The Coldest Places In India You Need To Visit

India is considered to be the land of never-ending summer; this, of course, can be held true for Rajasthan, parts of Gujarat and the southernmost states. Read any other country’s guide to visiting India, and you’ll be surprised to see the hot, humid climate warnings everywhere.

In all honesty, this is one of the biggest myths about India. What most people don’t realize that India’s topography and climate are as diverse as its people, and one can experience the blazing desert heat, the severe cold of the Himalayas and everything else in between.

While most of us in the plains have this constant urge to leave to the mountains and never return, it’s just not feasible to pack your bags to not look back. What you can do instead is read through such inspiring posts and give your thoughts a chill. A bit of day-dreaming won’t do you any harm.

Read on to know of the coldest places in India.

1. Dras

State: Jammu and Kashmir

Elevation: 3,280 meters above sea level

Often referred to as the ‘Gateway to Ladakh’, Dras is a solitary town in the infamous district of Kargil. Known as the coldest place in India, Dras is also considered to be the second coldest inhabited place in the world, losing only to Oymyakon in Russia.

With average lows as much as -22°C, temperature stoops down to -50°C in the extreme winter.

2. Kargil

State: Jammu and Kashmir

Elevation: 2,676 meters above sea level

Situated along the banks of Suru River, Kargil became known to the masses during the infamous war against Pakistan in 1999. Located just about 10 kilometers from the India-Pakistan border, Kargil is a popular summer destination with a number of adventure activities including high-altitude trekking, river rafting, mountaineering, etc.

3. Leh and Ladakh

State: Jammu and Kashmir

Elevation: 3,500 meters above sea level

The paradise for bikers and adventure enthusiasts, Leh is the capital of the ancient kingdom of Ladakh. The temperature in the winter stoops as low as -42°C and hovers between 5-7°C during the summer.

4. North Sikkim

State: Sikkim

Elevation: 3,500 meters above sea level

Home to the third highest mountain in the world, i.e. Kanchenjunga, North Sikkim is one of the coldest places in India. With alpine forests dissolving into the Tundra, the temperature in the region falls down to -40°C in the winter.

5. Spiti

State: Himachal Pradesh

Elevation: 4,000 meters above sea level

An underrated Himalayan desert, Spiti is relatively lesser known than Leh and Ladakh. Make the most out of it while it’s still not known to the commoners. The valley is surreal, mystical and enchanting, perhaps nothing like you have seen before. Kaza, the district headquarter of Spiti is one of the coldest towns in the vicinity with the average temperature in winter hovering around -45°C.

Benefits of Prenatal Vitamins

An extremely life changing experience is having a baby. Prenatal Vitamins is the one thing that you should remember in all the excitement of planning nurseries and buying cribs and cute baby clothes, and much before you even conceive.

Yes, prenatal vitamins are a must in today’s lifestyle where women do not meet their sufficient nutrition requirements from food alone. Most women don’t have time to eat proper nutritious food because it’s a hectic, fast paced life. So, you need to consult your doctor and start taking vitamins, if you’re planning to have a baby, before conception itself.

Prenatal vitamins have to be taken prior to, during and even after pregnancy simply because at this crucial time the body’s stores are depleted as the body prepares for the baby.

Why are prenatal vitamins vital?

Prenatal vitamins contain a combination of important vitamins and minerals that are required for the healthy growth of the baby. If these vitamins are taken at least six months prior to conception, then the chances of birth defects are reduced greatly.

Medical studies have shown that most birth defects usually occur within the first 28 days after conception and sometimes women aren’t even aware that they have conceived. The only way in which birth defects can be avoided or prevented are when you take prenatal vitamins before conception. Most birth defects can be prevented by a program of wholesome prenatal nutrition. Folic acid is only one of a long list of nutrients such as omega-3 fatty acids that reduce birth defects and boost the health of newborns.

Some of the vitamins and minerals that you can find in a common prenatal vitamin are:

Folic acid – This is one of the most important components of a vitamin. Folic acid helps tremendously in reducing the occurrence of neural defects such as spina bifida. Spina bifida occurs in the earliest stages of pregnancy when the spinal cord is not closed, exposing the nerves and resulting most often in paralysis and even mental retardation.

Natural sources of folic acid include green leafy vegetables, nuts, orange juice and other citrus fruits. Despite these sources, if you want to make sure you have adequate folic acid, it is better to take a supplement in the form of a vitamin. Folic acid is also known to prevent another serious defect, hydrocephalus, which is an incurable condition in which cerebrospinal fluid abnormally gathers in the brain’s cavities causing neurological dysfunction. Doctors recommend at least 400 mcg of folic acid in a day.

Calcium – Calcium is found in natural sources such as dairy products, eggs, soya beans, nuts and fish although it is highly recommended that you take supplements as they can be absorbed better by the body. As the fetus grows inside the body, it starts depleting the calcium in the bones of the mother’s body because it requires them for its own growth. Due to this, you could lose your own bone density and it could cause numerous problems later on, osteoporosis being just one of them. Calcium supplements provide the growing fetus with the required calcium sources.

Iron – When you are pregnant, the body produces more blood and as a result uses up more iron from the body. One of the most common problems that pregnant women are beset with is anemia. Because of this iron deficiency, anemia occurs and can cause fatigue and tiredness. Other complications could also result because of anemia. Iron supplements however are typically taken after the first trimester.

The proper prenatal vitamin

It’s effortless to secure a prenatal vitamin over the counter these days, but if you are specific about your and the baby’s health, a good idea would be to consult with your doctor before you conceive and ask them to recommend one for you. The reason is that your physician knows your medical history and will be equipped to suggest a prenatal vitamin that has all the perfect components of vitamins and minerals for you.

Possible risks linked with prenatal vitamins

While prenatal vitamins are essentially good for a pregnant woman or one who is planning to conceive, sometimes they also come with a few risk factors. Some prenatal vitamins can trigger side effects of an allergic nature such as hives, swelling of throat and mouth or difficulty in breathing. If any of these reactions occur, you should consult your doctor quickly.

A few over enthusiastic individuals sometimes consume multiple supplements and this can cause more harm than good because excess levels of certain vitamins in the body can become toxic. Other minor problems include nausea or constipation and doctors recommend that you drink a full glass of water while taking prenatal vitamins.

Barring this, prenatal vitamins are excellent sources of important nutrients for the mommy and the baby. Of course, you should include fresh and nutritious food in your diet as well and not exclusively depend on vitamins.

Good to know:

Scientific studies of women taking prenatal vitamins have shown that they can greatly reduce the risk of cancer, neuroblastoma and brain tumors in their children.

Inside A Fat Burning Program

People spend millions of dollars every time on fat burning pills, creams and for surgeries. After a while, the pile of fat will just come back and take their place. It is high time we all understand that it is only by adjusting our lifestyles and the way we eat that we can really lose fat and maintain our stature.

There are a lot of theories on fat burning program propounded by different people. But the truth remains that you will definitely not see results if you have not altered two very important things in your life: exercise and diet.

Every morning, enjoy a thirty to forty minutes aerobic workout. This will help you burn calories. Mix your morning workouts with running or proper jogging. Exercise will help you keep motivation through the fat burning program.

The second step is the nutritional approach – by altering what you eat. Carefully selecting foods will help you stay away from eating too many calories a day. Our body system tends to burn the same amount of calorie we take. If you are eating less food thinking that you will get slim, you are quite wrong. You have got to be eating well, but also be careful in your food choices and how you eat them.

Consume 4 to 5 smaller meals each day. Each of these meals should not contain more than 400 calories. If you can not do with this, do not worry, eat fruits in between meals. After each meal you can eat fruits and vegetables to help satiate excess hunger. Why is it beneficial to eat smaller meals everyday? The metabolic process of our body system increases by 10% immediately after a meal due to metabolism. Having smaller meals will keep your metabolic rate high, thereby breaking and removing more calories as waste.

Supplements can also be used. Before you start using supplements, speak to your physician and have them direct you on what and how to take them. Any weight loss program you prefer should begin right now, to restore that lost confidence in yourself and make you fit for the future.

Health Issues – Healthy Mothers Deliver Healthy Babies

In the fast life of the day, one often delays the issue of marriage; children and health issues are pushed as further away as possible, as issues of finance gain precedence over all the other issues. Often, career is the main concern. It is very difficult to get into a career of one’s choice in the first place and to maintain it is even more difficult. Therefore, when the question of pregnancy arises, one immediately gets visions of unemployment, which brings jitters of fear. There are other issues as well, like family compulsions and physical weaknesses, which need to be cleared, before one can decide to become a mother. Usually one is so engrossed with one’s work that one easily crosses the age of healthy pregnancy. However, it should not be so, and this is where pre pregnancy planning gains importance. Health issues, foods, women’s most fertile period, all these important considerations should remain in the mind of every woman to deliver healthy babies.

Keep Your Mind And Body Fit

When women older than 35 years decide to get pregnant, they can have congenital abnormalities in the newborn baby. As one ages, one also catches some form of illness or the other. High blood pressure, diabetes, blood pressure, anxiety, piles, weakness in the bones and limbs are some of the common ailments of today’s environment. In case the mother has any of the above, which is not treated properly before conceiving, the prospective child can have many abnormalities.

Some Common Ailments

Hypertension is common when twins are born. Older women too have this condition. During the stage of pregnancy planning, a well-controlled regimen of exercise can handle hypertension. One has to be very cautious in this stage. Constant monitoring is required under the guidance of a qualified medical practitioner. You need to remain stress free, and in a diet plan that keep a check on your weight. A little meditation also helps in curing hypertension. You also have to take medicines recommended by the doctor.

Diabetes is a disease that does not allow you to die and it does not allow you to live as well. In a natural condition the level of sugar in the blood rises with every intake of food and liquid. The pancreas of the body creates a chemical called insulin, which neutralizes the raised sugar content in blood. Under the influence of diabetes, pancreas stops creating insulin and the sugar level continues to rise, affecting the organs of the body. If diabetes is not controlled, you might lose your kidneys, eyes, heart and other organs of your body one by one. Diabetes can be controlled by administering insulin by injection. This condition needs to be in full control at the pre pregnancy planning stage lest this disease cripples the infant.

Heart diseases are common concerns of doctors worldwide nowadays. Especially with couples who wish to become parents at a later stage in their life, doctors insist on a complete checkup for defects in the valve, rheumatic heart disease, hole in the heart etc. After all clearances, the consultant decides whether you should become parents or not. Parents with heart disease are advised complete bed rest in the pre-pregnancy planning period. Any miscalculation can lead to a miscarriage or premature fetal death.

There are other diseases like thyroid, cancer, tuberculosis that need to be disclosed, and discussed in complete confidence with your consultant. The advice of the consultant is the final word in this matter, after all tests to consider competency have been conducted. Never ever, hide such illness, as they can be fatal for the mother and or the baby.

Genetic disorders, exposure to radiation and other harmful fluid (as in factories), Urinary infections and venereal diseases are some other reasons for would-be mothers to remain on their toes. Always be very sure of your medical condition before you attempt to become a mother.

Cancer Prevention: Our Very Best Anti Aging Serum

Cancer prevention is the ultimate proactive health care and our very best anti aging serum.

There is a strong belief about cancer – every one of us is walking around with some form of cancer… lurking within… the billion dollar question to our health, our future, our destiny… what will cause that cancer to grow becoming a life threatening illness, or what within our body will be able to suppress the terror alert, and we go on enjoying life. In the 1920’s, Dr. Otto Warburg, defined critical characteristics of the cancer cell. Cells could become cancerous if oxygen intake had been deprived by more than 35%. To survive, they become anaerobic cells – which means they can survive without oxygen (making it a “tougher” stronger survival of the fittest cell). That is the beast of the cancer cell. It ferments glucose (sugar!!!!!!!!!), fears oxygen like Superman and Kryptonite, and divides out of control.

“Oxidation” is a term for the process of removing electrons from an atom or molecule. Contrary to what the word itself implies, Oxygen is not the only culprit (oxidizing agent), there are many. Yes we need oxygen to live however our health, protection from the nasties of aging, cancer prevention is all about keeping a balance within between oxidative stress (producing free radicals) and antioxidants, our best cancer prevention. Think of antioxidants as the fire free radical extinguishers… providing electrons where needed. The best known ones are foods that contain vitamin C (our raw fruits and vegetables, cooking kills vitamin c) and vitamin E (nuts, seeds, AVOCADO (my fav), fish, olive oil. There is NO need to take vitamin C. Every couple of hours eat a Vitamin C rich food (only lasts in the body for a few hours) and please, unless prescribed by a healthcare professional, please do not take vitamin E supplements.

By creating an inner ecosystem, our biochemical terrain that is hostile to cancer, this same anti cancer environment removes the welcome mat for inflammation, immune system robbers and aging.

We throw around the concept of inflammation a lot in the cancer world, obesity, heart disease, aging… so lets just take a brief moment on inflammation: Leading causes: smoking, lack of sleep, lack of exercise, activation of stress hormones, alcohol, sugar, Omega 6 oils such as vegetable oils, trans fats… An anti-inflammatory diet is rich in Omega 3s, probiotics, fish, best oils are avocado, canola, sesame, olive oil. But when choosing foods, please keep it simple and pure. Don’t listen to the marketing on the product… they are out to sell you product not advise you on your health. Read the nutritional information yourself.

If you look at the major cancers of our time: Breast, Prostate, colorectal, kidney, lung, lymphoma… and look at the biochemical terrain that supports the growth of these cancers, either inflammation and/or glycemia (sugar levels) are factors in each and every one of them. Even if a cancer is removed through chemotherapy, radiation or surgery, if the biological environment has not been modified to become hostile toward cancer – the odds are greatly increased the cancers will multiply and return.

The best cancer treatment is cancer prevention. By:

An anti-inflammatory lifestyle with appropriate exercise and nutrition

Limiting sugar, alcohol,

Eliminating smoking and sedentary lifestyle (desk job still not an excuse!)

We can feel great, look great and minimize our risk of obesity, heart disease, cancer, diabetes an array of other illnesses… and yes, is the very best anti aging treatment!

Best Low-Sugar Fruits For Diabetics

Nowadays, a lot of people have been suffering from health conditions, one of which is diabetes. Diabetes is a condition where a person's blood sugar gets high because his body does not produce enough insulin. Proper diet should be considered to stay healthy always.

Choosing the right meal to eat has been a challenge for people with diabetes. They have to watch for the sugar content of each food to take. But then, a well-balanced diet should still be observed.

Here are some fruits that diabetics can eat without worrying.

Raspberries, blackberries and cranberries are low-sugar fruits that you can have to watch your sugar intake if you are more of a fruit person. Some low to medium sugar content fruits are papaya, melon, watermelon, peaches, strawberries, apples and blueberries. You should not devour these fruits since you might have a sudden increase in sugar. Eating these fruits needs a bit of discipline.

You should also watch yourself from plums; Kiwis, pears, pineapple and oranges for these fruits have fairly high sugar content. And please beware from cherries, grapes, tangerines, pomegranates, mangoes, bananas and some dried fruits like prunes, dates and raisins because they have very high sugar content.

But whatever fruits you want to eat and add to your diet, you have to make sure that you are aware of its sugar content. Asking your doctor is always the best option. Making a food diary to plan your day to day meal is also highly advisable. That way you can be sure that you are not going beyond the limit and that you are not compromising your health as well.

They say, an ounce of prevention is better than a pound of cure. So, even if you are already on medication and that you can always grab a pill or two to level your sugar again, knowing what you need to eat to stay healthy will always be better.

Dealing With Racquetball Injuries

Playing any type of sports always entails risks of injuries. Racquetball is one sports activity that can be risky looking at the speed of play and the equipments used (racquets and balls).

Nevertheless, it is a presented with that sports injuries C severe, superficial or critical C can always be avoided, if you take safeguards. Apart from the protection gears you need to wear, the next are some reminders for you to deal with your racquetball-related injuries.

Eye protection

Racquetball is reckoned a lightweight sport when equated with others which can produce some terrible critical injuries. Alternatively, it is one of the most injury-prone sports because of the speed of the ball traveling within the small confines of the playing court.

Ninety- 5% of these injuries contains being hit in the eyes by the ball. Interior bleeding in the eye socket, lacerations, bleeding eyelids, abrasions, swollen eyes C these are the a lot off the most commonplace eye injuries.

Wearing correct eye gear prevents fundamental injuries to the eye. Be certain to check if your goggles are the right way recommended by the American Standard of Testing and Materials, and the Canadian Standards Association.

Feet protective cover

Racquetball is one game where you do a lot of running. It follows that you need to maintain your feet all during the game.

Ankle sprains can sideline you for in any case 7 days and disrupt your activities. Achilles tendon injuries are rare but they need correct medical care.

Blisters and calluses occur most often if you possess the wrong footwear or if they are a new pair and had not been broken in yet. Dont throw the old pair until you have the new ones fit your feet just right. Afterwards, you can play a hard game with them.

Elbow protective cover

They might call it tennis elbow, but this injury also happens to racquetball players. (Only 5% of all cases happen to tennis players.)

Manifestations incorporates pain around the elbow joint, with tenderness occurring on or underneath the bony bump. Natural expansive arm movements (even simple grip movements) can lead to pain and exacerbate the injury. Follow your physicians advice.

Next, talk over with your racquetball expert for incorrect technique in racquet handling. Is your grip wrong? What about the mass and type of your racquet?

Shoulder protection

Shoulder injury is caused by utilizing the shoulders C and not the right way using the side of the body C in swinging your racquet. These injuries generally develop from a past fall or a slam on the wall.

Remember: Use the entire side of the body in swinging the racquet, NOT the shoulders.

Knee protective cover

All the running and pivoting around on your feet is tough on your knees. In racquetball, all kinds of knee injuries are possible.

These injuries are sneaky, too. They commence with a dull ache somewhere around the sides or back of the knee right after playing. Later, the anguish arrives before, during, and after your play.

Get yourself a professional to teach you the proper stretching and conditioning program for your knees. (While you are at it, you may incorporate all the necessary conditioning moves for all the parts of the body that complement your racquetball playing.)

Racquetball is supposed to be fun. Avoid injuries before they can happen.

Speaking To Connect

In 1989, my first semester of college, I learned a valuable lesson. I was taking a calculus course, but I learned a lesson in public speaking. The professor was quite intelligent and could solve any integral on earth. Her calculus was perfect, but she forgot one small detail – the audience. The professor spoke too fast for us to learn the subject. She was most concerned with presenting the greatest number of problems in the least amount of time with 100% accuracy.

I learned a powerful lesson in public speaking. I learned that it's more important to strive for connection with the audience than to have technically perfect information that the audience does not fully grasp. Dale Carnegie and his Carnegie Institute of Technology pointed out this interesting fact as a result of extensive research. "Even in such technical lines as engineering, about 15% of one's financial success is due to one's technical knowledge and about 85% is due to skill in human engineering, to personality and the ability to lead people." When done correctly, speaking can open doors that pure academic information alone can not.

For starters, it opens the door that separates teachers from students. In my calculus class, for example, many students were unable to follow the lessons. Personally, I believe the students who enrolled in the class have a certain responsibility to adjust to the professor's teaching style – even if it's difficult. In the real world, it is often the many employees who must adjust to the one manager. From a practical perspective, it takes a lot less energy for me as a speaker to lead by example. If I want my students or employees to adjust, I have the opportunity to show them how to discipline myself to change – even when I do not want to do it. This is the first reason to focus on connecting over perfecting.

Speaking can also build a solid reputation more quickly. Again, referring to my calculus course, when the professor chose perfection over connection, it built her reputation quickly. It just was not the reputation that best served our education. When you are presenting an idea, you are essentially selling. You want the audience to convert from lookers to listeners and from listeners to buyers. When I say, "buy", I mean they accept your proposal. You persuade them to share your position. They learn what you are trying to teach. A favorable reputation makes the task of connecting easier.

Finally, speaking can help you to increase your income. I realize that everyone does not want to become a professional speaker. Beside, people do not pay for speaking. People pay for solutions to problems. You are more likely to increase

Income in any business when you can succinctly tell people what you do and how you can help to solve their problems. If they believe you can solve a problem for them, they will gladly contribute to your increase in income.

Here are some tips to help you connect with any audience to whom you speak.

1. Know your material – this fosters confidence – a major key to connecting.

2. Order – Study the sequence of your thoughts instead of perfecting every sentence word for word. This will alleviate stress and allow you to focus on connecting.

3. Eye contact – Looking at a person while you make your point (s) helps to develop trust between you.

4. Tell stories – Stories do more than entertain. They also endear you to your audience.

5. Blend in – Meet the audience before your speech. Get to know them and your 'speech' can feel more like a conversation among friends.

6. Act enthusiast – if you are not excited about your topic, do not expect anyone to stay awake.

It does not matter if you are teaching calculus to college students, strategies to salesmen or the value of commodities to consumers, you must connect if you want others to learn from you. As you build your reputation, connecting becomes easier. Ultimately, you give others a reason to hire you or send you opportunities to increase your business. Connecting is the bottom line. When you prepare for your next speaking opportunity, do not practice to perfect. Prepare to connect.

Self-Help Research

                                               SELF-HELP

                        HOW TO OVERCOME FEAR

    ACONITE Napellus is a poisonous plant (called “dakra” in Hindi).  It is one of the five species of Aconite plant cultivated in America but also found in Europe and the Himalayas.

    This homoeopathic medicine is given to those suffering from acute inflammatory conditions of the brain, lungs, heart, kidneys and other organs of the body.

    Also, for those suffering from anxiety, great nervous excitability, generally reflected in the form of fear of death.

    The fear is so marked that at times a patient starts predicting the time of his death.

    These conditions may be triggered of by exposure to dry cold air, particularly in autumn when the days are hot but the nights are cold.

    This medicine is effective in removing children’s fear of dark places.  Also, for people who feel frightened after receiving a threat.

    The fear, in case of women, may lead to abortion, or stopping of menses.  They may suffer from fear of death at the time of first delivery.

  Also, for breathing difficulty for babies born after tedious labour.  A good medicine for school-going problem cildren, who are at times punished severely either by parents at home or by teachers at school.

    Frequent dose of 30 potency daily until condition improves.  For chronic cases, there are other medicines.

                        FOR TONGUE-TIED LAILA-MAJNU

        AMBRA grisea, also known as Ambergris, is prescribed to persons who are intensely shy and blush easily.  They cannot do anything in the presence of others.  They generally suffer from acute constipation.  It is also ideal for those who become nervous in the company of strangers.  They either begin to cough or suffer an attack of hiccups.  At times they become asthmatic and their heart begins to pound at the very thought of having to make love.

    Ambra helps get over the shock of repeated deaths or business loss in the family.  In certain cases the unpleasant memories of the past haunt the patient.  Concentration becomes difficult.  It results in fitful sleep.

    Ambra is ideal for stopping bleeding from the nose, especially if it occurs in the morning.  It provides relief to women who discharge blood in between menstrual periods.  Even a slight exertion is enough to start the bleeding

    During periods, the left leg turns blue.  At times the periods may commence one week before the scheduled date followed by soreness, itching and swelling of the genitals.

    Dose:  6 or 30 potency dose may be repeated after every 6 or 12 hours until improvement is noticed in the condition.

                                HOMOEOPATHIC BADAAM

ANACARDIUM is a homoeopathic medicine prepared from the seeds of marking nut (used by washerman for identification markings on clothes.  The Indian name of this plant is “bhilava”.

    It is a remedy for mental fatigue, when even a slight mental exercise brings on a dull pressing headache.

    Also, for those who suffer from sudden loss of memory; when things told at a given moment are forgotten minutes later.

    Anacardium is prescribed to overcome memory weakness after an exhausting disease, or due to old age.

    Impaired memory may lead to depression or irritability or aversion to work, lack of self-confidence.  Also, fear of examinations, interviews or public appointments.

    Confusion reigns supreme in such persons.  They may also become suspicious that they are being observed.  They cannot easily take a decision.

    A patient may also become violent, and suffer from profound melancholy and hypochondriasis.  He may cause bodily injury to others without any cruel, malicious or wicked intention.

    It is also suitable for those who are hypersensitive when it comes to religious issues.

    It acts as “smiriti sudha” for the students, if taken 10 to 15 days before the examination in 200 potency doses weekly.

    This dose is also advised for patients mentioned above.

                                         OH! MY STOMACH

    ANTIM crudum, is a chemical compound also known as black sulphide of Antimony.  This homoeopathic medicine is commonly prescribed for gastric trouble due to sluggish stomach.

    It is more effective for those who overload the stomach with fat food, milk, meat, sweet, etc, and find it uncomfortable later.

    Owing to this, there may be a thick milky-white or dirty coating on the tongue, with or without violent, cutting pain in the abdomen, along with a feeling of heaviness in the stomach.

    Diarrhoea often follows such dietic errors, where stool may contain indigested food with partly watery fecal discharge.  At times loose motions may alternate with constipation, particularly noticed in old people.

    Antim crudum is also given in old cases where the trouble began after a swim or after a cold bath.  Headache is a common complaint after a cold bath in chilly winter.

    A good medicine for gout and arthritis of fingers, where the swelling and pain are worse owing to cold damp weather or after a cold bath, and one gets relief by heat.

    Antim crudum is prescribed for corns.  It is also effective in curing brittle nails.

    It has been found efficacious in stopping ache in decayed teeth (stumps) when there is an unbearable pain after eating or after taking cold drinks.

    For the hysteric or other sentimental patients, who generally remain sad, impulsive and have suicidal tendencies, especially by drowning.

    Also for young children who may be irritable and fretful when touched or looked at.  Some among them who become obese, Antim crudum is a remedy.

  Dose:  6 or 30 potency dose may be repeated three times every day.

                              NIP THE COLD IN THE BUD

    ANTIM  tart, a salt commonly known as Tartar emetic, is an indispensable

life-saving homoeopathic medicine.

    Owing to its marked action on respiratory system, particularly of the lungs, it not only helps in the absorption of mucus secretion, but also strengthens the lungs to expel the mucus.  Also resists subsequent attacks of cold.

    This homoeopathic drug is mostly prescribed for bronchitis, bronchopneumonia (cold in chest), asthma and other chest complaints.

    It is beneficial for young children and old, weak people, who easily become victims of exposure to sharp cold spell in winter, and suffer from chest congestion.

    Patients cough but are unable to get phlegm (mucus) out owing to weak body or the lungs.  Thus, the chest rattles.  The victim feels difficulty in breathing while lying in bed.

    The newborn and other infants may have their first attack at the time of birth.  But such children become prone to subsequent exposure to cold later in life until they reach adolescent age, if not treated judiciously.

    During such attacks the face becomes cold and darkish blue owing to lack of oxygen supply.  They may have low or high fever with their tongue thickly white-coated.  The nostrils may be dilated and in flapping condition and the child coughs loudly.  He becomes dull, drowsy and unconscious.

    Antim tart also relieves asphyxia from drowning, from foreign bodies, such as buttons, seeds, pebbles or marbles stuck in trachea or bronchi(air passage) or may be due to paralysis of lungs where the victim is almost breathless and gasps for air.

Dose:  3x or 30 potency dose to be repeated three to six times a day during acute attacks until the patient is all right.  For chronic cases 200 or higher potency doses.

                        ARNICA:  MUST FOR EVERY HOME

    “FALL HERB” or Panacea lapsorum, better known as Arnica grows in the mountains of Europe in plenty.  The tincture is prepared from the whole flowering plant.

    Arnica is called the king of traumatic remedies in homoeopathy because of its extensive use in injuries, fractures and haemorrhage.

    The acute manifestations are soreness, bruises and there is ache allover the body.

         Injuries

    The patient does not like to lie down as every thing on which he rests seems hard and uncomfortable.  He, therefore; constantly keeps on changing position.

               

    There may be ecchymosis (black and blue spot) caused by a fall or an accident with or without fever.

    Arnica has been found effective when there is internal head injury due to fall or blows and is known to remove the clot.

    Also, for patients who avoid any contact on account of pain and intense agony, particularly in inflammatory condition of gout and rheumatism.

       Sports

    Arnica is a great muscular tonic for the sportspersons, farmers, labourers and cyclists, etc. who are doing heavy physical work and when they feel limbs and whole body sore and aching.  The joints are also felt sprained.  It simply relieves discomfort even after hectic day of shopping, tours and picnics.

    Arnica alongwith other sports medicines, if taken under the guidance of an experienced homoeopath, may replace the use of drugs (anabolic steroids), generally taken for building up the stamina and the body muscles, without any fear of a positive dope test.

        After delivery

    It is effective in preventing abortion after a fall or shock.  Also, to prevent complications after delivery.  Helps contraction of uterus to expel placenta.

    A good drug for uterine haemorrhage, particularly after coition.

     It is excellent medicine for sore gums and is useful in stopping heavy bleeding and pain after tooth extraction.

    It removes the ill-effects of charcoal gas poisoning during winter season when a person becomes unconscious due to lack of oxygen.

    Dose – one thousand (or 1M) potency to be repeated as required.  For patients rendered unconscious after receiving head injury, etc., 10 M liquid drops would do the needful.

    Arnica should be kept in every house and everybody should know its use at the time of emergency.

                                  ARSENIC ALBUM

    ARSENIC album is commonly known as Sankhavisha or Sankhiya.

    It is effective in acute gastric disorders, maybe due to food-poisoning, gastroenteritis or cholera….. after consuming cold drinks, ice-cream, iced water, pickles, sauces, rancid food melon, etc.

    Arsenic album is an effective medicine for those persons who take excessive tea and smoke a lot, resulting in cardiac irritability and other heart problems.  This may lead to ascites and general swelling in the body, especially in those who are anaemic and weak.

    An excellent medicine for the gangrenous condition of mouth and throat, noma, aphthae and diphtheria, etc.  Also, for gangrene of internal organs and external body parts after injury, when there is sudden redness and shrivelled condition of the mucous lining.  The patient likes to keep the affected part covered.  It is also found useful in carbuncles and other spreading ulcers which ooze putrid watery discharge.

    Arsenic album acts wonderfully as a palliative medicine for those incurable cancerous problems where patient writhes with burning and stinging pain and suffers from agony.  Also, the chief remedy for angina, when it is of purely neurotic origin.

    It is a prime medicine for acute or chronic asthma which may often be associated with cardiac problems, where the suffocative attacks come at about midnight.

    It is good medicine in common cold when there is difficulty in breathing at night due to stuffy nose.

    Also, in tuberculosis of the upper one-third of the right lung, when the patient feels frequent but sharp pricking pain under the right collar bone.  The pain may be accompanied with a feeling of constriction in the chest, particularly noticeable on going upstairs or uphill.

    Arsenic album is an invaluable medicine for malarial fever when the patient gets attacks around noon or midnight.

    It is also an excellent medicine in those lingering cases of malarial fever (despite routine quinine course) when it takes the form of typhoid.

    This medicine is recommended in skin trouble (dry itching) of bran-like eruptions (as in dandruff) when the patient scratches the affected part until it is raw and bleeds.  At times scratching may lead to anxiety.

    Dose:  3 or 30 potency dose may be repeated at an interval of 3 to 4 hours until improvement beings.

                                        BELLADONA

 BELLADONA is a perennial herb which grows in the sandy parts of Europe and Asia.  The tincture is extracted from the entire plant before flowering time.  It was used as a cosmetic to brighten the eyes and flush the cheeks by Venetian ladies in olden times.  The medicinal value of this plant is due to its alkaloids, Atropin and Belladonin.

    This is the principal homoeopathic medicine recommended for relieving blood blood congestion in the head, chest, uterus, joints, skin, etc.  Owing to congestion in the brain, there is sudden and violent throbbing (pudpudi ka dard) in the head, particularly on the right side, which gets worse on bending down and lying down.  Belladona is especially prescribed to plethoric (with shining of cheeks) and vigorous persons particularly young children who are sensitive to changing atmospheric temperature.  They go to bed hale and hearty but wake up with sudden body temperature, which could be as high as 104 or 105 degrees Fahrenheit, may be with flushed face, red eyes, widely dilated pupils, moving the head restlessly from side to side.

    At times the child may become delirious and develop fear of imaginary things, or perform aggressive acts.  There may be convulsions due to high temperature along with strabismus (squinting of eyes).

    When there is no fever the child may wake up with a start and is frightened.  After falling asleep he may experience that he is falling down.

    Belladona is exceptionally good for pregnant women who marry late in life.  During labor, the uterus does not relax owing to deficient, ineffectual and spasmodic nature of labor pains, hindering the expulsion of the foetus.

    It also checks the bleeding after delivery.  Also, when the caking up of the breast (mastitis) of nursing women occurs and red streaks develop, this medicine is useful.

    Belladona is helpful in sore throat due to inflamed tonsils when the swallowing of liquids becomes difficult.  There may be a feeling of lump in the throat.

    Belladona is also useful in acute inflammatory conditions of stomach and bowels when there is a burning pain, great distress and distension.  Inflamed part is sensitive to slightest motion, touch and pressure, may be due to appendicitis, etc.

    It is equally useful in removing irritation of the bladder and urinary tract when there is retention of urine.  Also, dribbling of urine due to brain fever, etc.

    Belladona is effective in acute inflammatory rheumatism when there is painful swelling of joints which turns red.

    Dose:  200 or 1 m potency may have to be repeated at an interval of 15 or 30 minutes in severe pain or high fever

                               MULTI-PURPOSE MEDICINE

    BARYTA carb. or barium carbonate, is recommended for children who show signs of mental backwardness.  Such children are usually intensely shy and timid.  They slink away from strangers.  Their growth is stunted and their belly is swollen, face bloated, limbs emaciated and neck and groin glands are enlarged.  Their comprehension is weak.

    Baryta is also ideal for senior citizens who show symptoms of senile dementia (common feature is child-like behaviour).  It is effective in the treatment of enlarged prostate glands due to advanced aged among males.

    It is an excellent remedy for cerebral haemorrhage resulting in one-sided paralysis.

    Baryta is said to cure (as well as prevent) enlarged tonsils and related cough in children who are sensitive to cold and get frequent attacks of tonsillitis.

    If you are old and have difficulty in swallowing solid food, are hard of hearing, have tumours, lumps and tubercular growth and suffer from constipation, try baryta.

    Dose:  6 or 30 potency dose two or three times a day until improvement is noticed.  For higher potency dose consult your doctor.

                                     LIVER DISORDERS

CHELIDONIUM majus, also known as calendine, a herb is prescribed to those suffering from jaundice and other liver disorders.

Symptoms:  the skin is white, eyes are yellow, and the stool is whitish, grey or yellow and pasty.  The urine may be very pale.  Such patients may also have a strong desire for hot drinks.

The patient may be dyspeptic.  The taste of the mouth may be bitter and the tongue coated.  They may develop an intense dislike for food.  It is also prescribed for the treatment of gallstone and colic pain.  There may be fever owing to enlargement of liver.

Chelidonium is useful in pneumonia when the patient feels “tightness” in the chest, experiences difficulty in breathing and suffers from dry, spasmodic, paroxysmal cough, especially at night.

Also effective in neuralgia of the right side of the face, eyes and ear.  At times, neuralgia may precede pain in the liver and may extend from the right cheek to the teeth or the eyes.

Such patients may sometime experience “icy coldness ” on the tip of the fingers and at times their right foot may feel cold while the left is normal.

Dose:  6 or 30 potency dose to be repeated at 3-4 hours intervals per day in jaundice till the condition improves.  For gallstone, colic – 200 or 1 M potency doses may be given in consultation with the doctor.

                                                   AN AUTUMN CURE

    COLCHICUM AUTUMNALE, commonly called meadow saffron, is prescribed if the patient is sensitive to strong odours of raw or cooked food.  The reaction to odours may result in fainting nausea, retching and weakness.  It helps combat the feeling of nausea among pregnant women.  It is effective in controlling abnormal distension of the belly.

    Colchicum helps cure diarrhoea and dysentery, especially during the autumn season when the stools are bloody and full of scrapings from the intestine which may lead to protrusion of the anus.  Sometimes, stools may have jelly like mucus of variable character.  The patient may feel tingling, itching, burning or tearing pain in the anus.

    It is a splendid remedy for acute rheumatism and gout, specially in joints of fingers or the toes.  The pain generally gets worse on cold day and due to dampness, generally in the evening and particularly during the period of fall.

    It is lso recommended for summer rheumatism when the heat may slow down the flow of urine or the quantity of solids in the urine.  The urine becomes black or ink like.

    Colchicum is useful in wryneck.  Symptoms:  severe pressing pain in the neck and the muscles become tense.  At times swallowing becomes difficult.

    It helps prevent rheumatism and gout from affecting the hear, which otherwise leads to valvular defects along with muffled heart sounds and tight feeling in the chest and breathing difficulty.

    Dose:  30 potency dose may be repeated at 4 to 6 hours interval.  For distension 200 or 1 M dose may be repeated at 5 to 10 minutes interval until improvement in the condition.

                FROM TEETHING TROUBLE TO DELAYED MENSES

    Calcarea carb is common calcium carbonate.  This homoeopathic medicine is generally prescribed for delayed development and maturation of bones.  As a result an infant learns to stand and walk late.

    At times bones are formed irregularly leading to rickets (crooked bones),
knock-knees, bow legs, spinal curvature, delayed teething, exostosis, osteomalacia (adult rickets) and laryngomalacia, i.e., poor development of voice owing to weak voice box.

    Also, head bones and sutures take long time to close.  The head seems enlarged in relation to the size of the body, and at times the child is unable to hold his head up.  The enlargement may be due to hydrocephalus (collection of fluid).

    Calcarea carb is an excellent medicine for obesity in children and other grownup persons.  Also, for women who become corpulent after delivery.

    Such persons may be fair-skined or blond but flabby.  They sweat profusely all over the body.  The sweat is more pronounced on the head, nape, chest, armpit and genitals.

    Also, for persons who feel cold, particularly in the head, abdomen, feet and legs.  Since the patient is also sensitive to cold damp air, at times the body gets swollen.  The feet too are cold in winter.  But in summers the feet burn.

    Calcarea carb removes intolerance of milk in milk-fed babies during teething.  Also, for children who crave for eggs.   And for indigestible things like chalk, coal, slate pencils, earth, clay, etc.

    The abdomen of such children is distended like an inverted saucer, and painful to pressure owing to accumulation of wind, etc.  The rest of the body may be emaciated, with glands of the neck and lower jaw swollen.

    It is also a good medicine for polypus growth in the nose, ears, vagina, uterus, and bladder.  Also, for cystic growth and papillomata (benign tumour).  At times there is bleeding from these orifices owing to polyps.

    Calcarea carb removes cramps of calves, fingers and toes, etc.

    An excellent medicine for deafness, fever, painful limbs and paralysis, etc, occurring commonly among potters, brick-makers, fruit growers, etc.  Also for those who have breathing problems as a result of living in shady and cold places.

    Calcarea carb is also for women who are anaemic, have late menses or no menses at all, and thus rendered sterile.

    Calcarea carb is recommended to lactating mothers who have the problem of excessive or deficient milk secretion.

    It is also effective for males who have involuntary nocturnal emissions.  It removes the ill-effects of masturbation and too frequent sexual indulgence, where coition is followed by excessive perspiration, weakness, irritability, etc.

    Calcarea carb is beneficial in ulceration and opacity of the cornea.  It is an excellent medicine for those who have kidney and gallstone problems and experience profuse perspiration on the hands and feet during colic.

    Dose:  30 potency, two to three times a day as per requirement.  In severe pain 200 or 1 M potency repeated doses may be given until improvement starts.

                                   FOR WINTER COLD

HEPAR SULPH, also known as Hahnemann’s calcium sulphide, is prepared by mixing powdered oyster shell with pure flowers of sulphur in equal parts.

    This homoeopathic drug is prescribed for patients who are inherently irritable and whose speech and actions are hasty.  They may finish long sentences in one breath.  Every small thing disturbs these patients and make them intensely angry and violent.

    Also suited to dyspeptic patients who have great longing for vinegar, wine and sour and strong flavoured things.  Such patients are also oversensitive to pain.  The skin of the affected part may become very sensitive to touch, and the patient cannot even bear the touch of clothes.

    Hence useful in boils, abscess, ulcers, felon, and many other inflammatory and suppurative conditions of glands such as tonsils.

    Hepar sulph is also recommended to babies who are irritable and are always smelling sour, in spite of much washing.  They may have sour-smelling diarrhoea.

    It is an excellent medicine for cough and cold caused by sudden change of temperature, especially when sudden icy-cold winds blow.

    The patient coughs more in the mornings and evenings.  There is no chest congestion, though there is rattling, barking sort of sound while coughing with soreness in the chest.

    There may be stuffy feeling in the head, face and chest with blocked nose and hoarse voice in the beginning.  But profuse nasal and throat discharge takes place subsequently with pricking pain in throat.  The throat may become worse after eating any thing cold.

    There may be weakness of bladder and urine is passed slowly.

    Dose:  It can be taken in 30 potency, to be repeated at an interval of 3 to 4 hourly daily till the condition improves.

                                 FOR SENSITIVE WOMEN

                  

    IGNATIA Amara (or St Ignatia bean) is derived from a climbing shrub found in Cochin and some other parts of the world.  The tincture is prepared from the seeds of its fruis.

    This homoeopathic medicine is especially meant for those with a nervous temperament, particularly sensitive women.  It is one of the chief remedies for hysteria.

    For those who easily get excited, keep brooding or have experienced disappointment of love!

    Persons who are mentally and physically exhausted owing to grief.  Also for mental  sufferings due to regular conflict and tensions at home.

    Ignatia Amara is beneficial for those who often take drawn signs, much sobbing, etc.  Also, for those who are unhappy and can’t sleep because of grief.

    For those who have lost a near and dear one and are unable to control their emotions.

    The present socio-political state of turmoil may also lead to hysteria, at times leading to suicide.

    Ignatia Amara is meant for patients who have symptoms mentioned above.

    A small dose of 6 or 30 potency may be given everyday in the morning until the condition improves.

    For those who are chronic patients, should consult a Homoeopath.

                                           SPRING AILMENTS

LACHESIS is also known as “bushmaster” of “surukuku”, a deadly poisonous snake of South America.  The venom of this snake is used as medicine.

    This homoeopathic medicine is mostly prescribed for new and old inflammatory conditions and other troubles which generally begin on the left side of the body and later spread to the right side whether it is sore throat, tonsillitis, mumps, headache, eye, ear, kidney or ovary problems.  Even in arthritis, paralysis, etc.

    Also, for persons who are often unable to swallow warm liquids.

    Lachesis is effective in dry hacking cough in children caused by tickling in throat, particularly in the voice box.  The cough becomes worse during sleep.

    Lachesis is effective in heart diseases when a patient’s face becomes purple and bloated.  The patient wakes up with palpitation, experiences breathlessness and suffocation.  The patient is afraid of going to sleep.

    The palpitation of the heart may also occur when a patient goes into warm room or has hot water bath.

    Lachesis is very effective in overcoming insane jealousy and suspicion.  The patient suspects every one without any reason, even servants and children.  He may not take medicine even from a doctor suspecting that he would be poisoned.

    At times, a person becomes too talkative.  The patient seems to be in a hurry and becomes impatient.  Sentences are at times left half finished.

    It is also a good medicine for headache, especially in left temple, maybe due to heat in summer months, but mostly due to disrupted natural discharge, such as menses and nasal discharge.  The headache occurs in the morning after waking up.

    Lachesis is useful in gangrene when the affected part is purple or mottled in appearance.  Also, effective in fistulous openings, fissures and piles.

    It is equally useful in whitlow (felon, carbuncles, abscesses, malignant pustules, pemphigus, herpes, chickenpox, malignant ulcers, etc., when the affected part is sensitive to touch and bluish purple in colour.  Also useful for heavy drinkers who develop a red nose.  At times the nose may be red owing to heart problems.

    It is also effective in paresis (semi-paralysis) of the tongue.

    Lachesis is a leading medicine for menopausal disorders, when the period stops and all sorts of troubles make their appearance, such as hot flushes, headache, mania, etc.  Also for painful menstruation where pains are relieved by the flow of the blood.

    Dose:  200 or 1 M potency single dose is sufficient.

                             LACK OF CONFIDENCE  

               

    LYCOPODIUM clavatum is a perennial herb which grows in Europe and Asia.  This homoeopathic medicine is recommended to all age groups, particularly for old persons with keen intellect.

    Also, for persons who are nervous and emotional.  Lycopodium is beneficial in failure of intellectual functions (sensorium), particularly in old men.  The patient may become forgetful.  There may be aversion to undertaking a new assignment.  And there is general lack of confidence.

    Thus a good medicine  for lawyers, lecturers and other public men.

    Effective for children who dread mathematics.

    Lycopodium is effective medicine for gastric trouble resulting from recent or old liver trouble.  The patient may have insatiable hunger (bulimia) with much bloating after eating, particularly after lunch hours or in the evening.

    At times there may be a feeling of satiety, which may alternate with a feeling of hunger of peculiar kind where the patient sits down at the table very hungry, but after a few morsels he feels distressingly full.

    Sometimes the patient may fast or miss one or two meals a day.  Such condition is generally observed in those patients who are either suffering from diseases like arthritis, gout or stone problems, or are likely to develop such troubles in the near future.

    Also in diseases where symptoms run from right to left side of the body as in sore throat, including tonsillitis and problems of chest, abdomen, liver and ovaries.

    It has cured many cases of right-sided hernia in children.

    Lycopodium is effective in snuffles (obstruction of nose) in children and young people.  The eyes may at times remain half open during sleep.

    Also effective in poor vision and night blindness.

    Lycopodium helps the patient of neglected pneumonia when it is associated with liver complications.

    It has been found useful in all fevers, particularly malaria, where attacks of chill may come between 8 a.m. and 9 a.m. or between 4 p.m. and 8 p.m. and the patient may shiver with incessant yawning and nausea.

    Lycopodium is an excellent medicine for kidney stones and there is red sediment in urine generally passed after a terrible attack of renal colic.

    It is one of the best remedies for impotent persons.  But it is not an aphrodisiac and its abuse can be dangerous.

    Equally useful for women when they have dryness of vagina leading to burning pain during and after coition.  Sometimes vaginal bleeding takes place after passing stool.  At times gas emits from female genital.

    Lycopodium has been found effective when there is premature greying of hair.  Also, for baldness at the top of the head.  And falling of hair after delivery in women.

    Dose:  200 or 1 M potency dose may be taken once every week until condition improves.

                         PROBLEMS OF EARLY GROWTH

PHOSPHORUS is a poisonous substance found abundantly in bone, flesh, cheese, peas, etc., besides as a mineral in rock phosphate.  Its therapeutic value lies in its inherent power to irritate mucus membranes of various body systems.

    This homoeopathic medicine is selectively prescribed for delicate but active, intelligent and sensitive young persons who register early body growth.  Such persons tend to stoop and may later suffer from ailments leading to tuberculosis, if proper care is not taken.

    Since these young persons have low vitality, they are easy victims of common cold; which may be protracted dry, irritating hoarse cough; worse in the evening, after drinking, eating, talking or laughing.  Or, persistent thin nasal discharge after an attack of pneumonia or bronchitis.

    Phosphorus is the prime medicine for recurrent bronchial diseases which follow common cold.  The most commonly observed complaints being bronchitis and bronchopneumonia (pasli chalna).

    It is useful in stopping bleeding in haemophilic and haemophiloids patients when the blood is bright red and noncoagulable.  Besides it has marked power to stop haemorrhage from any outlet, may it be the mouth, nose, vagina or anus.

    Phosphorus is the only homoeopathic medicine for the constriction of lower end of food pipe (Achalasia and scleroderma) when there is difficulty in swallowing and at times food comes out immediately after swallowing.

    Blindness, either due to paralysis of optic nerve or after electric shock or after lightening, can be removed by the timely use of phosphorus.  It is also useful in early stages of cataracts, when the vision is misty but patient can see better either by shading the eyes with hands or in twilight.

    A good medicine for acute or chronic diarrhoea when stool is passed involuntarily immediately after eating or drinking, with gurgling in stomach and down to intenstine.  The stool may be greasy.  At times fetid, painless stool oozes out.

    The most notable feature is that patient may have a desire for cold drinks even in the extreme chilly weather.  The patient is not able to lie on the left side as it causes anxiety, pain in heart and palpitation.  Thus useful in various heart problems, particularly the fatty heart.

    Phosphorus is an excellent medicine for the necrosis (degeneration) of the lower jaw of people working in match factories.  It is also an antidote for the ill-effects of chloroform, iodine and excessive use of the common table salt.

    Dose:  1 M potency one dose a day to be taken only once.  Normally, it should not be repeated without consulting a doctor.

                              FOR GENTLE AND TIMID PERSONS

PULSATILLA nigricans is commonly known as pasque or wind flower, which grows in Europe in plenty.

    This homoeopathic medicine is generally recommended to gentle and timid persons, particularly females who dread the opposite sex, and hence aversion to marriage.

    Also, for children who are fussy and easily get discouraged when snubbed or punished.

    These patients may have a dislike for fat or fried food, such as omelette, channa-bhatura, puri-parantha, meat, pork, etc., owing to weak digestion.  Often the patient complains of bad taste in the mouth in early morning.  The tongue may be coated, and despite dry mouth there is no thirst.

    A patient complains of heavy stomach after eating.  Sometimes pain may occur in stomach after an hour of eating.

    Pulsatilla is effective in rheumatoid arthritis, etc., when pain shifts rapidly from one joint to another.

    It is an excellent medicine for toothache when pain is almost unbearable.  The patient feels relieved after keeping water in the mouth.

    Also, in ear-ache in children and others when the pain appears in the evening or at night.   The ear may appear red and puffed.

    Good medicine for cold that primarily settles in the nose and later in the chest.  The discharge is thick, yellowish green and bland.

    It is helpful in bronchial asthma in children from suppressed rash in measles, or in women from suppressed menses.

    Also effective in recurrent styes, especially the upper eyelids.

    Pulsatilla is an excellent medicine for eye problems when the patient is always rubbing the eyes.  The vision may be dim due to early stage of paralysis of optic nerve.

    Delayed menses at puberty which may be due to nervous nature or severe anaemia.  At times violent headache may be felt by girls owing to non-commencement of menses.  Also, when the labor is delayed and difficult owing to wrong position of the foetus in the womb.

    Pulsatilla is equally effective in leucorrhoea (white vaginal discharge) when it is thick milky white or creamy, may be associated with low backache.

    Also, when there is milk in breasts of the girls at puberty and non-pregnant women during menstrual flow.

    It is commonly prescribed to cure the after-effects of mumps when breasts and testicles get inflamed and swollen.

    Als effective in suppression of gonorrhoea.  Normally such patients are afraid of lying down, as they get an irresistible urge to pass urine frequently.

    A little girl child who kicks covers of at night and has involuntary urination at night, can be given Pulsatilla.

    A typical Pulsatilla patient sleeps on her back with hands over the head, and wants the head high as she feels uncomfortable with one pillow.  And she does not wake up fresh.

    Dose:  3x or 30 potency dose may be repeated after 4 to 6 hours daily until improvement starts.

                                 FOR SPRAINS & STRAINS

             

RHUS tox, also known as poison oak, is prescribed for sprain and overexertion of muscles or tendons.  This can also be caused by lifting heavy objects or stretching to reach an object at an uncomfortable angle.

    This homoeopathic medicine is recommended to overcome weakness of joints from sprains after a dose of Arnica has removed the first and most painful symptoms.

    In women there may be prolapse, or uterine haemorrhage, due to weakness of pelvic muscles from strain or lifting of heavy load.

    Rhus tox also cures fevers and paralysis of the limbs resulting from exposure to cold damp weather.  There is frequent urge to urinate.

Bed-wetting

    Also useful in involuntary urination (bed-wetting) by children, particularly boys at night owing to weakness of the bladder.

    For those suffering from enlargement of heart owing to strenuous and violent exercise (athlete’s heart); or any other organic heart disease where the pulse is quick,  irregular and weak resulting in numbness of the left arm.

    Recommended for inflammation and redness of the skin, with intense itching particularly of the fingers or toes; owing to cold weather or due to frost bite.  There may be vesicles herpes, eczema like condition of the skin, particularly during the rainy season where the areola (base) is red or purple in colour.

    Rhus tox is suitable in chronic rheumatoid arthritis, spondylosis and spondylitis, when the patient initially finds it difficult to move.  The patient feels better after walking or warming up for some time, therefore he gets exhausted because of weak joints.

    Excellent medicine for eye complaints during rainy season due to excessive dampness.  There is redness of the eye with profuse gush of hot tears on opening the swollen lids (eye flue).

    Rhus tox is forbidden for women in early stages of pregnancy.

    Dose:  30 potency doses repeated daily for acute cases.  For chronic cases of arthritis, etc., 200 potency weekly.

                                    TV AND ACHING EYES

RUTA graveolens, or Rue, is a native plant of South Europe.  The tincture is prepared from fresh herb gathered shortly after blooming.

    This homoeopathic drug is prescribed for the wounds on bone surface caused by a blow, accident or a fall.  The patient complains of soreness and aching pain at the fractured site even after the repair process.

    Ruta is also known to remove contraction of hands and feet after injuries.

    For the tubercular outgrowth of the bones and repeated dislocations, particularly of the knees, ankles and the wrist joints.

    A perfect medicine for farmers, carpenters, gardeners, labourers, cobblers, tailors and mechanics, who use iron instruments resulting in formation of hard nodules (corns) in the palms and fingers.  Also for students and other people who hold their pens tightly while writing.

    An excellent medicine for the ganglion (the cystic tumor) particularly of the right hand.

    Ruta is given to those with aching eyes after too much reading, or doing fine needle work or watching TV continuously.  This may result in frequent winking of the eye.

    A valuable medicine for the prolapse of the rectum, especially after delivery.

    Dose:  200 potency single weekly dose until the visible signs and symptoms have been overcome.

                                        FOR WEAK CHILDREN

            

SANGUNARIA canadensis, commonly known as the “blood root is a perennial plant that grows abundantly in the United States of America.  The tincture is prepared from the fresh root.

    This homoeopathic medicine is prescribed mainly to young children who are weak either from birth or afterwards.  They do not have normal appetite.  But they are fond of toffees, ice cream, golgappa and other sweet, sour or saltish things.

    “The child brings his only chappati back home in tiffin”, is the general complaint of mothers of such children.  Grinding of teeth at night along with salivation while asleep, may occur in such children.

    Children with pinworms (chalune) may feel irritation in anus and the surrounding area, thus spend sleepless nights.  Or they may complain of mild pain in the belly.  The children are sensitive to cold and sour things and may develop a red patch on the cheek owing to chest problems, such as acute or chronic bronchitis, bronchopneumonia and tuberculosis, etc.

    Sangunaria may particularly be required in pneumonia when lungs are filled with blood and the sputum (in grownup persons) may appear rust-coloured and smell offensive.

    Sangunaria is an excellent medicine when women have headache during menopause.  The headache begins on waking up at the time of sunrise.  It continues to get worse during noon and then diminishes at sunset.

    The headache begins from the nape of the neck and spreads upward and settles over the right eye.  It generally gets aggravated by light, noise and strong smell.  The patient likes a dark room, is compelled to lie down.  Sometimes when the headache is severe, the patient vomits food, bile or the slime, and gets relief from pain.

    Sangunaria is effective in rheumatoid arthritis of the parts where bones are least covered with flesh, particularly right shoulder, the elbow or the knee.  Also, good medicine for the stiffness of the neck or the back when the pain extends to the head on right side, or to the right arm, especially in spondylosis.

    Dose:  3x or 6x potency dose three or four times a day in pneumonia.  For other problems 30 potency dose, two to three times a day until improvement starts.

                      HOMOEOPATHY & BIGREY NAWABS

    NUX VOMICA is known as poison nut, “kuchla” in Hindi.  This homoeopathic medicine is prepared from “poison nut” seeds.  One third of all the diseases are reportedly cured by this medicine alone.

    It is said “if you do not know what should be prescribed then give Nux Vomica.  It is often used as an antidote for over-drugging.

    Nux Vomica is generally prescribed to males who are thin, irritable, and lose temper by slight provocation.  Also for those who do a good deal of mental work, study a lot or handle business affairs and lead indoor life.

    Because of mental strain, such people often seek the help of stimulants, such as coffee, liquor, or use sedatives like opium or any other cannabis preparation.

    People who take rich food, attend parties and generally overindulge themselves until late night, often have irregular bowel movement (or have constipation).  They take laxatives like Hajmola, liver tonics, etc.

    Nux Vomica soothes and calms over-excited nervous system and improves digestion and bowel movement.  It increases appetite, vigour and gives potency to males who have ruined themselves by excessive use of stimulants.  That is why it is called the medicine of “bigrey” Nawab (spoilt men).

    It may be taken in low potency of 6 or 30 (in case of irritable over-excited persons), and above 200 or more potency in case of habitually constipated and hard drinkers.  It is one of the best remedy for mania-a-potu (acuge alcoholism).

Nux Vomica of 6 and 30 potency should be taken once a day before going to sleep at night.  If it is 200 potency then it should be taken once a week.  If it is still higher then once a fortnight.

The Mediterranean Diet

With the plethora of diets so acutely focused on carbohydrates intake, you may be wondering why the Mediterranean diet beat out a low-carbohydrate approach. After all, LC diets not only work for some people, studies also show that low- and very low-carbohydrate diets have helped obese individuals decrease insulin resistance, lower triglycerides, favorably change blood cholesterol levels and lose weight. Yet they are not for everyone.

First, LC diets may be tough to stick with over the long term. And, one solution to that issue may involve transition from low carbohydrate to "controlled" carbohydrate, eating a specific amount of carbohydrates per sitting and making healthy carbohydrate per sitting and making healthy carbohydrate choices (fiber rich whole grains, legumes, fruits and vegetables) .

Secondly, recent research out of the University of Alabama Birmingham found that high-fat; Low-carbohydrate diets may be detrimental to those with ischemic cardiovascular disease or a predisposition to heart attacks. In their study, obese and normal weight rats fed a high-fat, LC diet had larger, more damaging heart attacks compared to rats on a low-fat control diet.

In addition, the rats on the high-fat, LC diet had greater risk of death from pump failures and arrhythmias. Altering dietary macronutrient composition looks to affect the type of fuel the heart uses to function, when in fact carbohydrates is the most efficient source of fuel for our bodies when recovering from a heart attack. Although these results do not suggest that high-fat, low-carbohydrate diets cause heart attacks or that they are harmful, it does raise some red flags that should be taken into consideration prior to going on a similar diet.

Take a close look at your lifestyle and choose the plan that will best meet your needs. And, why go on a low-carbohydrate diet, or at least why stay on one if a Mediterranean diet may be just as effective?

THE BOTTOM LINE: If you talk to your co-workers, neighbors and friends, you'll probably meet at least one person who has been successful on just about every popular diet out there. And according to the POUNDS LOST trial, the actual parameters of the diet (carbohydrate, fat and protein content) may matter less than your ability to stick with it.

After all, if you can not follow a diet plan, you will not lose weight. So, take a close, realistic look at your lifestyle and choose the plan that will best meet your needs. And remember, though diets work in the short term, the best way to keep weight off forever is by making healthy foods a permanent part of your diet and incorporating lifestyle changes you can live with.

Advice on Early Orthodontic Evaluation for Having Better Health

Parents want their children to lead a happy and healthy life. Orthodontic evaluation is recommended at an early age to help parents along the path to improving their child’s health.

Orthodontics practices thrive to make sure parents understand the significant role early orthodontic evaluation- and treatment, if necessary- plays in children’s oral health. They also inform their patients and patients’ parents about the notable dynamic between oral health and overall health.

The American Association of Orthodontists encourages children to get an evaluation by their orthodontist by age 7.

Being assessed at this age doesn’t always equate to treatment being necessary. But there are some alignment issues and unhealthy oral habits that may need to be addressed this early in life.

Knowing whether a child is on a monitor-only or a treatment path at a young age can result in less invasive orthodontic treatment now, rather than surgery later.

There are some issues that if detected and treated while a child is still growing, we can take that child off of a surgery path. We have the fact that they are still growing on our side. Once growth stops, treatment options become more limited.

Problems Best Detected Early

Underbite is an example of a common and serious malocclusion that often can be fixed without surgery when identified and cared for at a young age. Underbite occurs when the lower jaw juts out farther than the upper jaw and fosters an improper bite pattern, along with facial deformity.

Serious teeth crowding issues noted and treated when a child is young can avert the need for tooth extractions and future surgery.

Orthodontists recommend identifying and correcting poor oral habits, such as prolonged pacifier use, thumb or finger sucking, mouth breathing and tongue thrusting (pressing the tongue through the teeth, keeping the front teeth from touching) at an early age.

Some children will naturally outgrow bad habits such as thumb-sucking. For those who continue poor oral habits and there is a fear they will lead to bite and alignment issues, treatments are available.

A standard case of early orthodontic treatment is an appliance that is set along the palette of a child’s mouth who has difficulty in quitting thumb and finger sucking. The device prevents the child from experiencing the satisfying sensation typically received from the habit.

Chronic mouth breathing can lead to complications in dental and facial development, such as long face syndrome, narrow mouths and receding or protruding jaws, according to Health.com.

Patients who experience facial development issues caused by chronic mouth breathing often require the use of corrective dental appliances, sometimes along with traditional braces, to cure “high vaulted mouth roofs, narrowing sinuses and deformed jaws. Left untreated, more serious facial surgery can be needed,” according to Health.com.

The point we want to be sure parents take away from this is that whether you’re a child or an adult, braces can correct a variety of bite and alignment issues. However, when we’re dealing with children, we can use a child’s growth to our advantage to create ideal bite and alignment.

Excellent oral health positively affects overall health. Many studies conclude that periodontal disease can lead to heart disease and other systemic ailments. It is less difficult to practice good oral hygiene and keep periodontal disease and tooth decay at bay when teeth are aligned and the bite is correct, he said.

Parents can help their children on the path to a lifetime of healthy smiles and overall health by beginning consultation with their orthodontist by age 7.

Gain Muscle and Lose Weight – The Whey Protein Diet

Whey protein or whey protein powder is a kind of globular protein that is primarily used by the bodybuilders, weightlifters and athletics. The name suggests, this globular protein prepared from whey. Whey is a by-product of cheese production. Now a day, whey protein increases its popularity significantly. There are several reasons are responsible for that. The prime reason of it is – scientists found some anti-inflammatory and anti-cancer properties on it. Not only that, it is a mild protein that easily absorbed in the human body in a very short time frame. Alternatively, it is easily acceptable by vegetarians.

As mentioned earlier, whey protein is one of the best proteins apart from egg white and widely used as a dietary supplement in bodybuilding arena. However, if you’re suffering with milk allergies, then we strongly recommend you – DO NOT use whey protein.  

In recent days, obesity has now become a global epidemic and it doesn’t obey any border! Not only in Europe, Asian and other countries also growing numbers of obesity victims. Most importantly, there is no magical solution available to get rid of overweight. Proper exercise and balanced diet is the only solution to get slim and trim. From this perspective, the dietary protein or health supplements takes place. Usually, people do their workouts in the gym and the basic rule of weight training is – torn the muscles using workout, burn calories, reduce fat and build new muscles by consuming proteins and other essential elements like vitamin and mineral and dietary fiber.  

Why Whey Protein?

Whey protein is the highest quality protein, as mentioned earlier – it is primarily consumed directly as a health supplement by the bodybuilders, weightlifters and athletics. However, many people also use it in cooking and other food products for indirect consumption. The reason of its popularity is – it’s not only quickly absorbed in the human body (usually it will take only 15 minutes to digest) but also it helps to build the initial muscle blocks. It can repair and rebuild muscles.

Whey protein comes with different variations. According to their manufacturing process, they are classified under three categories. They are – isolated, concentrate and hydrolyzed.  Isolated and concentrate whey are mostly used, nevertheless, the hydrolyzed whey is more effective than the other two varieties, but they are more costly than others.  

Who Can Consume Whey Protein?

Well, practically everyone can use it. Specially, those people who require high volume of protein like – bodybuilder, athletics and weightlifters. Alternatively, women and children can consume it too. But the doses are different from adults to children.

Unlike other “so-called” health supplements, it is completely free from any side effects. But before buying any product, make sure that – the product is organic and no chemical/preservatives added to it. Finally, if you have milk allergy or digestive problem, please consult with your instructor and doctor before adding it into your diet regime. Last but not the list, usually, you need 0.8 grams of protein in every kilogram, so, you need not to consume excessive amount of protein, because consuming an excessive number of protein can’t help you, rather create problems for you.

Lyme Disease Symptoms and Treatments

What is Lyme Disease?

Lyme disease is a multistage bacterial infectious disease that attacks multiple systems in the human body. Lyme disease is caused by a bacterium known as Borrelia burgdorferi or “spirochete” which being spread by tick bites. Spirochetes are pleomorphic means that they can appear as two or more completely different organisms. This makes both diagnosis and treatment of lyme disease tricky because they are capable of shape-shifting and can fool both the body’s immune system and the antibiotics deployed to destroy them.

Other bacteria which can expose to the disease is Borrelia afzeli commonly found in Europe.The bacterium is spread through bites of infected tick. The blacklegged tick can be found on deer (deer tick, Ixodes scapularis) and susceptible for most cases of the disease in northeastern, mid-Atlantic, and north-central United States. To transmit the bacterium, the tick must be attach to human body part for at least 36-48 hours or more. The ticks commonly attach at the human body areas such as the groin, armpits, and scalp. Although Lyme disease is an infectious disease, the disease can’t be transmitted from person to person.

What are the symptoms of Lymes disease?

The symptoms of can be divided into three phases – early, mild and late phase.
Common symptoms of early stage is a distinctive circular skin rash, known as erythema chronicum  migrans.The common size of erythema migrans rash is around 5 to 30 cm in diameter.
In the early stage, the lymes diseases shows other symptoms pertaining to flu-like symptoms and the symptoms include:
•    tiredness (fatigue)
•    muscle pain
•    joint pain  
•    headache  
•    fever or chills
•    neck stiffness  

Lymes Disease Treatment

Antibiotics, is available in the disease treatment, which is also the primary treatment for Lyme disease. It is effective and almost all patients recover after antibiotic treatment. Nevertheless, curing may take weeks to months after finishing antibiotic treatment. Information about disease treatment is very important. Such details about prevention and cure may be found on the internet with deep explanations on physical therapies. Visiting your therapist will also help much because you get one on one advice on what should be done. Quick recovering will come as a result of adhering exactly to precautions and therapies.

How to Diagnose It Lymes Disease

The lymes disease diagnosis is accomplished based on the symptoms of lymes disease and a history of possible exposure to tick bites. Find out more about lyme disease symptoms. Laboratory blood tests are other helpful diagnosis tools in the patient who have the symptoms of lymes disease.

Free Nursing Continuing Education

There are many organizations that offer accredited, Free Continuing Education courses through their websites. These are mostly demo or pre-registration versions. Registration in these sites is free. Once the aspirant registers, the website sends the password by email. This password can be used to access all info, such as the list of courses available, cost and number of hours allotted for each course, and FAQs.

For instance, http://www.nursingmatters.com hosts one pre-registration, free course every month. For November it is a 1-hour course on `Pediatric Psychopharmacology’.

The range of programs offered by these sites is astoundingly broad and include topics such as the following: Age-Specific Considerations in Patient Care, An Overview of Alzheimer’s Disease, Breastfeeding: The Basics, ECG Interpretation: Learning the Basics, Ecstasy: Under the Influence, Latex Allergy: More Than Skin Deep, Perspectives on Childhood Poisoning, Performance Improvement: A Change for the Better, and What’s up at the Joint? New Tracer Methodology. While most courses are of 1 or 2 hours’ duration, some may go up to 8 hours or more depending upon the topic concerned.

Many of these courses use multimedia and communicational platforms such as interactivity, voicemail, video conferencing and more. They also incorporate highly interactive seminars and assessment sessions. At the end of any course, the end user can take an assessment test and get his performance evaluated instantly. All these can be done at any time that is convenient to the end user.

Several Continuing Education organizations offer free courses to nurses, particularly in times of human need. One such course is `Hurricane Katrina: Preventing Infectious Diseases’, a 1.5-hour course offered by Wild Iris Medical Education, as advertised in their website http://www.nursingceu.com. Such courses can be a boon to the community.

Differentiated surgical tactics in patients with colic polyps and polyposis

Modern approaches to surgical treatment of patients with colic polyps and polyposis (CPP)
Although the discussion on possibilities of conservative treatment of colic polyps, in particular -by taking non-steroid anti-inflammatory drugs, aspirin, therapeutic enemas with celandine juice, is still going on [12,14,21,25], majority of specialists [2,3,4,8,12,14,19,21,24] adhere to the opinion, that the only adequate method of treatment of the disease is surgery, and the main reason for that is cancerous transformation of the polyps. 
There are numerous publications on the issues of surgical treatment of diffuse colic polyposis. As far back as in 1923 году G. Pennington expressed the opinion, that the only radical treatment of diffuse colic polyposis is colectomy with permanent ileostoma. Until recent times the single-stage operations like colproctectomy, subtotal colectomy were treated as unsafe for patients due to significant shifts in homeostasis caused. For this reason number of authors preferred multi-step operations [18, 19, 21,]. However the recent studies demonstrated, that in this case 63,4% patients develop complications, lethality rate reaches 19,4% [21, 24], and risk of neoplastic transformation in the remaining parts of colon remains high. This makes impossible to perform the next step of surgical intervention due to increased extent of cancerous process or presence of remote metastases [1,2,3,18]. V.D.Feodorov and А.М. Nikitin [19,24] studied the results of multi-step (93 patients) and one-step (174 patients) operations.
Postoperative complications have been observed correspondingly in 63,4 и 39,1% of patients, lethality rate comprised 19,4 и 9,7%. Over recent years colorectal surgeons in such cases tend to perform sphincter-preserving operations. There are two trends: one – colproctectomy and forming the enteric reservoirs [2.3,12,19,21]; the second – using the method of endoscopic polypectomy for sanation of the remaining parts of colon before surgery and in consequent periods of observation [4.5,9,11,13,15]. 
After the report of Doniec J.M. in 2003 about usage of high frequency current during fibrocolonoscopy in treatment of colic polyps, regardless to their localization, the coagulation method became widespread. The experience to date allows holding it safe and highly efficient in CPP cases. [4, 6, 9, 26]. 
Number of authors [4, 11, 15, 16] think, that active case finding and timely removal of polyps significantly reduces the risk of development of colon cancer in 99.5% of examined patients.  
In 1983 Bergmann U. et al. for the first time implemented the method of transanal removal of benign rectal tumors using transanal endoscopic microsurgery (ТЕМ).
It is possible to remove neoplasms of lower and medium parts of rectal ampulla together with sub-mucosal layer, using specially designed operating rectoscope with three-D optics using up to four microsurgical instruments. This method provides adequate lateral resection line in case of benign tumors, and in case of malignant ones allows to expand the extent of intervention up to segmental or even to circular resection of the lesion site of the organ across to whole mass of enteric wall with formation of end-to-end anastomosis. The main application point of the method is treatment of “large” (more than 3 cm in diameter), trailing and malignant villous tumors, because electric coagulation in such cases leads to unsatisfactory results. [22,23].
Spreading of polyps through the entire gastro-intestinal tract, grave condition of patients complicates both diagnostics and choice of surgical tactics. Some authors [17.19, 21, 24] propose combination of both endoscopic and open surgery, depending on the character of the lesion and clinical course of the disease. Its important to note, that regardless to the progress in surgical treatment of CPP, the complications and fatality rates remain high enough and amount to 4-40% [17,21,24]. Multi-step operations lead to highest number of complications and lethality. Complications often occur at colectomy with abdominoanal proctectomy with pulling-through the ileum to anal canal, as well as at subtotal colectomy with ileorectal anastomosis. So, there occur: strictures of the pulled-down bowel (2.8%) и ileostomic fistulas (1.2%) [19,21,24]. Ileus, which occurs in about 3,3% patients, is the main cause of lethality at such operations. The main cause of lethality of patients in the long term is progression of cancer (24,1%). 
Thus, the choice of tactics and method of surgical treatment in CPP remains the issue of the day. Surgical tactics has to be differentiated and individual, depending on the character of the disease and the level of involvement of colon. Timely diagnostic and prognosis of course of CPP is a prerequisite for development and choosing the most effective differentiated surgical tactics. 

Objective
Development of differentiated surgical tactics in patients with CPP based on utilization of advanced complex of diagnostics and prognosis of the risk of malignization of colic polyps. 

Materials and methods
There are analyzed results of diagnostics and treatment of 183 patients with CPP, who were treated at Republican Coloproctology Research Center (RCPRC) and Republican Oncology Research Center (ROCR) of the Ministry of Health of Uzbekistan in 1998-2008. The patients were divided into 2 groups. The 1st (comparison) group consisted of 81 patients, in which the traditional examination and surgical treatment methods were used. The 2nd (main) group consisted of 102 patients in which there were applied the newly developed methods of complex diagnostic and differentiated surgical tactics. The main group consisted of 60 males (58.8%) and 42 females (41.2%), and the comparison one of 52 (64,2%) males и 29 (35,8%) females (Table 1). 

Table 1
Distribution of patients by sex and age
Age of patients (years) Main group Comparison group
Males Females Total Males Females Total
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %
Under 20 3 2,9 4 3,9 7 6,8 2 2,5 0 0 2 2,5
20-29 10 9,8 15 14,7 25 24,5 16 19,7 5 6,2 21 25,9
30-39 12 11,8 2 2,0 14 13,7 3 3,7 2 2,5 5 6,2
40-49 9 8,8 14 13,7 23 22,5 12 14,8 7 8,6 19 23,4
50-59 13 12,7 7 6,9 20 19,6 11 13,6 13 16,0 24 29,6
60 and older 13 12,7 0 0,0 13 12,7 7 8,6 3 3,7 10 12,3
Total 60 58,8 42 41,2 102 100,0 51 63,0 30 37,0 81 100,0
Average age 45,6±1,92 37,1±1,85 42,0±1,41 42,3±2,17 44,0±2,63 42,9±1,68

Average age of patients in the main group made 42.0±1.41 years, in the comparison group – 42,9±1,68 years, i.e. patients of the two groups were comparable by age and sex. 

The clinical forms of CPP in patients are presented in the Table 2.  
Table 2 
Distribution of patients by clinical features, n=183
Clinical forms Main group Comparison group
Solitary polyps 33 19
Multiple polyps 18 27
Diffuse leasons 43 28
Out of them Peuts-Jegher’s syndrome 9 2
Malignant polyposis 8 7
Distal part of intestine 70 65
Left side 12 6

Subtotal 3 4
Total 17 6
Villous polyps 14 9
Ademonatous 35 22
Adenopapillomatous 27 18
Hyperplastic 10 11
Proliferative 5 9
Cancer in citu 11 13
Complications
Posthemorragic anemia 22 31
Cachexy 7 2
Strictures 6 3
Chronic colonic ileus 7 11
Malignization 10 5
Toxic dilatation of colon 2 1
Acute colonic ileus (intussusception) 3 5
Bleeding from rectum 35 32
Colonic perforation 1 1

The main group had more severe clinical features than the comparison one (Table 2). 

Substantiation of the algorithm of the differentiated surgical tactics
We developed the complex of diagnostic and prognostic criteria for evaluation of disease severity and risk of malignization of CPP. There were identified 4 malignization risk groups – minimal, moderate, significant and high risk. On the basis of published data and on our own experience we developed the algorithm of differentiated surgical tactics in patients with CPP depending on the malignization risk group. (Picture 1). 
1 group – minimal malignization risk, includes patients with preclinical phase and initial disease symptoms, with solitary adenomatous and villous polyps no bigger than 5-8 mm, less than 10 items in total, in most cases with involvement of rectum only, that is why there were used transanal and endoscopic methods of surgical treatment.
2 group – moderate malignization risk, includes patients with multiple proliferating and hyperplastic polyps with size not exceeding 15mm, up to 50-100 pieces in total, mainly with involvement of rectum and distal parts of sigma. We, as the majority of modern authors, adhere to tactics of dynamic [7, 20] endoscopic bipolar electrocoagulation of these polyps. 
While performing the endoscopic polypectomy we were guided by the following criteria:
1) Excision has to be started from the most proximally located adenomas, to avoid traumatizing the eschar formed after coagulation during sometimes unavoidable multiple insertions of endoscope.;
2) One should not try to remove all the polyps in one step, depending of their quantity and size the polyps, the aim of the endoscopic intervention can be fulfilled in several steps with removal of 20-30 polyps in one session.;
3) First of all one should remove the biggest and suspicious in terms of malignization polyps, in which the electrocoagulation is performed on the level of basement of the pedicle with subsequent histological examination of not less than 3-4 of them, capturing into microscopic section all parts of the polyp (basement, peduncle and head);
4) All patients have to be kept under observation by the specialized facility; intervals between check-ups should not exceed 6 months. 
3rd group – significant malignization risk. There are included patients with diffuse polyposis, initial presentations of Peuts-Jeghers, Trucot, Gardner syndroms, with polyps sized between 15-30 mm, 100-500 pieces in total, of adenopapillomatous, proliferative, and dysplastic nature. In this group there is implemented two-step radical surgery tactics. During the 2nd step, if necessary, there were performed reconstructive operations. In these patients, depending on the character, level and extent of lesion there are performed either one-step resections of the involved parts of colon, or combination of resection with unloading ileostomy. The second variant is usually used as urgent operation in weak patients with significant weight loss. In several months – after stabilization of their condition – reconstructive operation with closure of the ileostomy is performed. 
In number of cases, when other organs of gastro-intestinal tract are involved – intestine, stomach or gallbladder – the simultaneous operations are performed in those cases where general condition of the patient allows. 
In the group 4 – high malignization risk, which includes patients with total diffuse polyposis of colon, intestinal polyposis of gastrointestinal tract (Peuts-Jeghers, Trucot, Gardner syndromes), malignant polyps or transformation from cancer in situ into adenocarcinoma – there are used 3 variants of surgical tactics. 
If there are gastric polyps –endoscopic bipolar electrocoagulation of gastric and colonic polyps has been performed as the 1st step. On the second step there were performed radical extended operations on colon with lymphodissection, and on the 3rd stage – reconstructive operations.
In case of polyps of intestine the first radical extended operations are performed on intestine and colon, and roughly in 1 year after that – reconstructive ones.
In case if there is no polyps in stomach and intestine the two-step tactics is used – radical extended operations on colon as the first step and reconstructive operations after 1 year as the second step. We propose the algorithm of differentiated surgical tactics in patients with CPP (picture 1). 
Picture 1.  
ALGORITHM OF DIFFERENTIANTED SURGICAL TACTICS IN PATIENTS WITH COLIC POLYPS AND POLYPOSIS

Results of treatment
The Table 3 shows the types of operations performed in the main and comparison groups. One can see that the groups are comparable by the character and volume of operations.  
Table 3
Types of operations in patients with CPP
Type of operation Main group, 
n=85 Comparison group, n=73
Transanal polypectomy 29 (34,1) 19 (26,0)
Total colectomy, ileostomy 9 (10,6) 4 (5,5)
Abdomino-anal proctectomy with pull-down of proximal parts of colon to anal canal 22 (25,9) 15 (23,3)
Sub-total colectomy with colorectal anastomosis 1 (1,2) 1 (1,4)
Abdomino-anal proctectomy, colostomy 4 (4,7) 13 (17,9)
Hartmann’s operation 3 (3,5) 2 (2,7)
Left hemicolectomy with transverso-rectal anastomosis 1 (1,2) 2 (2,7)
Duhamel’s operation with colorectal anastomosis – 1 (1,4)
Abdomino-perineal extirpation of rectum, colostomy – 2 (2,7)
Laparotomy, enterotomy, proctotomy, polypectomy, resection of intestine, side-to-side anastomosis 1 (1,2) 2 (2,7)
Sigmoid colectomy with colorectal anastomosis (CDH-29 or CDH-31 apparatus) 1 (1,2) 4 (5,5)
Total coloproctectomy, disinvagination of intestine, ileostomy 0 (0%) 1 (1,4%)
Preventive double-barrel ileostomy 1 (1,2) –
Operation of DeLorme 1 (1,2) –
Operation of Miculicz 1 (1,2) –
Reconstructive operations 11 (12,9) 5 (6,8)

In 25 patients there are performed simultaneous operations. Abdominoanal proctectomy with pulling down of proximal parts of colon to anal canal was combined in 5 patients with removal of ovarian cysts, hysterectomy, echinococcectomy and Bilroth 1 partial gastrectomy. Left hemicolectomy with transverse-rectal anastomosis in 2 patients was combined with cholecystectomy and ureterolythotomy. Right hemicolectomy with ileotrasversoanastomosis in 4 patients was combined with ovarian cyctectomy and echinococcectomy. Sigmoid colectomy with colorectal anastomosis in 3 patients combined with Kummel’s posterior rectopexy and amputation of uterus. Sub-total colectomy with colorectal anastomosis in 2 patients combined with appendectomy and ovarian cystectomy. Total colectomy with ileorectal anastomosis in 5 patients combined with cholecystectomy, gastric resection and herniotomy. Sigmoid colectomy with colorectal anastomosis in 4 patients combined with appendectomy, ovarian cystectomy and metrofiromectomy. Reconstructive operations in 4 patients combined with cholecystectomy, gastric resection and herniotomy. In 4 patients gastric resection and in 1 patient cholecystectomy have been performed due to Peuts-Jegher’s syndrome (diffuse polyposis of stomach and gallbladder). 
The data we brought confirm the correctness of the chosen surgical tactics and indicate the need to improve the methods of early diagnostics of CPP. In Table 4 there are shown the results of treatment of main and comparison groups. As it is seen, recovery rate in the main group was significantly higher than in the comparison one – 83,5±3,7% and 65,7±5,2%, and the rate of relapses was significantly lower – 1,2±2,2% и 12,3±3,5% accordingly. 
Таблица 4. 
Results of surgical treatment of patients with CPP in the comparison groups

Treatment outcome Main group, n=85 Comparison group, n=73
абс. % абс. %
Recovery 71 83,5±3,7* 48 65,7±5,2
Improvement 8 9,4±2,8* 12 16,4±4,2
No change 1 1,2±1,2 4 5,5±2,4
Worsening 1 1,2±1,2 – 0±0
Relapse 1 1,2±2,2* 9 12,3±3,5
Fatal outcome 3 3,5±2,0* – –
Footnote * – Differences between the indicators of main and comparative group are statistically valid (Р<0.05).

At the same time, one should note, that there were no fatal outcomes in the patients of comparison group, whereas in the main group 3 patients (3,5±2,0%) died due to cardiac failure (2) и ileus (1). Cardiac failure was a cause of death of 1 patient with multiple polyps, who undergone reconstructive operation and 1 patient with diffuse polyposis after simultaneous operation. Ileus was a cause of death of 1 patient with diffuse polyposis, who undergone radical (abdominoanal proctectomy, subtotal colproctectomy, single-barrelled ascendostomy) operation. As seen, fatal outcomes in the main group were attributed to severe baseline condition, and in 2 out of 3 cases they occurred after expanded reconstructive operations. 
Conclusions
1. In patients with colonic polyps and polyposis the differentiated surgical tactics should be applied, using both endoscopic and radical operations, taking into account the extent and character of involvement, as well as the risk of malignization. 
2. In order to choose differentiated surgical tactics in these patients 4 groups of severity of lesion and malignization risk have to be distinguished on the basis of criteria we developed earlier. 
3. Application of the developed algorithm of differentiated surgical tactics allows improving the treatment outcomes significantly, particularly to increase recovery rate and reduce the rate of relapses several times. 
4. As necessary the operations on colon have to be complemented by operations on other gastrointestinal tract organs (stomach, intestine, gallbladder etc.).
5. There is a need in further development of surgical tactics, preoperative preparation, anaesthetic and resuscitation management in patients with colonic polyps and polyposis, especially in the 3rd and 4th risk groups, in debilitated patients and in cases of urgent operations. 

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