a measurement of the depth of a periodontal pocket (see periodontal disease).
– electroencephalograms – are useful in DIAGNOSIS: for example, the abnormal electroencephalogram occurring in EPILEPSY is characteristic of this disease. The normal waves, known as alpha waves, occur with a frequency of 10 per second. Abnormal waves, with a frequency of 7 or fewer per second, are known as delta waves and occur in the region of cerebral tumours and in the brains of epileptics. An electroencephalogram can assess whether an individual is awake, alert or asleep. It may also be used during surgery to monitor the depth of unconsciousness in anaesthetised patients.... electroencephalography (eeg)
Severe and extensive burns are most frequently produced by the clothes – for example, of a child – catching ?re. This applies especially to cotton garments, which blaze up quickly. It should be remembered that such a ?ame can immediately be extinguished by making the individual lie on the ?oor so that the ?ames are uppermost, and wrapping him or her in a rug, mat or blanket. As prevention is always better than cure, particular care should always be exercised with electric ?res and kettles or pots of boiling water in houses where there are young children or old people. Children’s clothes, and especially night-clothes, should be made of non-in?ammable material: pyjamas are also much safer than nightdresses.
Severe scalds are usually produced by escape of steam in boiler explosions. Cigarettes are a common cause of ?res and therefore of burns; people who have fallen asleep in bed or in a chair while smoking may set ?re to the bed or chair. Discarded, unextinguished cigarettes are another cause.
Degrees of burns Burns are referred to as either super?cial (or partial-thickness) burns, when there is su?cient skin tissue left to ensure regrowth of skin over the burned site; and deep (or full-thickness) burns, when the skin is totally destroyed and grafting will be necessary.
Symptoms Whilst many domestic burns are minor and insigni?cant, more severe burns and scalds can prove to be very dangerous to life. The main danger is due to SHOCK, which arises as a result of loss of ?uid from the circulating blood at the site of a serious burn. This loss of ?uid leads to a fall in the volume of the circulating blood. As the maintenance of an adequate blood volume is essential to life, the body attempts to compensate for this loss by withdrawing ?uid from the uninjured areas of the body into the circulation. If carried too far, however, this in turn begins to affect the viability of the body cells. As a sequel, essential body cells, such as those of the liver and kidneys, begin to suffer, and the liver and kidneys cease to function properly. This will show itself by the development of JAUNDICE and the appearance of albumin in the urine (see PROTEINURIA). In addition, the circulation begins to fail with a resultant lack of oxygen (see ANOXIA) in the tissues, and the victim becomes cyanosed (see CYANOSIS), restless and collapsed: in some cases, death ensues. In addition, there is a strong risk of infection occurring. This is the case with severe burns in particular, which leave a large raw surface exposed and very vulnerable to any micro-organisms. The combination of shock and infection can all too often be life-threatening unless expert treatment is immediately available.
The immediate outcome of a burn is largely determined by its extent. This is of more signi?cance than the depth of the burn. To assess the extent of a burn in relation to the surface of the body, what is known as the Rule of Nine has been evolved. The head and each arm cover 9 per cent of the body surface, whilst the front of the body, the back of the body, and each leg each cover 18 per cent, with the perineum (or crutch) accounting for the remaining 1 per cent. The greater the extent of the burn, the more seriously ill will the victim become from loss of ?uid from his or her circulation, and therefore the more prompt should be his or her removal to hospital for expert treatment. The depth of the burn, unless this is very great, is mainly of import when the question arises as to how much surgical treatment, including skin grafting, will be required.
Treatment This depends upon the severity of the burn. In the case of quite minor burns or scalds, all that may be necessary if they are seen immediately is to hold the part under cold running water until the pain is relieved. Cooling is one of the most e?ective ways of relieving the pain of a burn. If the burn involves the distal part of a limb – for example, the hand and forearm – one of the most e?ective ways of relieving pain is to immerse the burned part in lukewarm water and add cold water until the pain disappears. As the water warms and pain returns, more cold water is added. After some three to four hours, pain will not reappear on warming, and the burn may be dressed in the usual way. Thereafter a simple dressing (e.g. a piece of sterile gauze covered by cotton-wool, and on top of this a bandage or adhesive dressing) should be applied. The part should be kept at rest and the dressing kept quite dry until healing takes place. Blisters should be pierced with a sterile needle, but the skin should not be cut away. No ointment or oil should be applied, and an antiseptic is not usually necessary.
In slightly more severe burns or scalds, it is probably advisable to use some antiseptic dressing. These are the cases which should be taken to a doctor – whether a general practitioner, a factory doctor, or to a hospital Accident & Emergency department. There is still no general consensus of expert opinion as to the best ‘antiseptic’ to use. Among those recommended are CHLORHEXIDINE, and antibiotics such as BACITRACIN, NEOMYCIN and polymixin. An alternative is to use a Tulle Gras dressing which has been impregnated with a suitable antibiotic.
In the case of severe burns and scalds, the only sound rule is immediate removal to hospital. Unless there is any need for immediate resuscitation, such as arti?cial respiration, or attention to other injuries there may be, such as fractures or haemorrhage, nothing should be done on the spot to the patient except to make sure that s/he is as comfortable as possible and to keep them warm, and to cover the burn with a sterile (or clean) cloth such as a sheet, pillowcases, or towels wrung out in cold water. If pain is severe, morphine should be given – usually intravenously. Once the victim is in hospital, the primary decision is as to the extent of the burn, and whether or not a transfusion is necessary. If the burn is more than 9 per cent of the body surface in extent, a transfusion is called for. The precise treatment of the burn varies, but the essential is to prevent infection if this has not already occurred, or, if it has, to bring it under control as quickly as possible. The treatment of severe burns has made great advances, with quick transport to specialised burns units, modern resuscitative measures, the use of skin grafting and other arti?cial covering techniques and active rehabilitation programmes, o?ering victims a good chance of returning to normal life.
CHEMICAL BURNS Phenol or lysol can be washed o? promptly before they do much damage. Acid or alkali burns should be neutralised by washing them repeatedly with sodium bicarbonate or 1 per cent acetic acid, respectively. Alternatively, the following bu?er solution may be used for either acid or alkali burns: monobasic potassium phosphate (70 grams), dibasic sodium phosphate (70 grams) in 850 millilitres of water. (See also PHOSPHORUS BURNS.)... burns and scalds
Hin: Patharchur;
Ben: Paterchur;Mal: Panikkurkka, kannikkurkka;Tam: Karpuravalli;Kan: karpurahalli;Tel: Sugandhavalkam.It is found through out the tropics and cultivated in homestead gardens. It is a large succulent aromatic perennial herb with hispidly villous or tomentose fleshy stem. Leaves are simple, opposite, broadly ovate, crenate and fleshy. Flowers are pale purplish in dense whorls at distant intervals in a long slender raceme. Fruits are orbicular or ovoid nutlets. The leaves are useful in cephalagia, otalgia, anorexia, dyspepsia, flatulence, colic, diarrhoea, cholera, halitosis, convulsions, epilepsy, cough, asthma, hiccough, bronchitis, strangury, hepatopathy and malarial fever (Warrier et al,1995).2. Coleus vettiveroides K.C. Jacob, syn. Plectranthus vettiveroides (Jacob) Singh & Sharma.San: Valakam, Hriberam;Hin: Valak;Mal: Iruveli;Tam: Karuver;Tel: Karuveru,It is seen in tropical countries and cultivated in gardens. It is a small profusely branched, succulent aromatic herb with quadrangular stems and branches and deep straw coloured aromatic roots. Leaves are glandular hairy, broadly ovate with dentate margins and prominent veins on the bark. Blue flowers are borne on terminal racemes. Fruits are nutlets. The whole plant is useful in hyperdipsia, vitiated conditions of pitta, burning sensation, strangury, leprosy, skin diseases, leucoderma, fever, vomiting, diarrhoea, ulcers and as hair tonic.3. Coleus forskohlii Briq. syn. C. barbatus Benth.Hin: Garmai
Kan: Maganiberu, MakandiberuGuj: MaimulIt is a perennial aromatic herb grown under tropical to temperate conditions for its carrot-like tubers which are used as condiments in the preparation of pickles. Its tuberous roots are an exclusive source of a diterpenoid forskolin which has the unique property of activating almost all hormone sensitive adenylate cyclase enzymes in a biological system. It is useful in the treatment of congestive heart failure, glaucoma, asthma, cancer and in preventing immature greying of hair (Hegde,1997).Agrotechnology: The Coleus group of plants grows in tropical to subtropical situations and in warm temperate climatic zone on mountains of India, Nepal, Burma, Sri Lanka, Thailand and Africa. It comes up well on the sun exposed dry hill slopes from 300m to 1800m altitude. A well drained medium fertile soil is suitable for its cultivation. it is propagated vegetatively through stem and root cuttings. Vine cuttings to a length of 10-15cm from the top portion are most ideal for planting. The land is ploughed or dug to a depth of 15-20cm and ridges are formed 30cm apart. Vine cuttings are planted on the ridges at 30cm spacing after incorporating basal manure. 10t of FYM and NPK at 50:50:50kg/ha are incorporated into the soil. Top dressing of N and K is also suggested for improved yields. Weeding and earthing up at 45 days after planting along with topdressing is highly beneficial. Bacterial wilt and root knot nematode are reported in the crop. Drenching the soil with fungicide, deep ploughing in the summer, burning of crop residues and crop rotation are helpful to tide over the disease and pest problem. The crop can be harvested after 5-6 months.Properties and activity: The medicinal property of Coleus amboinicus is attributed to codeine, carvacrol, flavones, aromatic acids and tannins present in the plant. The essential oil from the plant contains carvacrol, ethyl salicylate, thymol, eugenol and chavicol. Leaves also contain cirsimaritin, -sitosterol- -D-glucoside and oxalacetic acid. Leaves are bitter, acrid, thermogenic, aromatic, anodyne, appetising, digestive, carminative, stomachic, anthelmintic, constipating, deodorant, expectorant, diuretic and liver tonic.Coleus vettiveroides is bitter, cooling, diuretic, trichogenous and antipyretic.Coleus forskohlii roots are rich in diterpenoids like forskolin, coleonols, coleons, barbatusin, cyclobutatusin, coleosol, coleol, coleonone, deoxycoleonol, 7-deacetylforskolin and 6-acetyl-7-deacetylforskolin. Its root is spasmolytic, CNS active, hypothermic and diuretic. Forskolin is bronchodialative and hypotensive (Hussain et al,1992). Forskolin is also useful in preventing the clotting of blood platelets, in reducing intraocular pressure in glaucoma and as an aid to nerve regeneration following trauma (Sharma, 1998)... coleusHin: Akasgaddah;
Mal: Kadamba, KollankovaTam: Akashagarudan, Gollankovai;Tel: Murudonda, NagadondaCorallocarpus is a prostrate or climbing herb distributed in Punjab, Sind, Gujarat, Deccan, Karnataka and Sri Lanka. It is monoecious with large root which is turnip-shaped and slender stem which is grooved, zigzag and glabrous. Tendrils are simple, slender and glabrous. Leaves are sub-orbicular in outline, light green above and pale beneath, deeply cordate at the base, angled or more or less deeply 3-5 lobed. Petiole is long and glabrous. Male flowers are small and arranged at the tip of a straight stiff glabrous peduncle. Calyx is slightly hairy, long and rounded at the base. Corolla is long and greenish yellow. Female flowers are usually solitary with short, stout and glabrous peduncles. Fruit is stalked, long, ellipsoid or ovoid. Seeds are pyriform, turgid, brown and with a whitish corded margin. It is prescribed in later stages of dysentery and old veneral complaints. For external use in chronic rheumatism, it is made into a liniment with cumin seed, onion and castor oil. It is used in case of snakebite where it is administered internally and applied to the bitten part. The root is given in syphilitic rheumatism and later stages of dysentery. The plant is bitter, sweet, alexipharmic and emetic. The root is said to possess alterative and laxative properties (Kirtikar and Basu, 1988). Root contains a bitter principle like Breyonin (Chopra et al, 1980).Agrotechnology: Cucurbits can be successfully grown during January-March and September- December. For the rainfed crop, sowing can also be started after the receipt of the first few showers.Pits of 60cm diameter and 30-45cm depth are to be taken at the desired spacing. Well rotten FYM or vegetable mixture is to be mixed with topsoil in the pit and seeds are to be sown at 4-5/pit. Unhealthy plants are to be removed after 2 weeks and retained 2-3 plants/pit. FYM is to be applied at 20-25t/ha as basal dose along with half dose of N (35kg/ha) and full dose of P (25kg) and K (25kg). The remaining dose of N (35kg) can be applied in 2 equal split doses at fortnightly intervals. During the initial stages of growth, irrigation is to be given at an interval of 3-4 days and at alternate days during flowering and fruiting periods. For trailing cucumber, pumpkin and melon, dried twigs are to be spread on the ground. Bitter gourd, bottle gourd, snake gourd and ash gourd are to be trailed on Pandals. Weeding and raking of the soil are to be conducted at the time of fertilizer application. Earthing up may be done during rainy season. The most dreaded pest of cucurbits is fruit flies which can be controlled by using fruit traps, covering the fruits with polythene, cloth or paper bags, removal and destruction of affected fruits and lastly spraying with Carbaryl or Malathion 0. 2% suspension containing sugar or jaggery at 10g/l at fortnightly intervals after fruit set initiation. During rainy season, downy mildew and mosaic diseases are severe in cucurbits. The former can be checked by spraying Mancozeb 0.2%. The spread of mosaic can be checked by controlling the vectors using Dimethoate or Phosphamidon 0.05% and destruction of affected plants and collateral hosts. Harvesting to be done at least 10 days after insecticide or fungicide application (KAU,1996).... cucurbitsmay be due to malfunction of the part of the brain that controls breathing (as occurs in some cases of stroke and head injury).
It may also occur as a result of heart failure or in healthy people at high altitudes, especially during sleep.... cheyne–stokes respiration
Most hazards stem from the pressure increase with depth.
Conditions treated include burst lung and decompression sickness.... scuba-diving medicine
Treatment is excision with a margin of normal tissue. The specimen must be examined histologically, and prognosis depends on the depth of invasion. Very super?cial melanomas carry an excellent outlook once removed, but deeper tumours may spread to regional lymph glands and beyond with fatal results. Public-awareness campaigns have led to the earlier presentation of melanomas in recent years, with corresponding bene?t. (See also SUNBURN.)... melanoma
Varieties These are classi?ed according to the immediate e?ect produced: INCISED WOUNDS are usually in?icted with some sharp instrument, and are clean cuts, in which the tissues are simply divided without any damage to surrounding parts. The bleeding from such a wound is apt to be very free, but can be readily controlled. PUNCTURE WOUNDS, or stabs, are in?icted with a pointed instrument. These wounds are dangerous, partly because their depth involves the danger of wounding vital organs; partly because bleeding from a stab is hard to control; and partly because they are di?cult to sterilise. The wound produced by the nickel-nosed bullet is a puncture, much less severe than the ugly lacerated wound caused by an expanding bullet, or by a ricochet, and, if no clothing has been carried in by the bullet, the wound is clean and usually heals at once. LACERATED WOUNDS are those in which tissues are torn, such as injuries caused by machinery.
Little bleeding may occur and a limb can be torn completely away without great loss of blood. Such wounds are, however, especially liable to infection. CONTUSED WOUNDS are those accompanied by much bruising of surrounding parts, as in the case of a blow from a cudgel or poker. There is little bleeding, but healing is slow on account of damage to the edges of the wound. Any of these varieties may become infected.
First-aid treatment The ?rst aim is to check any bleeding. This may be done by pressure upon the edges of the wound with a clean handkerchief, or, if the bleeding is serious, by putting the ?nger in the wound and pressing it upon the spot from which the blood is coming.
If medical attention is available within a few hours, a wound should not be interfered with further than is necessary to stop the bleeding and to cover it with a clean dry handkerchief or bandage. When expert assistance is not soon obtainable, the wound should be cleaned with an antiseptic such as CHLORHEXIDINE or boiled water and the injured part ?xed so that movement is prevented or minimised. A wounded hand or arm is ?xed with a SLING, a wounded leg with a splint (see SPLINTS). If the victim is in SHOCK, he or she must be treated for that. (See also APPENDIX 1: BASIC FIRST AID.)... wounds
(1) the external ear, consisting of the auricle on the surface of the head, and the tube which leads inwards to the drum; (2) the middle ear, separated from the former by the tympanic membrane or drum, and from the internal ear by two other membranes, but communicating with the throat by the Eustachian tube; and (3) the internal ear, comprising the complicated labyrinth from which runs the vestibulocochlear nerve into the brain.
External ear The auricle or pinna consists of a framework of elastic cartilage covered by skin, the lobule at the lower end being a small mass of fat. From the bottom of the concha the external auditory (or acoustic) meatus runs inwards for 25 mm (1 inch), to end blindly at the drum. The outer half of the passage is surrounded by cartilage, lined by skin, on which are placed ?ne hairs pointing outwards, and glands secreting a small amount of wax. In the inner half, the skin is smooth and lies directly upon the temporal bone, in the substance of which the whole hearing apparatus is enclosed.
Middle ear The tympanic membrane, forming the drum, is stretched completely across the end of the passage. It is about 8 mm (one-third of an inch) across, very thin, and white or pale pink in colour, so that it is partly transparent and some of the contents of the middle ear shine through it. The cavity of the middle ear is about 8 mm (one-third of an inch) wide and 4 mm (one-sixth of an inch) in depth from the tympanic membrane to the inner wall of bone. Its important contents are three small bones – the malleus (hammer), incus (anvil) and stapes (stirrup) – collectively known as the auditory ossicles, with two minute muscles which regulate their movements, and the chorda tympani nerve which runs across the cavity. These three bones form a chain across the middle ear, connecting the drum with the internal ear. Their function is to convert the air-waves, which strike upon the drum, into mechanical movements which can affect the ?uid in the inner ear.
The middle ear has two connections which are of great importance as regards disease (see EAR, DISEASES OF). In front, it communicates by a passage 37 mm (1.5 inches) long – the Eustachian (or auditory) tube – with the upper part of the throat, behind the nose; behind and above, it opens into a cavity known as the mastoid antrum. The Eustachian tube admits air from the throat, and so keeps the pressure on both sides of the drum fairly equal.
Internal ear This consists of a complex system of hollows in the substance of the temporal bone enclosing a membranous duplicate. Between the membrane and the bone is a ?uid known as perilymph, while the membrane is distended by another collection of ?uid known as endolymph. This membranous labyrinth, as it is called, consists of two parts. The hinder part, comprising a sac (the utricle) and three short semicircular canals opening at each end into it, is the part concerned with the balancing sense; the forward part consists of another small bag (the saccule), and of a still more important part, the cochlear duct, and is the part concerned with hearing. In the cochlear duct is placed the spiral organ of Corti, on which sound-waves are ?nally received and by which the sounds are communicated to the cochlear nerve, a branch of the vestibulocochlear nerve, which ends in ?laments to this organ of Corti. The essential parts in the organ of Corti are a double row of rods and several rows of cells furnished with ?ne hairs of varying length which respond to di?ering sound frequencies.
The act of hearing When sound-waves in the air reach the ear, the drum is alternately pressed in and pulled out, in consequence of which a to-and-fro movement is communicated to the chain of ossicles. The foot of the stapes communicates these movements to the perilymph. Finally these motions reach the delicate ?laments placed in the organ of Corti, and so affect the auditory nerve, which conveys impressions to the centre in the brain.... ear
In normal, quiet breathing, only about a 10th of the air in the lungs passes out to be replaced by the same amount of fresh air (tidal volume). This new air mixes with the stale air (residual volume) already held in the lungs. The normal breathing rate for an adult at rest is 13–17 breaths per minute. (See also respiration.) At high altitudes, the lungs have to work harder in order to provide the body with sufficient oxygen (see mountain sickness). Breathlessness may occur in severe anaemia because abnormal or low levels of the oxygen-carrying pigment haemoglobin means that the lungs need to work harder to supply the body with oxygen. Breathing difficulty that intensifies on exertion may be caused by reduced circulation of blood through the lungs. This may be due to heart failure, pulmonary embolism, or pulmonary hypertension. Breathing difficulty due to air-flow obstruction may be caused by chronic bronchitis, asthma, an allergic reaction, or lung cancer. Breathing difficulty may also be due to inefficient transfer of oxygen from the lungs into the bloodstream. Temporary damage to lung tissue may be due to pneumonia, pneumothorax, pulmonary oedema, or pleural effusion. Permanent lung damage may be due to emphysema. Chest pain (for example, due to a broken rib) that is made worse by chest or lung movement can make normal breathing difficult and painful, as can pleurisy, which is associated with pain in the lower chest and often in the shoulder tip of the affected side. Abnormalities of the skeletal structure of the thorax (chest), such as severe scoliosis or kyphosis, may cause difficulty in breathing by impairing normal movements of the ribcage.... breathing
Symptoms These depend upon whether the anaemia is sudden in onset, as in severe haemorrhage, or gradual. In all cases, however, the striking sign is pallor, the depth of which depends upon the severity of the anaemia. The colour of the skin may be misleading, except in cases due to severe haemorrhage, as the skin of many Caucasian people is normally pale. The best guide is the colour of the internal lining of the eyelid. When the onset of the anaemia is sudden, the patient complains of weakness and giddiness, and loses consciousness if he or she tries to stand or sit up. The breathing is rapid and distressed, the pulse is rapid and the blood pressure is low. In chronic cases the tongue is often sore (GLOSSITIS), and the nails of the ?ngers may be brittle and concave instead of convex (koilonychia). In some cases, particularly in women, the Plummer-Vinson syndrome is present: this consists of di?culty in swallowing and may be accompanied by huskiness; in these cases glossitis is also present. There may be slight enlargement of the SPLEEN, and there is usually some diminution in gastric acidity.
CHANGES IN THE BLOOD The characteristic change is a diminution in both the haemoglobin and the red cell content of the blood. There is a relatively greater fall in the haemoglobin than in the red cell count. If the blood is examined under a microscope, the red cells are seen to be paler and smaller than normal. These small red cells are known as microcytes.
Treatment consists primarily of giving suf?cient iron by mouth to restore, and then maintain, a normal blood picture. The main iron preparation now used is ferrous sulphate, 200 mg, thrice daily after meals. When the blood picture has become normal, the dosage is gradually reduced. A preparation of iron is available which can be given intravenously, but this is only used in cases which do not respond to iron given by mouth, or in cases in which it is essential to obtain a quick response.
If, of course, there is haemorrhage, this must be arrested, and if the loss of blood has been severe it may be necessary to give a blood transfusion (see TRANSFUSION – Transfusion of blood). Care must be taken to ensure that the patient is having an adequate diet. If there is any underlying metabolic, oncological, toxic or infective condition, this, of course, must be adequately treated after appropriate investigations.
Megaloblastic hyperchromic anaemia There are various forms of anaemia of this type, such as those due to nutritional de?ciencies, but the most important is that known as pernicious anaemia.
PERNICIOUS ANAEMIA An autoimmune disease in which sensitised lymphocytes (see LYMPHOCYTE) destroy the PARIETAL cells of the stomach. These cells normally produce INTRINSIC FACTOR, the carrier protein for vitamin B12 (see APPENDIX 5: VITAMINS) that permits its absorption in the terminal part of the ILEUM. Lack of the factor prevents vitamin B12 absorption and this causes macrocytic (or megaloblastic) anaemia. The disorder can affect men and women, usually those over the age of 40; onset is insidious so it may be well advanced before medical advice is sought. The skin and MUCOSA become pale, the tongue is smooth and atrophic and is accompanied by CHEILOSIS. Peripheral NEUROPATHY is often present, resulting in PARAESTHESIA and numbness and sometimes ATAXIA. A rare complication is subacute combined degeneration of the SPINAL CORD.
In 1926 two Americans, G R Minot and W P Murphy, discovered that pernicious anaemia, a previously fatal condition, responded to treatment with liver which provides the absent intrinsic factor. Normal development requires a substance known as extrinsic factor, and this depends on the presence of intrinsic factor for its absorption from the gut. The disease is characterised in the blood by abnormally large red cells (macrocytes) which vary in shape and size, while the number of white cells (LEUCOCYTES) diminishes. A key diagnostic ?nd is the presence of cells in the BONE MARROW.
Treatment consists of injections of vitamin B12 in the form of hydroxocobalamin which must be continued for life.
Aplastic anaemia is a disease in which the red blood corpuscles are very greatly reduced, and in which no attempt appears to be made in the bone marrow towards their regeneration. It is more accurately called hypoplastic anaemia as the degree of impairment of bone-marrow function is rarely complete. The cause in many cases is not known, but in rather less than half the cases the condition is due to some toxic substance, such as benzol or certain drugs, or ionising radiations. The patient becomes very pale, with a tendency to haemorrhages under the skin and mucous membranes, and the temperature may at times be raised. The red blood corpuscles diminish steadily in numbers. Treatment consists primarily of regular blood transfusions. Although the disease is often fatal, the outlook has improved in recent years: around 25 per cent of patients recover when adequately treated, and others survive for several years. In severe cases promising results are being reported from the use of bone-marrow transplantation.
Haemolytic anaemia results from the excessive destruction, or HAEMOLYSIS, of the red blood cells. This may be the result of undue fragility of the red blood cells, when the condition is known as congenital haemolytic anaemia, or of acholuric JAUNDICE.
Sickle-cell anaemia A form of anaemia characteristically found in people of African descent, so-called because of the sickle shape of the red blood cells. It is caused by the presence of the abnormal HAEMOGLOBIN, haemoglobin S, due to AMINO ACID substitutions in their polypeptide chains, re?ecting a genetic mutation. Deoxygenation of haemoglobin S leads to sickling, which increases the blood viscosity and tends to obstruct ?ow, thereby increasing the sickling of other cells. THROMBOSIS and areas of tissue INFARCTION may follow, causing severe pain, swelling and tenderness. The resulting sickle cells are more fragile than normal red blood cells, and have a shorter life span, hence the anaemia. Advice is obtainable from the Sickle Cell Society.... inadequate intake of iron
In yoga, deep rhythmic breathing is used to achieve a state of relaxation. During childbirth, breathing exercises relax the mother and also help to control contractions and reduce pain. (See also physiotherapy.)... breathing exercises
Divers with decompression sickness are immediately placed inside a recompression chamber. Pressure within the chamber is raised, causing the bubbles within the tissues to redissolve. Subsequently, the pressure in the chamber is slowly reduced, allowing the excess gas to escape safely via the lungs. If treated promptly, most divers with the “bends” make a full recovery. In serious, untreated cases, there may be long-term problems, such as paralysis.... decompression sickness
There are 2 types of sleep: (rapid eye movement) and (nonrapid eye movement) sleep, which alternate in cycles. sleep consists of 4 stages of progressively greater “depth”, with slowing of brain activity. In sleep, the brain becomes more active; the eyes move rapidly and dreaming occurs.
Sleep is a fundamental human need, as shown by the effects of sleep deprivation, although its purpose is not understood in detail. The need for sleep varies from person to person and decreases with age. Sleep disorders include difficulty in falling or remaining asleep (see insomnia); difficulty in staying awake (see narcolepsy); disruption of sleep by jetlag and bed-wetting, night terrors, or sleepwalking. (See also sleep apnoea.)... sleep
The brain coordinates the motor nerve impulses to the 6 tiny muscles that move each eye to achieve alignment of the eyes.
Accurate alignment allows the brain to fuse the images from each eye, but because each eye has a slightly different view of a given object, the brain obtains information that is interpreted as solidity or depth.
This stereoscopic vision is important in judging distance.... vision
Adrenaline given by injection is used in the emergency treatment of anaphylaxis and cardiac arrest. It is also included in some local anaesthetic solutions, particularly those used in dentistry, to prolong anaesthesia, and is used as eye drops for treating glaucoma.... adrenaline
burning mouth syndrome (BMS) a disorder characterized by a burning sensation in the mouth for which there is no obvious medical or dental cause. Other symptoms may include thirst, sore throat, and an unpleasant taste. BMS occurs most commonly in older females and may be related to menopause, stress, or vitamin deficiencies.... burn
FAMILY: Annonaceae
SYNONYMS: Unona odorantissimum, flower of flowers.
GENERAL DESCRIPTION: A tall tropical tree up to 20 metres high with large, tender, fragrant flowers, which can be pink, mauve or yellow. The yellow flowers are considered best for the extraction of essential oil.
DISTRIBUTION: Native to tropical Asia, especially Indonesia and the Philippines. Major oil producers are Madagascar, Reunion and the Comoro Islands.
OTHER SPECIES: Very closely related to cananga (C. odoratum var. macrophylla), although the oil produced from the ylang ylang is considered of superior quality for perfumery work, having a more refined quality.
HERBAL/FOLK TRADITION: In Indonesia, the flowers are spread on the beds of newly married couples on their wedding night. In the Molucca Islands, an ointment is made from ylang ylang and cucuma flowers in a coconut oil base for cosmetic and hair care, skin diseases, to prevent fever (including malaria) and fight infections.
In the Victorian age, the oil was used in the popular hair treatment Macassar oil, due to its stimulating effect on the scalp, encouraging hair growth. The oil was also used to soothe insect bites, and is thought to have a regulating effect on cardiac and respiratory rhythm.
ACTIONS: Aphrodisiac, antidepressant, anti infectious, antiseborrhoeic, antiseptic, euphoric, hypotensive, nervine, regulator, sedative (nervous), stimulant (circulatory), tonic.
EXTRACTION: Essential oil by water or steam distillation from the freshly picked flowers. The first distillate (about 40 per cent) is called ylang ylang extra, which is the top grade. There are then three further successive distillates, called Grades 1, 2 and 3. A ‘complete’ oil is also produced which represents the total or ‘unfractionated’ oil, but this is sometimes constructed by blending ylang ylang 1 and 2 together, which are the two least popular grades. (An absolute and concrete are also produced by solvent extraction for their long-lasting floral-balsamic effect.)
CHARACTERISTICS: Ylang ylang extra is a pale yellow, oily liquid with an intensely sweet, soft, floral-balsamic, slightly spicy scent – a good oil has a creamy rich topnote. A very intriguing perfume oil in its own right, it also blends well with rosewood, jasmine, vetiver, opopanax, bergamot, mimosa, cassie, Peru balsam, rose, tuberose, costus and others. It is an excellent fixative. The other grades lack the depth and richness of the ylang ylang extra.
PRINCIPAL CONSTITUENTS: Methyl benzoate, methyl salicylate, methyl paracretol, benzyl acetate, eugenol, geraniol, linalol and terpenes: pinene, cadinene, among others.
SAFETY DATA: Non-toxic, non-irritant, a few cases of sensitization reported. Use in moderation, since its heady scent can cause headaches or nausea.
AROMATHERAPY/HOME: USE
Skin care: Acne, hair growth, hair rinse, insect bites, irritated and oily skin, general skin care.
Circulation muscles and joints: High blood pressure, hyperpnoea (abnormally fast breathing), tachycardia, palpitations.
Nervous system: Depression, frigidity, impotence, insomnia, nervous tension and stress-related disorders – ‘The writer, working with odorous materials for more than twenty years, long ago noticed that ... ylang ylang soothes and inhibits anger born of frustration.’.
OTHER USES: Extensively used as a fragrance component and fixative in soaps, cosmetics and perfumes, especially oriental and floral types; ylang ylang extra tends to be used in high-class perfumes, ylang ylang 3 in soaps, detergents, etc. Used as a flavour ingredient, mainly in alcoholic and soft drinks, fruit flavours and desserts.... ylang ylang
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