negatively with Adiponectin concentrations (r=0.42,p<0’001) in normalalbuminuria, microalbuminuria, and macroalbuminuria when univariate linear regression analysis was done.
pioglitazone therapy, gender differences and systolic blood pressure were independently associated with associated with HMW Adiponectin levels when multiple stepwise regression analysis was disclosed.
With reference to retinopathy and nephropathy in T2DM total Adiponectin and HMW Adiponectin are positively correlated, but not with neuropathy.
~are the results of the study conducted by Kato K, Osawa H, Ochi M, Kusunoki Y, Ebisui O, Ohno K, Ohashi J, ShimizuI, Fuiji Y, Tanimoto M, Makino H of Ehime Prefectural Hospital, Ehime Japan on serum total and high molecular weight Adiponectin levels and correlation with severity of diabetic retinopathy and nephropathy.
Aim: was to determine the relation between serum total or HMW Adiponectin and diabetic microangiopathy.
As Adiponectin is secreted by adipocytes and it improves insulin sensitivity its high molecular weight isoform should be more effective.
Design
Number of patients analyzed 198
Criteria – T2DM patients whose fasting serum samples were available
ELISA(enzyme-linked immunosorbent assay) was used to measure serum total and HMW Adiponectin.
Results:
Increased total serum Adiponectin was seen both in retinopathy and nephropathy.
Serum Adiponectin level in Retinopathy
Mg/l
P<0.004
Serum Adiponectin level in nephropathy
Mg/l
P<0.001
Mean+/-none
Stage I- 7,0+/-0.3
6.9+/- simple
stageII ,7.7+/-0.5
8.3+/-1.0 preproliferate
stageIII 9.5+/-0.9
8.4+/-0.8 proliferative
Stage IV 16+/-4.5
12+/-1.1
Increased HMW Adiponectin was seen both in retinopathy and nephropathy.
Serum HMW Level in retinopathy
Mg/l
P=0.005
Serum HMW level in nephropathy
Mg/l
P=0.007
4.6+/ 0.5
3.7+/0.2
4.6+/0.6
4.3+/0.4
8.4+/0.8
5.3+/0.7
7.9+/2.2
Neuropathy was correlated to neither total Adiponectin nor HMW Adiponectin.
HMW ; total Adiponectin ratio did not correlate to microangiopathy
In retinopathy and nephropathy stage total Adiponectin and HMW Adiponectin were independent factor.
Retinopathy
P=
Nephropathy
P=
0.0055
0.0003
0.0027
0.0018
Other factors that effect independently are age, gender, body mass index, duration of T2DM .these are even more important when serum creatinine, and hypertension are added.
Thiazolidinediones do not affect.
Decreased total Adiponectin is an independent risk factor for the progression to T2DM and HMW is more closely associated
~is the conclusion drawn by Nakashima R,Kamei N, Yamane K, Nakanishi S, Nakashima A, Kohno N.—dept of molecular and internal medicine, graduate school of biomedical sciences, Hiroshima University, 1-2-3 Kauum I Minami_ku, hishoshima city 734-8552 Japan.
Aim: of the study was to assess whether decreased total and HMW Adiponectine are independent risk factors for the development of T2DM
Design.
Japanese-American patients of Hawaii- Los Angels -Hiroshima were enrolled between 1992-2002.
Average follow up was 5.4yrs.
Study demo graph 321 men 445 women
Observation:
112 developed into T2DM had decreased total Adiponectin and HMW Adiponectin level(P<0.001)
In a Cox proportional hazards model, both decreased Adiponectin and HMW Adiponectin were independent factors for progressive diabetic risk after tabulation of waist hip ratio, age, gender, BMI homeostasis and glucose tolerance tests/
Hazards ration
Total 0.600 P=0.018
HMW 0.614 P=0.001
Lowest vs. highest dividing teritiles of Adiponectin and hazard ration were
Total 1,787 (95% confidence interval,1.006-3.173)
HMW 2.493(95% confidence interval, 1.342 – 4.632)
Gestation diabetes mellitus(GDM)
Deficiency of serum HMW Adiponectin may be an early event in the natural history of T2DM--This is the conclusion drawn by Retnakumar R, Connelly PW, Maguire G, Sermer M, Zinman B, Hanner A,- of the division of Endocrinology university of Toronto Canada rretnakumar@mtsinai.on.ca after their study high molecular weight Adiponectin in gestational diabetes. and implication for the patho-physiology of T2DM.
AIM: to determine if low serum levels of HMW was a feature of GDM
Antidiabetic activity of Adiponectin has been conclusive by various recent studies.
Circulatory levels of the HMW were found low in T2DM patients so it could be mediating the antidiabetic action.
GDM identifies a population of women who are at high risk in the future for T2DM.
The study focused to correlate them.
Method:
A total of 121 women were studied at Oral Glucose Tolerance Test (OGTT)
Based on the OGTT 40 women with GDM and 80 women were studied.
The serum was then immunoassayed and measured for HMW isoforms.
Results:
Median HMW was lower in women with GDM (3.5mircogm/ml) as compared to women without (5.5 microgm/ml)(p<0.0001)
After adjusting the covariates the HMW Adiponectin was still lower in GDM women 3.6 vs. 5.3 microgm/l, p<0.001
Insulin sensitivity IS(OGTT) was directly proportional to HMW Adiponectin in the blood r=0.38, p<0.0001
Pancreatic B-cells function is directly proportional to the serum HMW Adiponectin. The insulin sensitivity index shows r = 0.33,p<0.0002
Blood glucose levels including area- under the glucose curve during OGTT was inversely proportional r=0.31,p=0.0007
Multiple linear analysis shows HMW Adiponectin is an independent determinant of AUC (glucose),IS(OGTT) ISSI respectively.
CONCLUSION
Adiponectine is protein produced by and secreted exclusively by adipocytes. It regulates the metabolism of lipids and glucose. It influences the body response to insulin. It has antiflammatory action on the cells lining the walls of the blood vessels. Increase in Adiponectine decreases risks of heart attacks.
REFERENCES
Medicine Net.com
Wikipedia
~JClinical Endocrinol Metab.2008 27,(Epub ahead of print.)
ABSTRACT
Adiponectine is protein produced by and secreted exclusively by adipocytes. It regulates the metabolism of lipids and glucose. It influences the body response to insulin. It has antiflammatory action on the cells lining the walls of the blood vessels. Increase in Adiponectine decreases risks of heart attacks. The article looks t\at the tests and the conclusion drawn by various researching bodies.
INTRODUCTION
Decreased, Adiponectine levels particularly the heavy molecular weight (HMW) is not only an early indicator of gestation diabetes(GDM) with a potential to progressive diabetes mellitus. higher levels of Adiponectine particularly HMW is associated with type1 diabetes mellitus(T1DM) , and type 2 diabetes mellitus(T2DM) though relation was found between severity of retinopathy and nephropathy but not neuropathy.
Diabetes mellitus:
Diabetes Mellitus (DM) Better known just as "diabetes" -- a chronic disease associated with abnormally high levels of the sugar glucose in the blood. Diabetes is due to one of two mechanisms:(1) Inadequate production of insulin (which is made by the pancreas and lowers blood glucose) or(2) Inadequate sensitivity of cells to the action of insulin.The two main types of diabetes correspond to these two mechanisms and are called insulin dependent (type 1) and non-insulin dependent (type 2) diabetes.. Gestation diabetes mellitus(GDM) is a condition seen in women during pregnancy where there is frank hyperglycemia and glycosuria.
Adiponectine:
Orthologs
Human
Mouse
Entrez
9370
11450
Ensembl
ENSG00000181092
ENSMUSG00000022878
Uniprot
Q15848
Q6GTX4
Refseq
NM_004797 (mRNA)NP_004788 (protein)
NM_009605 (mRNA)NP_033735 (protein)
Location
Chr 3: 188.04 - 188.06 Mb
Chr 16: 23.06 - 23.07 Mb
Symbols--ADIPOQ,ACDC,ACrP30,APM-1 APM1,GBP28,
History -- Adiponectine first characterized in mice as a transcript the human analogue was found in adipose and was found to decrease obesity despite of being created by the adipose cell. The cell was localized to chromosome 3p27 region affecting susceptibility to T2DM and obesity.
Function:
It regulates the metabolism of lipids and glucose.
It influences the body response to insulin
It has antiflammatory action on the cells lining the walls of the blood vessel
Increase Adiponectine decrease risks of heart attacks.
Association of diabetes mellitus and Adiponectine
T1DM is associated with higher levels than healthy subjects. Increase is associated with HMW sub form and is unaffected by gender and diabetic kidney disease.—
T2DM shows higher HMW Adiponectine this is also associated with renal insufficiency
A correlation to HMW Adiponectine was found between severity of retinopathy and nephropathy but not with neuropathy in T2DM
HMW Adiponectine was an independent risk factor for progressive T2DM particularly the HMW isoform
HMW Adiponectine is decreased in GDM deficiency of HMW may indicate an early event in natural T2DM.
RESEARCH
Adiponectine and T1DM
In type 1 diabetes there is no insulin or not enough of it.
T1DM is per se associated with higher Adiponectine level as compared to healthy individuals—a study conducted by Tarnow I,Rosssing P, Parving HH, Flybjerg A. at the medical research laboratories Clinical Institute,Aaarlus university hospital, steno diabetes center Gentofle, department. Of endocrinology, Righshospital University of Copenhagen
Aim: to investigate the distribution of the three molecular subforms of Adiponectine in well characterized group of T1DM with varying degrees of nephropathy and healthy control patients.
The presentation of Adiponectine was seen in 3 isoform.
High molecular weight(HMW) which was a primary active form
Medium molecular weight (MMW) a subforms
Low molecular weight(LMW) an unresolved molecular form
Study-207 patients were studied. The patient distribution was thus.
58 with normal albuminuria
46 with micro albuminuria
46 with macro albuminuria
57 matched control.
A fast protein liquid chromatography was done and results measured with immunoflorometric assay. the results observed where:
The relative concentration of total Adiponectine and all subforms were higher in T1DM that healthy controls.
Relative fractions when up regulated where.
P<0.001 in HMW subforms
P<0.001 in MMW subforms
P<0.05 in LMW subforms.
Levels of total and HMW were unaffected by nephropathy status defined by albumin excretion rate
Unaffected by gender
Unaffected by kidney; disease.
ADIPONECTIN AND T2DM
In type 2 diabetes, there is generally enough insulin but the cells upon it should act are not normally sensitive to its action
The serum HMW Adiponectin concentrations are higher in T2DM with nephropathy and lese levels are also associated with renal insufficiency---is the conclusion drawn by a study conducted by Komba H, Igaki N, Goto S, Yokota K, Doi H, Take moto T, Kohmo , Hirosue Y at the department of internal medicine Takasago Municipal hospital, Japan(hkomba@med.kobe-u.ac.jp )
Aim: was to study if the HMW complex of Adiponectin is associated with renal insufficiency in T2DM
Method: a total of 179 T2DM patients were selected from the outpatient. These patients where then divided to 4 groups depending on the albumin: creatine ratio (n).
Normal albuminuria n=86
Micro albuminuria n=44
Macro albuminuria n= 23
Hemodialysis n=26
This was then specifically assayed for HMW Adiponectin with a commercially available enzyme-linked immunosorbent assay kit.
Results:
Patient condition
Adiponectin level microgms/ml
hemodialysis
17.1+/-8.2
Macroalbuminuria
14.3+/-8.7
Microalbuminuria
10.8+/-7.0
Glomerular filtration rate related negatively with Adiponectin concentrations (r=0.42,p<0’001) in normalalbuminuria, microalbuminuria, and macroalbuminuria when univariate linear regression analysis was done.
pioglitazone therapy, gender differences and systolic blood pressure were independently associated with associated with HMW Adiponectin levels when multiple stepwise regression analysis was disclosed.
With reference to retinopathy and nephropathy in T2DM total Adiponectin and HMW Adiponectin are positively correlated, but not with neuropathy.
~are the results of the study conducted by Kato K, Osawa H, Ochi M, Kusunoki Y, Ebisui O, Ohno K, Ohashi J, ShimizuI, Fuiji Y, Tanimoto M, Makino H of Ehime Prefectural Hospital, Ehime Japan on serum total and high molecular weight Adiponectin levels and correlation with severity of diabetic retinopathy and nephropathy.
Aim: was to determine the relation between serum total or HMW Adiponectin and diabetic microangiopathy.
As Adiponectin is secreted by adipocytes and it improves insulin sensitivity its high molecular weight isoform should be more effective.
Design
Number of patients analyzed 198
Criteria – T2DM patients whose fasting serum samples were available
ELISA(enzyme-linked immunosorbent assay) was used to measure serum total and HMW Adiponectin.
Results:
Increased total serum Adiponectin was seen both in retinopathy and nephropathy.
Serum Adiponectin level in Retinopathy
Mg/l
P<0.004
Serum Adiponectin level in nephropathy
Mg/l
P<0.001
Mean+/-none
Stage I- 7,0+/-0.3
6.9+/- simple
stageII ,7.7+/-0.5
8.3+/-1.0 preproliferate
stageIII 9.5+/-0.9
8.4+/-0.8 proliferative
Stage IV 16+/-4.5
12+/-1.1
Increased HMW Adiponectin was seen both in retinopathy and nephropathy.
Serum HMW Level in retinopathy
Mg/l
P=0.005
Serum HMW level in nephropathy
Mg/l
P=0.007
4.6+/ 0.5
3.7+/0.2
4.6+/0.6
4.3+/0.4
8.4+/0.8
5.3+/0.7
7.9+/2.2
Neuropathy was correlated to neither total Adiponectin nor HMW Adiponectin.
HMW ; total Adiponectin ratio did not correlate to microangiopathy
In retinopathy and nephropathy stage total Adiponectin and HMW Adiponectin were independent factor.
Retinopathy
P=
Nephropathy
P=
0.0055
0.0003
0.0027
0.0018
Other factors that effect independently are age, gender, body mass index, duration of T2DM .these are even more important when serum creatinine, and hypertension are added.
Thiazolidinediones do not affect.
Decreased total Adiponectin is an independent risk factor for the progression to T2DM and HMW is more closely associated
~is the conclusion drawn by Nakashima R,Kamei N, Yamane K, Nakanishi S, Nakashima A, Kohno N.—dept of molecular and internal medicine, graduate school of biomedical sciences, Hiroshima University, 1-2-3 Kauum I Minami_ku, hishoshima city 734-8552 Japan.
Aim: of the study was to assess whether decreased total and HMW Adiponectine are independent risk factors for the development of T2DM
Design.
Japanese-American patients of Hawaii- Los Angels -Hiroshima were enrolled between 1992-2002.
Average follow up was 5.4yrs.
Study demo graph 321 men 445 women
Observation:
112 developed into T2DM had decreased total Adiponectin and HMW Adiponectin level(P<0.001)
In a Cox proportional hazards model, both decreased Adiponectin and HMW Adiponectin were independent factors for progressive diabetic risk after tabulation of waist hip ratio, age, gender, BMI homeostasis and glucose tolerance tests/
Hazards ration
Total 0.600 P=0.018
HMW 0.614 P=0.001
Lowest vs. highest dividing teritiles of Adiponectin and hazard ration were
Total 1,787 (95% confidence interval,1.006-3.173)
HMW 2.493(95% confidence interval, 1.342 – 4.632)
Gestation diabetes mellitus(GDM)
Deficiency of serum HMW Adiponectin may be an early event in the natural history of T2DM--This is the conclusion drawn by Retnakumar R, Connelly PW, Maguire G, Sermer M, Zinman B, Hanner A,- of the division of Endocrinology university of Toronto Canada rretnakumar@mtsinai.on.ca after their study high molecular weight Adiponectin in gestational diabetes. and implication for the patho-physiology of T2DM.
AIM: to determine if low serum levels of HMW was a feature of GDM
Antidiabetic activity of Adiponectin has been conclusive by various recent studies.
Circulatory levels of the HMW were found low in T2DM patients so it could be mediating the antidiabetic action.
GDM identifies a population of women who are at high risk in the future for T2DM.
The study focused to correlate them.
Method:
A total of 121 women were studied at Oral Glucose Tolerance Test (OGTT)
Based on the OGTT 40 women with GDM and 80 women were studied.
The serum was then immunoassayed and measured for HMW isoforms.
Results:
Median HMW was lower in women with GDM (3.5mircogm/ml) as compared to women without (5.5 microgm/ml)(p<0.0001)
After adjusting the covariates the HMW Adiponectin was still lower in GDM women 3.6 vs. 5.3 microgm/l, p<0.001
Insulin sensitivity IS(OGTT) was directly proportional to HMW Adiponectin in the blood r=0.38, p<0.0001
Pancreatic B-cells function is directly proportional to the serum HMW Adiponectin. The insulin sensitivity index shows r = 0.33,p<0.0002
Blood glucose levels including area- under the glucose curve during OGTT was inversely proportional r=0.31,p=0.0007
Multiple linear analysis shows HMW Adiponectin is an independent determinant of AUC (glucose),IS(OGTT) ISSI respectively.
CONCLUSION
Adiponectine is protein produced by and secreted exclusively by adipocytes. It regulates the metabolism of lipids and glucose. It influences the body response to insulin. It has antiflammatory action on the cells lining the walls of the blood vessels. Increase in Adiponectine decreases risks of heart attacks.
REFERENCES
Medicine Net.com
Wikipedia
Tuesday, August 4, 2009
An introduction to homeopathy.
Inputs from Dr.Arvind kothePrincipal Kamaxi homeopathy college
Shiroda Goa.
Homeopathy is an individualistic mode of drug therapy based on the law of seemlier
This essentially means that the portrait of the drug and the portrait of the disease should match. The history of the patient is taken and matched with the remedy.
The study of the drug portrait is such that it should match the portrait of the disease and then the drug is administrated this is essentially homeopathy defined.
In practice also seemlier also deals with individuality what is individuality in this context?
Disease is the response of individual to unfavorable environment. E.g. The temperature increase may be tolerated by some, while some find the need to turn on the fan while others would require the air cooler.
The reaction to unfavorable condition manifests as signs and symptoms. The symptoms manifested can be physical emotional or mental level. When collected adequately we get an aggregate of symptoms.
This aggregate is then shifted to pinpoint the causative.
The patient might manifest symptoms that do not match with the general portrait of the disease. This long side with constitution of the person (things like physical build, temperature etc. Helps to create a profile. Peculiar symptoms + constitution f the man + body build +body temperature +relation to environment makes the homelier.
Homelier + history + ingrained past history=> totality
Learning medicine is necessary as unless you know the normal it is not possible to perceive the abnormal, the study of the mind becomes essential for physiology +psychology is what helps you to achieve the totality.
The detail proforma of the patient is drawn by detailed history; taking. There are times it could take an hour or two. (standard proforma has been evolved by the Kamaxi homeopathy college.
Homeopathy also as a concept called potenstiastion which is unique to it. Here it is percolations to the minimum dose.
The source of medication like all other systems are plant, mineral and animal. This is diluted by 99% in sugar/alcohol.
This dilution is conducted to the limit where it becomes an energy form such that it stimulates the system and acts on the body. There is strengthening the immune system. Hence the prescription is a total systemic cure and not disease focused. This term as monopharmacy—where multiple symptoms ar not treated wit multiple drugs but a single medication is administered.
Homeopathy is excellent option when it comes to
Pediatrics
Dermatology
Psycho-somatic disorders.
This does not mean it is restricted to these. Homeopathy can independently treat a lot of diseases, and act as an alley to others.
Being an young stream, it has picked the best from the existing streams.
On the flip side clinical trails are just being standardized and acknowledged. Various research centers are just getting acceptability.
Shiroda Goa.
Homeopathy is an individualistic mode of drug therapy based on the law of seemlier
This essentially means that the portrait of the drug and the portrait of the disease should match. The history of the patient is taken and matched with the remedy.
The study of the drug portrait is such that it should match the portrait of the disease and then the drug is administrated this is essentially homeopathy defined.
In practice also seemlier also deals with individuality what is individuality in this context?
Disease is the response of individual to unfavorable environment. E.g. The temperature increase may be tolerated by some, while some find the need to turn on the fan while others would require the air cooler.
The reaction to unfavorable condition manifests as signs and symptoms. The symptoms manifested can be physical emotional or mental level. When collected adequately we get an aggregate of symptoms.
This aggregate is then shifted to pinpoint the causative.
The patient might manifest symptoms that do not match with the general portrait of the disease. This long side with constitution of the person (things like physical build, temperature etc. Helps to create a profile. Peculiar symptoms + constitution f the man + body build +body temperature +relation to environment makes the homelier.
Homelier + history + ingrained past history=> totality
Learning medicine is necessary as unless you know the normal it is not possible to perceive the abnormal, the study of the mind becomes essential for physiology +psychology is what helps you to achieve the totality.
The detail proforma of the patient is drawn by detailed history; taking. There are times it could take an hour or two. (standard proforma has been evolved by the Kamaxi homeopathy college.
Homeopathy also as a concept called potenstiastion which is unique to it. Here it is percolations to the minimum dose.
The source of medication like all other systems are plant, mineral and animal. This is diluted by 99% in sugar/alcohol.
This dilution is conducted to the limit where it becomes an energy form such that it stimulates the system and acts on the body. There is strengthening the immune system. Hence the prescription is a total systemic cure and not disease focused. This term as monopharmacy—where multiple symptoms ar not treated wit multiple drugs but a single medication is administered.
Homeopathy is excellent option when it comes to
Pediatrics
Dermatology
Psycho-somatic disorders.
This does not mean it is restricted to these. Homeopathy can independently treat a lot of diseases, and act as an alley to others.
Being an young stream, it has picked the best from the existing streams.
On the flip side clinical trails are just being standardized and acknowledged. Various research centers are just getting acceptability.
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