The meaning of the symbols of dreams/ seen in a dream.

Relating to the kidneys... renal

Inflammation of the nasal mucous membrane... rhinitis

Sti?ness of the joint between the great toe and the foot, which induces pain on walking. It is usually due to a crush injury or stubbing of the toe. Such stubbing is liable to occur in adolescents with a congenitally long toe. If trouble-some, the condition is treated by an operation to create a false joint.... hallux rigidus

A treatment which uses atomic particles and high energy rays to destroy cancerous cells.... radiotherapy

A proactive and goal-oriented activity to restore function and/or to maximize remaining function to bring about the highest possible level of independence, physically, psychologically, socially and economically. It involves combined and coordinated use of medical, nursing and allied health skills, along with social, educational and vocational services, to provide individual assessment, treatment, regular review, discharge planning and follow-up. Rehabilitation is concerned, not only with physical recovery, but also with psychological and social recovery and reintegration (or integration) of the person into the community.... rehabilitation

Recurrence of malarial parasitaemia with fresh infection of RBC’s by merozoites derived from hypnozoites in the liver. The reappearance of a disease after a period when the symptoms lessened or ceased. A renewed manifestation of clinical symptoms and/or parasitaemia associated with malaria infection, separated from the previous manifestation by an interval greater than the one reflecting the normal periodicity of paroxysms.... relapse

The period when the symptoms or signs of a disease have ceased.... remission

The surgical removal of tissue.... resection

An inherited ability of a pathogen or vector to survive treatment with a chemical designed to kill it. The ability of a parasite to live in the presence of a drug, that would normally kill members of the same species.... resistance

Cessation of breathing, often caused by envenomation (or poisoning).... respiratory arrest

All the organs and tissues associated with the act of RESPIRATION or breathing. The term includes the nasal cavity (see NOSE) and PHARYNX, along with the LARYNX, TRACHEA, bronchi (see BRONCHUS), BRONCHIOLES and LUNGS. The DIAPHRAGM and other muscles, such as those between the RIBS, are also part of the respiratory system which is responsible for oxygenating the blood and removing carbon dioxide from it.... respiratory system

Used broadly, rheumatism is a term meant to describe subjective sensations and not a specific disease, such as chronic joint inflammation, osteo- or rheumatoid arthritis...almost any chronic dull ache associated with the aging process... rheumatism

A disturbance of the calcium/phosphorus metabolism which occurs in the growing child as a result of vitamin D deficiency... rickets

See tinea.... ringworm

An aspect of personal behaviour or lifestyle, an environmental exposure, or an inborn or inherited characteristic, which, on the basis of scientific evidence, is known to be associated with health-related condition(s) considered important to prevent.... risk factor

Ribonucleic acid. A type of nucleic acid that carries the message coded in DNA (the genes) to the manufacturing system of the cell.... rna

Having the action of counter irritant... rubefacient

In 2003, 695,500 live births were registered in the United Kingdom; 38 per cent occurred outside marriage. Overall, total fertility is falling slowly. The number of births per 1,000 women aged over 40 years has been rising, and in 1999 was 8.9 per cent. In Great Britain in 2003, 193,817 legal abortions were performed under the Abortion Act 1967.... birth rate

The proportion of deaths in a specified population. The death rate is calculated by dividing the number of deaths in a population in a year by the midyear resident population. Death rates are often expressed as the number of deaths per 100 000 persons. The rate may be restricted to deaths in specific age, race, sex, or geographic groups or deaths from specific causes of death (specific rate), or it may be related to the entire population (crude rate).... death rate

See “death rate”.... mortality rate

A common form of irritant contact DERMATITIS in the nappy area in babies under one year old. Wetting of the skin by urine, abrasion, and chemical changes due to faecal contamination all play a part. Good hygiene and use of disposable absorbent nappies have much reduced its incidence. An ointment containing a barrier, such as titanium dioxide, may help; other medications such as mild CORTICOSTEROIDS or antibiotics should be used very cautiously and only under the guidance of a doctor, as harmful effects may result – especially from overuse.... nappy rash

See URTICARIA.... nettle-rash

... nuclear magnetic resonance

Review by individuals from the same discipline and with essentially equal qualifications (peers).... peer review

A form of rheumatism characterised by gross early-morning sti?ness, which tends to ease o? during the day, and pain in the shoulders and sometimes around the hips. It affects women more than men, and is rare under the age of 60. The cause is still obscure. It responds well to PREDNISOLONE, but treatment may need to be long continued. On the other hand the condition is not progressive and does not lead to disability.... polymyalgia rheumatica

An almost invariably fatal viral infection of the CNS in mammals. Caused by a rhabdovirus and mostlytransmitted by bite. While there is no effective treatment for the infection, it can be prevented by the use of a human diploid vaccine if given before the onset of symptoms.... rabies

A unit of ionising RADIATION absorbed by an individual. The acronym stands for radiation absorbed dose.... rad

This NERVE arises from the BRACHIAL plexus in the axilla. At ?rst descending posteriorly and then anteriorly, it ends just above the elbow by dividing into the super?cial radial and interosseous nerves. It supplies motor function to the muscles which extend the arm, wrist, and some ?ngers, and supplies sensation to parts of the posterior and lateral aspects of the arm, forearm and hand.... radial nerve

The term applied to the nausea, vomiting and loss of appetite which may follow exposure to RADIATION – for example, at work – or the use of RADIOTHERAPY in the treatment of cancer and other diseases. People exposed to radiation at work should have that exposure carefully monitored so it does not exceed safety limits. Doses of radiation given during radiotherapy treatment are carefully measured: even so, patients may suffer side-effects. The phenothiazine group of tranquillisers, such as CHLORPROMAZINE, as well as the ANTIHISTAMINE DRUGS, are of value in the prevention and treatment of radiation sickness.... radiation sickness

Breakdown of the nuclei of some elements resulting in the emission of energy in the form of alpha, beta and gamma rays. Because of this particle emission, the elements decay into other elements. Radium and uranium are naturally occurring radioactive elements. RADIOTHERAPY treatment utilises arti?cially produced isotopes (alternative forms of an element) such as iodine-131 and cobalt-60.... radioactivity

Diagnostic radiography is the technique of examining parts of the body by passing X-RAYS through them to produce images on ?uorescent screens or photographic plates.... radiography

See X-RAYS.... radiology

The radiations of radium consist of: (1) alpha rays, which are positively charged helium nuclei; (2) beta rays – negatively charged electrons; (3) gamma rays, similar to X-RAYS but of shorter wavelength. These days the use of radium is largely restricted to the treatment of carcinoma of the neck of the womb, the tongue, and the lips. Neither X-rays nor radium supersede active surgical measures when these are available for the complete removal of a tumour.... radium

The outer of the two bones in the forearm.... radius

A technique introduced in 1960 which enables the minute quantities of natural substances in the blood such as HORMONES to be measured. A radioimmunoassay depends upon the ability of an unlabelled hormone to inhibit, by simple competition, the binding of isotopically labelled hormone by speci?c ANTIBODIES. The requirements for a radioimmunoassay include adequate amounts of the hormone; a method for labelling the hormone with a radioactive isotope; the production of satisfactory antibodies; and a technique for separating antibody-bound from free hormone. Radioimmunoassay is more sensitive than the best bioassay for a given hormone, and the most sensitive radioimmunoassays permit the detection of picogram (pg = 10?12g) and femtogram (fg = 10?15g) amounts of material.... radioimmunoassay

An H2-receptor antagonist drug used in the treatment of DUODENAL ULCER by reducing the hyperacidity of the gastric juice. The drug blocks the production of histamine produced by mast cells in the stomach lining. Histamine stimulates the acid-secreting cells in the stomach. Ranitidine, like other H2-blocking drugs, should be used in combination with an antibiotic drug to treat ulcers caused by Helicobacter pylori infection in the stomach. The drug should be given for up to eight weeks with repeat courses if ulcers recur.... ranitidine

A swelling which occasionally appears beneath the tongue, caused by a collection of saliva in the distended duct of a salivary gland. (See also MOUTH, DISEASES OF.)... ranula

See ERUPTION.... rash

An aseptic (that is, not involving infection) ARTHRITIS secondary to an episode of infection elsewhere in the body. It often occurs in association with ENTERITIS caused by salmonella (see FOOD POISONING) and certain SHIGELLA strains, and in both YERSINEA and CAMPYLOBACTER enteritis. Non-gonococcal urethritis, usually due to CHLAMYDIA, is another cause of reactive arthritis; Reiter’s syndrome is a particularly ?orid form, characterised by mucocutaneous and ocular lesions.

The SYNOVITIS usually starts acutely and is frequently asymmetrical, with the knees and ankles most commonly affected. Often there are in?ammatory lesions of tendon sheaths and entheses (bone and muscle functions) such as plantar fasciitis (see FASCIITIS). The severity and duration of the acute episode are extremely variable. Individuals with the histocompatibility antigen HLA B27 are particularly prone to severe attacks.... reactive arthritis

(1) Organs, which may consist of one cell or a small group of cells, that respond to di?erent forms of external or internal stimuli by conveying impulses down nerves to the CENTRAL NERVOUS SYSTEM, alerting it to changes in the internal or external environment.

(2) A small, discrete area on the cell membrane or within the cell with which molecules or molecular complexes (e.g. hormones, drugs, and other chemical messengers) interact. When this interaction takes place it initiates a change in the working of the cell.... receptor

Tending to recede. In genetic terms, a recessive gene is one whose expression remains dormant if paired with an unlike allele. The trait will only be manifest in an individual homozygous for the recessive gene. (See GENES.)... recessive

DNA or deoxyribonucleic acid containing GENES from various sources that have been combined by GENETIC ENGINEERING.... recombinant dna

If an individual is unconscious – whether as a result of accident or illness or when in the postoperative recovery unit – but is breathing and has a pulse, he or she should be placed in the recovery position. The individual is turned on his or her side to allow the tongue to fall forwards and so reduce the likelihood of pharyngeal obstruction (see PHARYNX). Fluid in the mouth can also drain outwards instead of into the TRACHEA and LUNGS. The person can lie on either side with upper or lower leg ?exed. Sometimes the semi-prone position is used; this gives better drainage from the mouth and greater stability during transport, but makes it more di?cult to observe the face, colour or breathing. (See APPENDIX 1: BASIC FIRST AID.)... recovery position

Reactivation of infection; in malaria, renewed manifestation of infection due to survival of RBC forms.... recrudescence

The last part of the large INTESTINE. It pursues a more or less straight course downwards through the cavity of the pelvis, lying against the sacrum at the back of this cavity. This section of the intestine is about 23 cm (9 inches) long: its ?rst part is freely movable and corresponds to the upper three pieces of the sacrum; the second part corresponds to the lower two pieces of the sacrum and the coccyx; whilst the third part, known also as the anal canal, is about 25 mm (1 inch) long, runs downwards and backwards, and is kept tightly closed by the internal and external SPHINCTER muscles which surround it. The opening to the exterior is known as the ANUS. The structure of the rectum is similar to that of the rest of the intestine.... rectum

The manipulation of part of the body from an abnormal position to the correct one (e.g. fractures, dislocations or hernias).... reduction

Pain felt in one part of the body which is actually arising from a distant site (e.g. pain from the diaphragm is felt at the shoulder tip). This occurs because both sites develop from similar embryological tissue and therefore have

common pain pathways in the CENTRAL NERVOUS SYSTEM. (See also PAIN.)... referred pain

The deviation of rays of light on passing from one transparent medium into another of di?erent density. The refractive surfaces of the EYE are the anterior surface of the cornea (which accounts for approximately two-thirds of the focusing or refractive power of the eye), and the lens (one-third of the focusing power of the eye). The refractive power of the lens can change, whereas that of the cornea is ?xed. (For errors of refraction, see under EYE, DISORDERS OF.)... refraction

Resistant to ordinary treatment or infection.... refractory

Regurgitation is a term used in various connections in medicine. For instance, in diseases of the HEART it is used to indicate a condition in which, as the result of valvular disease, the blood does not entirely pass on from the atria of the heart to the ventricles, or from the ventricles into the arteries. The defective valve is said to be incompetent, and a certain amount of blood leaks past it, or regurgitates back, into the cavity from which it has been driven. (See HEART, DISEASES OF.)

The term is also applied to the return to the mouth of food already swallowed and present in the gullet or stomach (see also REFLUX).... regurgitation

A term used in transplant medicine (see TRANSPLANTATION) to describe the body’s immunological response to foreign tissue (see IMMUNITY). Various drugs, such as CICLOSPORIN A, can be used to dampen the host’s response to a graft or organ transplant and reduce the risk of rejection.... rejection

So-called because of the characteristic temperature chart showing recurring bouts of fever, this is an infectious disease caused by SPIROCHAETE. There are two main forms of the disease.

Louse-borne relapsing fever is an EPIDEMIC disease, usually associated with wars and famines, which has occurred in practically every country in the world. For long confused with TYPHUS FEVER and typhoid fever (see ENTERIC FEVER), it was not until the 1870s that the causal organism was described by Obermeier. It is now known as the Borrelia recurrentis, a motile spiral organism 10–20 micrometres in length. The organism is transmitted from person to person by the louse, Pediculus humanus.

Symptoms The incubation period is up to 12 days (but usually seven). The onset is sudden, with high temperature, generalised aches and pains, and nose-bleeding. In about half of cases, a rash appears at an early stage, beginning in the neck and spreading down over the trunk and arms. JAUNDICE may occur; and both the LIVER and the SPLEEN are enlarged. The temperature subsides after ?ve or six days, to rise again in about a week. There may be up to four such relapses (see the introductory paragraph above).

Treatment Preventive measures are the same as those for typhus. Rest in bed is essential, as are good nursing and a light, nourishing diet. There is usually a quick response to PENICILLIN; the TETRACYCLINES and CHLORAMPHENICOL are also e?ective. Following such treatment the incidence of relapse is about 15 per cent. The mortality rate is low, except in a starved population.

Tick-borne relapsing fever is an ENDEMIC disease which occurs in most tropical and sub-tropical countries. The causative organism is Borrelia duttoni, which is transmitted by a tick, Ornithodorus moubata. David Livingstone suggested that it was a tick-borne disease, but it was not until 1905 that Dutton and Todd produced the de?nitive evidence.

Symptoms The main di?erences from the louse-borne disease are: (a) the incubation period is usually shorter, 3–6 days (but may be as short as two days or as long as 12); (b) the febrile period is usually shorter, and the afebrile periods are more variable in duration, sometimes only lasting for a day or two; (c) relapses are much more numerous.

Treatment Preventive measures are more di?cult to carry out than in the case of the louse-borne infection. Protective clothing should always be worn in ‘tick country’, and old, heavily infected houses should be destroyed. Curative treatment is the same as for the louse-borne infection.... relapsing fever

See HYPERNEPHROMA.... renal cell carcinoma

An ENZYME produced by the kidney (see KIDNEYS) and released into the blood in response to STRESS. Renin reacts with a compound produced by the liver to produce ANGIOTENSIN. This causes blood vessels to constrict and raises the blood pressure. If too much renin is produced, this results in renal HYPERTENSION.... renin

The radiological examination of the KIDNEYS using a gamma camera. This is a device that can follow the course of an injected radioactive (see RADIOACTIVITY) compound which is concentrated and excreted by the kidneys. This provides information on kidney function.... renography

The process in which air passes into and out of the lungs so that the blood can absorb oxygen and give o? carbon dioxide and water. This occurs 18 times a minute in a healthy adult at rest and is called the respiratory rate. An individual breathes more than 25,000 times a day and during this time inhales around 16 kg of air.

Mechanism of respiration For the structure of the respiratory apparatus, see AIR PASSAGES; CHEST; LUNGS. The air passes rhythmically into and out of the air passages, and mixes with the air already in the lungs, these two movements being known as inspiration and expiration. INSPIRATION is due to a muscular e?ort which enlarges the chest, so that the lungs have to expand in order to ?ll up the vacuum that would otherwise be left, the air entering these organs by the air passages. The increase of the chest in size from above downwards is mainly due to the diaphragm, the muscular ?bres of which contract and reduce its domed shape and cause it to descend, pushing down the abdominal organs beneath it. EXPIRATION is an elastic recoil, the diaphragm rising and the ribs sinking into the position that they naturally occupy, when muscular contraction is ?nished. Occasionally, forced expiration may occur, involving powerful muscles of the abdomen and thorax; this is typically seen in forcible coughing.

Nervous control Respiration is usually either an automatic or a REFLEX ACTION, each expiration sending up sensory impulses to the CENTRAL NERVOUS SYSTEM, from which impulses are sent down various other nerves to the muscles that produce inspiration. Several centres govern the rate and force of the breathing, although all are presided over by a chief respiratory centre in the medulla oblongata (see under BRAIN – Divisions). This in turn is controlled by the higher centres in the cerebral hemispheres, so that breathing can be voluntarily stopped or quickened.

Quantity of air The lungs do not completely empty themselves at each expiration and re?ll at each inspiration. With each breath, less than one-tenth of the total air in the lungs passes out and is replaced by the same quantity of fresh air, which mixes with the stale air in the lungs. This renewal, which in quiet breathing amounts to about 500 millilitres, is known as the tidal air. By a special inspiratory e?ort, an individual can draw in about 3,000 millilitres, this amount being known as complemental air. By a special expiratory e?ort, too, after an ordinary breath one can expel much more than the tidal air from the lungs – this extra amount being known as the supplemental or reserve air, and amounting to about 1,300 millilitres. If an individual takes as deep an inspiration as possible and then makes a forced expiration, the amount expired is known as the vital capacity, and amounts to around 4,000 millilitres in a healthy adult male of average size. Figures for women are about 25 per cent lower. The vital capacity varies with size, sex, age and ethnic origin.

Over and above the vital capacity, the lungs contain air which cannot be expelled; this is known as residual air, and amounts to another 1,500 millilitres.

Tests of respiratory e?ciency are used to assess lung function in health and disease. Pulmonary-function tests, as they are known, include spirometry (see SPIROMETER), PEAK FLOW METER (which measures the rate at which a person can expel air from the lungs, thus testing vital capacity and the extent of BRONCHOSPASM), and measurements of the concentration of oxygen and carbon dioxide in the blood. (See also LUNG VOLUMES.)

Abnormal forms of respiration Apart from mere changes in rate and force, respiration is modi?ed in several ways, either involuntarily or voluntarily. SNORING, or stertorous breathing, is due to a ?accid state of the soft palate causing it to vibrate as the air passes into the throat, or simply to sleeping with the mouth open, which has a similar e?ect. COUGH is a series of violent expirations, at each of which the larynx is suddenly opened after the pressure of air in the lungs has risen considerably; its object is to expel some irritating substance from the air passages. SNEEZING is a single sudden expiration, which di?ers from coughing in that the sudden rush of air is directed by the soft palate up into the nose in order to expel some source of irritation from this narrow passage. CHEYNE-STOKES BREATHING is a type of breathing found in persons suffering from stroke, heart disease, and some other conditions, in which death is impending; it consists in an alternate dying away and gradual strengthening of the inspirations. Other disorders of breathing are found in CROUP and in ASTHMA.... respiration

See EYE.... retina

Inflammation of the retina... retinitis

A rare malignant growth of the retina (see EYE) which occurs in infants. It can sometimes be discovered at birth because shining a light in the baby’s pupil produces a white re?ection rather than a red one. Alternatively, the infant may present with a SQUINT or a mass in the abdomen. In 25 per cent of cases there is a family history of the condition and abnormality of chromosome 13 is common (see CHROMOSOMES). It is treated by removing the eye or, if affecting both eyes, by laser PHOTOCOAGULATION with or without RADIOTHERAPY.... retinoblastoma

Retinol is the o?cial chemical name of vitamin

A. (See APPENDIX 5: VITAMINS.)... retinol

See EYE, DISORDERS OF – Retina, disorders of.... retinopathy

An instrument for pulling apart the edges of an incision to allow better surgical access to the organs and tissues being operated on.... retractor

In?ammation of the optic nerve behind (rather than within) the EYE. It usually occurs in young adults and presents with a rapid deterioration in vision over a few hours. Colour vision is also impaired. Usually vision recovers over a few weeks, but colour vision may be permanently lost. It can be associated with certain viral illnesses and with MULTIPLE SCLEROSIS (MS). (See also EYE, DISORDERS OF.)... retrobulbar neuritis

Movement in a contrary or backward direction from normal (e.g. a retrograde pyelogram introduces dye into the pelvis of the kidney by passing it up the ureters).... retrograde

A research design used to test hypotheses in which inferences about exposure to the putative causal factor(s) are derived from data relating to characteristics of the persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or other outcome condition of interest, and their characteristics and past experiences are compared with those of other, unaffected persons.... retrospective study

A VIRUS containing ribonucleic acid (RNA) which is able to change its genetic material into deoxyribonucleic acid (DNA) using an ENZYME called reverse transcriptase. This conversion enables the retrovirus to become integrated into the host cell’s DNA. Retroviruses are believed to be involved in the development of some cancers; they are also associated with disorders linked with an impaired immune system (see IMMUNITY). HIV is a retrovirus.

Retroviruses are also used in the development of gene therapy (see GENETIC ENGINEERING).... retrovirus

The medical speciality concerned with the study and management of diseases of the JOINTS and CONNECTIVE TISSUE.... rheumatology

An acute febrile illness, usually seen in children, which may include ARTHRALGIA, ARTHRITIS, CHOREA, carditis (see below) and rash (see ERUPTION). The illness has been shown to follow a beta-haemolytic streptococcal infection (see STREPTOCOCCUS).

Rheumatic fever is now extremely uncommon in developed countries, but remains common in developing areas. Diagnosis is based on the presence of two or more major manifestations – endocarditis (see under HEART, DISEASES OF), POLYARTHRITIS, chorea, ERYTHEMA marginatum, subcutaneous nodules – or one major and two or more minor ones – fever, arthralgia, previous attacks, raised ESR, raised white blood cell count, and ELECTROCARDIOGRAM (ECG) changes. Evidence of previous infection with streptococcus is also a criterion.

Clinical features Fever is high, with attacks of shivering or rigor. Joint pain and swelling (arthralgia) may affect the knee, ankle, wrist or shoulder and may migrate from one joint to another. TACHYCARDIA may indicate cardiac involvement. Subcutaneous nodules may occur, particularly over the back of the wrist or over the elbow or knee. Erythema marginatum is a red rash, looking like the outline of a map, characteristic of the condition.

Cardiac involvement includes PERICARDITIS, ENDOCARDITIS, and MYOCARDITIS. The main long-term complication is damage to the mitral and aortic valves (see HEART).

The chief neurological problem is chorea (St Vitus’s dance) which may develop after the acute symptoms have subsided.

Chronic rheumatic heart disease occurs subsequently in at least half of those who have had rheumatic fever with carditis. The heart valve usually involved is the mitral; less commonly the aortic, tricuspid and pulmonary. The lesions may take 10–20 years to develop in developed countries but sooner elsewhere. The heart valves progressively ?brose and ?brosis may also develop in the myocardium and pericardium. The outcome is either mitral stenosis or mitral regurgitation and the subsequent malfunction of this or other heart valves affected is chronic failure in the functioning of the heart. (see HEART, DISEASES OF).

Treatment Eradication of streptococcal infection is essential. Other features are treated symptomatically. PARACETAMOL may be preferred to ASPIRIN as an antipyretic in young children. One of the NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS) may bene?t the joint symptoms. CORTICOSTEROIDS may be indicated for more serious complications.

Patients who have developed cardiac-valve abnormalities require antibiotic prophylaxis during dental treatment and other procedures where bacteria may enter the bloodstream. Secondary cardiac problems may occur several decades later and require replacement of affected heart valves.... rheumatic fever

The condition characterised by swelling of the NOSE due to enormous enlargement of the sebaceous glands which may develop in the later stages of ROSACEA.... rhinophyma

Repair of the NOSE or modi?cation of its shape by operation. This operation is performed by reconstructive and ENT (ear, nose and throat) surgeons alike. It may involve alteration of the bony skeleton of the nose and/or alteration of the SEPTUM (septorhinoplasty). It is mostly performed for cosmetic reasons; however, any disease process or injury which has caused a defect in the nose may be repaired as well. The latter problem would usually involve the utilisation of some form of skin ?ap, whereas this would not be required for cosmetic surgical purposes.... rhinoplasty

The persistent discharge of watery mucus from the NOSE. This is a usual symptom as a result of COMMON COLD or consequent upon ALLERGY (perennial rhinitis and HAY FEVER).... rhinorrhoea

A chronic in?ammation of the synovial lining (see SYNOVIAL MEMBRANE) of several joints, tendon sheaths or bursae which is not due to SEPSIS or a reaction to URIC ACID crystals. It is distinguished from other patterns of in?ammatory arthritis by the symmetrical involvement of a large number of peripheral joints; by the common blood-?nding of rheumatoid factor antibody; by the presence of bony erosions around joints; and, in a few, by the presence of subcutaneous nodules with necrobiotic (decaying) centres.

Causes There is a major immunogenetic predisposition to rheumatoid arthritis in people carrying the HLA-DR4 antigen (see HLA SYSTEM). Other minor immunogenetic factors have also been implicated. In addition, there is a degree of familial clustering which suggests other unidenti?ed genetic factors. Genetic factors cannot alone explain aetiology, and environmental and chance factors must be important, but these have yet to be identi?ed.

Epidemiology Rheumatoid arthritis more commonly occurs in women from the age of 30 onwards, the sex ratio being approximately 4:1. Typical rheumatoid arthritis may occur in adolescence, but in childhood chronic SYNOVITIS usually takes one of a number of di?erent patterns, classi?ed under juvenile chronic arthritis.

Pathology The primary lesion is an in?ammation of the synovial membrane of joints. The synovial ?uid becomes diluted with in?ammatory exudate: if this persists for months it leads to progressive destruction of articular CARTILAGE and BONE. Cartilage is replaced by in?ammatory tissue known as pannus; a similar tissue invades bone to form erosions. Synovitis also affects tendon sheaths, and may lead to adhesion ?brosis or attrition and rupture of tendons. Subcutaneous and other bursae may be involved. Necrobiotic nodules also occur at sites outside synovium, including the subcutaneous tissues, the lungs, the pericardium and the pleura.

Clinical features Rheumatoid arthritis varies from the very mild to the severely disabling. Many mild cases probably go undiagnosed. At least 50 per cent of patients continue to lead a reasonably normal life; around 25 per cent are signi?cantly disabled in terms of work and leisure activities; and a minority become markedly disabled and are limited in their independence. There is often an early acute phase, followed by substantial remission, but in other patients gradual step-wise deterioration may occur, with progressive involvement of an increasing number of joints.

The diagnosis of rheumatoid arthritis is largely based on clinical symptoms and signs. Approximately 70 per cent of patients have rheumatoid factor ANTIBODIES in the SERUM but, because of the large number of false positives and false negatives, this test has very little value in clinical practice. It may be a useful pointer to a worse prognosis in early cases if the level is high. X-RAYS may help in diagnosing early cases and are particularly helpful when considering surgery or possible complications such as pathological fracture. Patients commonly develop ANAEMIA, which may be partly due to gastrointestinal blood loss from antiin?ammatory drug treatment (see below).

Treatment involves physical, pharmacological, and surgical measures, together with psychological and social support tailored to the individual patient’s needs. Regular activity should be maintained. Resting of certain joints such as the wrist with splints may be helpful at night or to assist prolonged manual activities. Sound footwear is important. Early use of antirheumatic drugs reduces long-term disability. Drug treatment includes simple ANALGESICS, NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS), and slow-acting drugs including GOLD SALTS (in the form of SODIUM AUROTHIOMALATE), PENICILLAMINE, SULFASALAZINE, METHOTREXATE and AZATHIOPRINE.

The non-steroidal agents are largely e?ective in reducing pain and early-morning sti?ness, and have no e?ect on the chronic in?ammatory process. It is important, especially in the elderly, to explain to patients the adverse effects of NSAIDs, the dosage of which can be cut by prescribing paracetamol at the same time. Combinations of anti-rheumatic drugs seem better than single agents. The slow-acting drugs take approximately three months to act but have a more global e?ect on chronic in?ammation, with a greater reduction in swelling and an associated fall in erythrocyte sedimentation rate (ESR) and rise in the level of HAEMOGLOBIN. Local CORTICOSTEROIDS are useful, given into individual joints. Systemic corticosteroids carry serious problems if continued long term, but may be useful under special circumstances. Much research is currently going on into the use of tumour necrosis factor antagonists such as INFLIXIMAB and etanercept, but their precise role remains uncertain.... rheumatoid arthritis

A method of CONTRACEPTION which attempts to prevent conception by avoiding intercourse during the fertile part of the menstrual cycle. (See MENSTRUATION; SAFE PERIOD.)... rhythm method

Also known as tribavirin, this drug inhibits a wide variety of DNA and RNA viruses. It is administered by inhalation to treat severe BRONCHIOLITIS caused by RESPIRATORY SYNCYTIAL VIRUS (RSV), particularly in infants who also have congenital heart disease. It is not used in uncomplicated bronchiolitis as its bene?ts are arguable in that circumstance: the babies are likely to recover without treatment.

Ribavarin, along with INTERFERON alpha-2b, is given orally to treat patients with chronic HEPATITIS C infection. It is also used to treat LASSA FEVER.... ribavirin

Sti?ness, resistance to movement. The term is often used in NEUROLOGY – for example, limb rigidity is a sign of PARKINSONISM. Smooth rigidity is described as being ‘plastic’ and jerky rigidity as ‘cogwheel’.... rigidity

Shivering. If prolonged, it is generally accompanied by fever, and may be a sign of the onset of some acute disease such as INFLUENZA, PNEUMONIA, or some internal in?ammation. Rigor mortis is the name given to the sti?ness that ensues soon after death. (See DEATH, SIGNS OF; MUSCLE.)... rigor

The function of identifying and assessing problems that could occur and bring about losses legally, clinically or financially.... risk management

A fever of the typhus group (see TYPHUS FEVER). It received its name from the fact that it was ?rst reported in the Rocky Mountain States of the United States; these are still the most heavily infected areas, but the fever is now found in all parts of the US. The causative organism is Rickettsia rickettsi, which is transmitted to humans by tics.... rocky mountain spotted fever

A chronic form of BASAL CELL CARCINOMA, the most common form of skin cancer.... rodent ulcer

A psychological test (see PSYCHOLOGY) for investigating personality and disorders of personality. Also called the ‘ink blot test’, it is now rarely used. It was devised by a Swiss psychiatrist, Hermann Rorschach (1884–1922), who determined individuals’ reactions to a series of symmetrical ink-blots, ten in number and standardised by him.... rorschach test

Common chronic in?ammation of the facial skin, this condition is seen in middle and late life. Redness, obvious dilatation of venules and crops of ACNE-like papules and pustules affect mainly the central forehead, cheeks, nose and chin. A keratoconjunctivitis (combined in?ammation of the cornea and conjunctiva of the EYE) may be associated. Subjects ?ush easily, especially after alcohol or hot drinks. Eventually the affected areas may become thickened and oedematous, and in men, proliferation of ?brous and sebaceous tissue may lead to gross thickening and enlargement of the nose (RHINOPHYMA).

Treatment Long-term, low-dose, oral tetracycline (see ANTIBIOTICS; TETRACYCLINES) is the treatment of choice. In mild cases, METRONIDAZOLE gel can be helpful. Potent topical CORTICOSTEROIDS are contraindicated and make rosacea worse.... rosacea

(Latin / English) The dew of the sea / resembling a bitter rose Rosemaree, Rosemarey, Rosemaria, Rosemarie, Rosmarie, Rozmary, Rosamaria, Rosamarie... rosemary

Dietary ?bre is that part of food which cannot be digested in the gastrointestinal tract, although it can be metabolised in the colon by the micro-organisms there. Roughage falls into four groups: cellulose, hemicelluloses, lignins and pectins, found in unre?ned foods such as wholemeal cereals and ?our, root vegetables, nuts and fruit. It has long been known to affect bowel function, probably because of its capacity to hold water in a gel-like form. It plays an important role in the prevention of CONSTIPATION, DIVERTICULOSIS, IRRITABLE BOWEL SYNDROME (IBS), APPENDICITIS, DIABETES MELLITUS and cancer of the colon (see INTESTINE). At present, many western diets do not contain enough roughage.... roughage

Repetitive strain injury – see UPPER LIMB DISORDERS.... rsi

Rubella, or German measles, is an acute infectious disease of a mild type, which may sometimes be di?cult to di?erentiate from mild forms of MEASLES and SCARLET FEVER.

Cause A virus spread by close contact with infected individuals. Rubella is infectious for a week before the rash appears and at least four days afterwards. It occurs in epidemics (see EPIDEMIC) every three years or so, predominantly in the winter and spring. Children are more likely to be affected than infants. One attack gives permanent IMMUNITY. The incubation period is usually 14–21 days.

Symptoms are very mild, and the disease is not at all serious. On the day of onset there may be shivering, headache, slight CATARRH with sneezing, coughing and sore throat, with very slight fever – not above 37·8 °C (100 °F). At the same time the glands of the neck become enlarged. Within 24 hours of the onset a pink, slightly raised eruption appears, ?rst on the face or neck, then on the chest, and the second day spreads all over the body. The clinical signs and symptoms of many other viral infections are indistinguishable from rubella so a precise diagnosis cannot be made without taking samples (such as saliva) for antibody testing, but this is rarely done in practice.

An attack of German measles during the early months of pregnancy may be responsible for CONGENITAL defects in the FETUS (for information on fetal abnormalities, see under PREGNANCY AND LABOUR). The incidence of such defects is not precisely known, but probably around 20 per cent of children whose mothers have had German measles in the ?rst three months of the pregnancy are born with congenital defects. These defects take a variety of forms, but the most important ones are: low birth weight with retarded physical development; malformations of the HEART; cataract (see under EYE, DISORDERS OF); and DEAFNESS.

Treatment There is no speci?c treatment. Children who develop the disease should not return to school until they have recovered, and in any case not before four days have passed from the onset of the rash.

In view of the possible dangerous e?ect of the disease upon the fetus, particular care should be taken to isolate pregnant mothers from contact with infected subjects. As the risk is particularly high during the ?rst 16 weeks of pregnancy, any pregnant mother exposed to infection during this period should be given an intramuscular injection of GAMMA-GLOBULIN. A vaccine is available to protect an individual against rubella (see IMMUNISATION).

In the United Kingdom it is NHS policy for all children to have the combined measles, mumps and rubella vaccine (see MMR VACCINE), subject to parental consent. All women of childbearing age, who have been shown by a simple laboratory test not to have had the disease, should be vaccinated, provided that the woman is not pregnant at the time and has not been exposed to the risk of pregnancy during the previous eight weeks.... rubella

(Greek) From the medicinal herb Ruta, Rou... rue

A popular name for HERNIA.... rupture

Also known as Röntgen rays, these were discovered in 1895 by Wilhelm Conrad Röntgen. Their use for diagnostic imaging (radiology) and for cancer therapy (see RADIOTHERAPY) is now an integral part of medicine. Many other forms of diagnostic imaging have been developed in recent years, sometimes also loosely called ‘radiology’. Similarly the use of chemotherapeutic agents in cancer has led to the term oncology which may be applied to the treatment of cancer by both drugs and X-rays.

The rays are part of the electro-magnetic spectrum; their wavelengths are between 10?9 and 10? 13 metres; in behaviour and energy they are identical to the gamma rays emitted by radioactive isotopes. Diagnostic X-rays are generated in an evacuated tube containing an anode and cathode. Electrons striking the anode cause emission of X-rays of varying energy; the energy is largely dependent on the potential di?erence (kilovoltage) between anode and cathode. The altered tissue penetration at di?erent kilovoltages is used in radiographing di?erent regions, for example in breast radiography (25–40 kV) or chest radiography (120–150 kV). Most diagnostic examinations use kilovoltages between 60 and 120. The energy of X-rays enables them to pass through body tissues unless they make contact with the constituent atoms. Tissue attenuation varies with atomic structure, so that air-containing organs such as the lung o?er little attenuation, while material such as bone, with abundant calcium, will absorb the majority of incident X-rays. This results in an emerging X-ray pattern which corresponds to the structures in the region examined.

Radiography The recording of the resulting images is achieved in several ways, mostly depending on the use of materials which ?uoresce in response to X-rays. CONTRAST X-RAYS Many body organs are not shown by simple X-ray studies. This led to the development of contrast materials which make particular organs or structures wholly or partly opaque to X-rays. Thus, barium-sulphate preparations are largely used for examining the gastrointestinal tract: for example, barium swallow, barium meal, barium follow-through (or enteroclysis) and barium enema. Water-soluble iodine-containing contrast agents that ionise in solution have been developed for a range of other studies.

More recently a series of improved contrast molecules, chie?y non-ionising, has been developed, with fewer side-effects. They can, for example, safely be introduced into the spinal theca for myeloradiculography – contrast X-rays of the spinal cord. Using these agents, it is possible to show many organs and structures mostly by direct introduction, for example via a catheter (see CATHETERS). In urography, however, contrast medium injected intravenously is excreted by the kidneys which are outlined, together with ureters and bladder. A number of other more specialised contrast agents exist: for example, for cholecystography – radiological assessment of the gall-bladder. The use of contrast and the attendant techniques has greatly widened the range of radiology. IMAGE INTENSIFICATION The relative insensitivity of ?uorescent materials when used for observation of moving organs – for example, the oesophagus – has been overcome by the use of image intensi?cation. A faint ?uorographic image produced by X-rays leads to electron emission from a photo-cathode. By applying a high potential di?erence, the electrons are accelerated across an evacuated tube and are focused on to a small ?uorescent screen, giving a bright image. This is viewed by a TV camera and the image shown on a monitor and sometimes recorded on videotape or cine. TOMOGRAPHY X-ray images are two-dimensional representations of three-dimensional objects. Tomography (Greek tomos

– a slice) began with X-ray imaging produced by the linked movement of the X-ray tube and the cassette pivoting about a selected plane in the body: over- and underlying structures are blurred out, giving a more detailed image of a particular plane.

In 1975 Godfrey Houns?eld introduced COMPUTED TOMOGRAPHY (CT). This involves

(i) movement of an X-ray tube around the patient, with a narrow fan beam of X-rays; (ii) the corresponding use of sensitive detectors on the opposite side of the patient; (iii) computer analysis of the detector readings at each point on the rotation, with calculation of relative tissue attenuation at each point in the cross-sectional plant. This invention has enormously increased the ability to discriminate tissue composition, even without the use of contrast.

The tomographic e?ect – imaging of a particular plane – is achieved in many of the newer forms of imaging: ULTRASOUND, magnetic resonance imaging (see MRI) and some forms of nuclear medicine, in particular positron emission tomography (PET SCANNING). An alternative term for the production of images of a given plane is cross-sectional imaging.

While the production of X-ray and other images has been largely the responsibility of radiographers, the interpretation has been principally carried out by specialist doctors called radiologists. In addition they, and interested clinicians, have developed a number of procedures, such as arteriography (see ANGIOGRAPHY), which involve manipulative access for imaging – for example, selective coronary or renal arteriography.

The use of X-rays, ultrasound or computerised tomography to control the direction and position of needles has made possible guided biopsies (see BIOPSY) – for example, of pancreatic, pulmonary or bony lesions – and therapeutic procedures such as drainage of obstructed kidneys (percutaneous nephrostomy), or of abscesses. From these has grown a whole series of therapeutic procedures such as ANGIOPLASTY, STENT insertion and renal-stone track formation. This ?eld of interventional radiology has close a?nities with MINIMALLY INVASIVE SURGERY (MIS).

Radiotherapy, or treatment by X-rays The two chief sources of the ionising radiations used in radiotherapy are the gamma rays of RADIUM and the penetrating X-rays generated by apparatus working at various voltages. For super?cial lesions, energies of around 40 kilovolts are used; but for deep-seated conditions, such as cancer of the internal organs, much higher voltages are required. X-ray machines are now in use which work at two million volts. Even higher voltages are now available through the development of the linear accelerator, which makes use of the frequency magnetron which is the basis of radar. The linear accelerator receives its name from the fact that it accelerates a beam of electrons down a straight tube, 3 metres in length, and in this process a voltage of eight million is attained. The use of these very high voltages has led to the development of a highly specialised technique which has been devised for the treatment of cancer and like diseases.

Protective measures are routinely taken to ensure that the patient’s normal tissue is not damaged during radiotherapy. The operators too have to take special precautions, including limits on the time they can work with the equipment in any one period of time.

The greatest value of radiotherapy is in the treatment of malignant disease. In many patients it can be used for the treatment of malignant growths which are not accessible to surgery, whilst in others it is used in conjunction with surgery and chemotherapy.... x-rays

Within a few years medical scientists have introduced into the domestic scene a steroid which has changed the whole course of female history. HRT has solved some basic medical problems by making good the loss of oestrogen in a woman’s body when menstruation is finished and her body learns to adjust.

A lack of oestrogen induces hot flushes, night sweats, thinning of the bones (osteoporosis) with possible fractures, and a wide range of physical and emotional disorders.

HRT also prevents the increased frequency of coronary disease which may follow the menopause. With oestrogen only, HRT appears to increase the incidence of cancer of the uterine body. Use of oestrogen and progestogen avoids this.

HRT is available as a tablet, transdermal patch, implant or topical cream. Most women notice temporary improvement in their appearance and hot flushes as long as treatment is continued. HRT is not prescribed by the herbal practitioner. Soya and Hops are a mild alternative.

Side-effects of such treatment include blood pressure rise, weight gain and periods probably continue with a monthly bleed. Elderly women taking HRT for osteoporosis may develop bleeding problems, the risk of blood clot and gall bladder diseases.

Helonias has proved a useful alternative, effective in eliminating excess fluids, reducing hot flushes, and relieving that bloated feeling, thus helping the older woman to live a normal life.

Damiana. 1 heaped teaspoon leaves to each cup boiling water; infuse 5-10 minutes; strain. 1 cup 2-3 times daily for 3-6 weeks.

Sarsaparilla. 1oz (30g) root in 1 pint (500ml) water; simmer gently 20 minutes; strain. 1 cup 2-3 times daily for 3-6 weeks.

Supplementation. Daily. Vitamin E, 400iu. Vitamin B-complex (high potency). Evening Primrose oil capsules, 500mg morning and evening. Dolomite, for Calcium and Magnesium, 2 tablets morning and evening.

Note: An extensive study of breast cancer risks with HRT revealed a positive link between the risk of cancer and length of use. Risk of the disease increased with all types of women using HRT with every year of use. Pre-menstrual women were more than twice at risk. It would appear that oestrogens cannot be taken without risk. (Centre for Disease Control, Atlanta, USA) See: OESTROGENS. ... hormone replacement therapy (hrt)

An outdated unit of absorbed radiation dose, now superseded by the sievert. (See also radiation units.)... rem

See ROSACEA.... acne rosacea

A variety of chronic symptoms and physical findings that occur in some persons who are infected with HIV, but do not meet the Centres for Disease Control’s definition of AIDS. Symptoms may include chronic swollen glands, recurrent fevers, unintentional weight loss, chronic diarrhoea, lethargy, minor alterations of the immune system (less severe than those that occur in AIDS), and oral thrush. ARC may or may not develop into AIDS.... aids-related complex

See HAY FEVER.... allergic rhinitis

A condition (described originally by Dr Argyll Robertson) in which the pupils contract when the eyes converge on a near object, but fail to contract when a bright light falls on the eye. It is found in several diseases, especially in locomotor ataxia and neurosyphilis, an advanced manifestation of SYPHILIS.... argyll robertson pupil

See RISK REGISTER.... at-risk register

Apocynum androsaemifolium. N.O. Asclepiadaceae.

Synonym: Dogsbane, Milkweed.

Habitat: Indigenous to North America.

Features ? Root is nearly three-quarters of an inch thick, light brown, transversely- wrinkled bark, easily parting from white, woody centre ; groups of stone cells in outer bark. Whole plant gives a gelatinous, milky juice when wounded.

Part used ? Root.

Action: Cathartic, diuretic, detergent, emetic, tonic.

2-5 grains thrice daily as a general tonic, useful in dyspepsia. 5-15 grain doses in cardiac dropsy. Has been recommended in the treatment of Bright's disease. Large doses cause vomiting. Tendency to gripe can be eliminated by adding Peppermint, Calamus or other carminative.... bitter root

See MAMMOPLASTY.... breast reconstruction

See MAMMOPLASTY.... breast reduction

Sanguinaria canadensis. N.O. Papaveraceae.

Habitat: Widely distributed throughout North America.

Features ? Root reddish-brown, wrinkled lengthwise, about half-inch thick. Fracture short. Section whitish, with many small, red resin cells which sometimes suffuse the whole. Heavy odour, bitter and harsh to the taste.

Part used ? Root.

Action: Stimulant, tonic, expectorant.

Pulmonary complaints and bronchitis. Should be administered in whooping-cough and croup until emesis occurs. The powdered root is used as a snuff in nasal catarrh, and externally in ringworm and other skin eruptions. The American Thomsonians use it in the treatment of adenoids. Dose, 10 to 20 grains of the powdered root.... blood root

The number of fatal cases of specific disease, divided by total number of known cases and it is usually expressed as percent. Case fatality is one index of disease severity and is of more interest in acute than in chronic disease.... case fatality rate

Separation of the retina from the choroid in the EYE. It may be due to trauma or be secondary to tumour or in?ammation of the choroid, and causes blindness in the affected part of the retina. It can be treated surgically using PHOTOCOAGULATION.... detached retina

See SLEEP.... dreams

See ESR.... erythrocyte sedimentation rate

The number of live births that occur in a year for every 1,000 women of childbearing age (this is usually taken as 15–44 years of age). The fertility rate in the UK (all ages) was 54.9 in 2002 (UK Health Statistics, 2001 edition, The Stationery O?ce).... fertility rate

Short-wavelength penetrating electromagnetic rays produced by some radioactive compounds. More powerful than X-rays, they are used in certain RADIOTHERAPY treatments and to sterilise some materials.... gamma rays

A quotient, with the number of cases of a specified disease diagnosed or reported during a stated period of time as the numerator, and the number of persons in the population in which they occurred as the denominator.... incidence rate

The band of electromagnetic radiation which has a longer wavelength than that of the red in the visible spectrum. Infrared radiation is used in the special photographic process essential to THERMOGRAPHY. Its property of transmitting radiant heat has made infrared radiation invaluable in PHYSIOTHERAPY, where it warms tissues, soothes pain and increases the local circulation.... infrared radiation

Ruta chalepensis

Rutaceae

San: Gucchapatra;

Hin: Pismaram, Sadab, Satari;

Ben: Ermul;

Mal: Aruta, Nagatali;

Tam: Aruvadam, Arvada;

Kan: Sadabu, Nagadali; soppu, Simesdanu;

Tel: Sadapa, Aruda

Importance: Common rue or Garden rue also known as Herb of Grace due to its service in the Roman Catholic Church for sprinkling the holy water among the congregation, is an aromatic perennial herb. The plant is useful in vitiated conditions of kapha and vata, strangury, fever, flatulence, colic, amenorrhoea, epilepsy and hysteria. The oil acts as a stimulant for uterine and nervous systems. The fresh leaves are used for rheumatalgia. The juice obtained from the leaves is given to children for helminthic infections and is good for odontalgia and otalgia (Warrier et al, 1996). The dried leaves, powdered and combined with aromatics, are given as a remedy for dyspepsia and with the fresh leaves a tincture is made which is used as an external remedy in the first stages of paralysis (Nadkarni, 1998).

Distribution: The plant is a native of South Europe and it is found in subtropical countries. It is commonly cultivated in Indian gardens.

Botany: Ruta chalepensis Linn.syn. R. graveolens Linn. var. angustifolia Sensu Hook. f. belongs to the family Rutaceae. It is an aromatic perennial herb growing upto 75cm height. Leaves are compound, shortly petiolate with ultimate segments oblong or obovate-oblong. Flowers are yellow. Fruits are capsules and shortly pedicelled (Warrier et al, 1996).

Agrotechnology: The plant is suited to areas which are about 1000m above mean sea level and with moderate rainfall and sunlight. The plant can be propagated either by seeds or stem cuttings. Seeds are to be sown in seedbeds. Stem cuttings of length 20-25cm are to be planted in polybags for rooting. About 3-4 months old seedlings can be transplanted to pots and harvested when plants attain 6-8 months age. In highlands land is to be ploughed to a fine tilth, mixed with organic manure and seedlings are to be transplanted at a spacing of 45cm between plants. Irrigation is essential during summer months. Regular weeding is to be done. The plant is not attacked by any serious pests and diseases. Harvesting commences from sixth month onwards. The economic part is the whole plant and the oil extracted from it (Prasad et al, 1997).

Properties and activity: Roots contain coumarins-xanthyletin and (-)-byakangelicin. The alkaloids are rutacridone-epoxide, gravacridonol and its monomethyl ether, gravacridonchlorine, furacridone, 1-hydroxy-3-methoxy-N-methylacridone, iso-gravacridonechlorine, dictamine, r-fragarine and skimmianine. Skimmianine is also present in leaves and stem. Leaves and stem also contain graveolinine (1-methyl-2(3’,4’-methylenedioxyphenol)-4-methoxy- quinoline). Aerial parts give coumarins bergapten, xanthotoxin and psoralen. Coumarin- imperatin has also been reported from the plant. Herb contains alkaloids such as kokusagenine, rutamine(methylgraveoline) and graveoline(1-methyl-2(3’,4’- methylenedioxyphenyl)-4-quinoline). Tissue culture of the plant gives furacridone alkaloids-1-hydroxyrutacridone-epoxide, rutagravin and gravacridonol. Gravacridondiol and its glucoside have been obtained from the root tissue culture. The essential oil from leaves, stem and root yielded aliphatic ketones including 2-nonanone (10-35%), undecyl-2-acetate (0.5-15%), 2-nonyl acetate (trace-10%), nonylacetate, nonanol, 2-nonylpropionate, 2- nonylpropionate, 2-undecanol and its esters. The oil from roots gave pregeijerene also.

The plant is spasmolytic which is due to the presence of bergapten, xanthotoxin, the essential oil and a coumarin. It is also antispasmodic, emmenagogue, irritant, abortifacient and anti-bacterial. Leaf is analgesic, antirheumatic, antihysteric and anthelmintic (Husain et al, 1992).... garden rue

See ARTHROPLASTY.... joint replacement

A surgical operation to replace a diseased – usually osteoarthritic – KNEE with an arti?cial (metal or plastic) implant which covers the worn cartilage. As much of the original joint as possible is retained. The operations, like hip replacements, are usually done on older people (there is some restriction of movement) and about 90 per cent are successful.... knee-joint replacement

Eupatorium purpureum. N.O. Compositae.

Synonym: Eupatorium purpureum is also called Gravel Weed and Queen of the

Meadow, from which the medicinal "Gravel Root" is obtained.

Habitat: Gravel Root is a native of the United States, and must not be confused with the English Queen of the Meadow or Meadowsweet (Spiraea ulmaria).

Features ? Our present subject is a member of the Boneset (Eupatorium perfoliatum) family, and sometimes reaches six feet in height at full growth. It is peculiar for a purple band about an inch broad round the leaf joint. Pale purple to white flowers bloom in August and September. The rhizome, as the medicinal "root" should more properly be termed, is hard and tough, up to an inch thick, with a nearly white wood and thin grey-brown bark. Short, lateral branches give off thin, tough root several inches long.

Part used ? Root.

Action: Diuretic and stimulant.

Gravel root is much prescribed for cases of stone in the bladder and certain other troubles of the kidneys and urinary apparatus. A decoction of 1 ounce of the root to 1 pint (reduced from 1 1/2 pints) of water is made, and taken in wineglass doses. Gravel root is also met with in nervine formulae, in which its tonic properties are recognised.

The American physio-medical or "Thomsonite" M.D., F. H. England, has said that Gravel Root "induces very little stimulation. It expends nearly all its influence on the kidneys, bladder and uterus. It probably influences the whole sympathetic nervous system. Its use promotes the flow of urine as scarcely anything else will."... gravel root

A file kept for each patient, maintained by the hospital (medical practitioners also maintain medical records in their own practices), which documents the patient’s problems, diagnostic procedures, treatment and outcome. Related documents, such as written consent for surgery and other procedures, are also included in the record. In addition to facts about a patient’s illness, medical records nearly always contain other information such as clinical, demographic, sociocultural, sociological, economic, administrative and behavioural data. The record may be on paper or computerized.... medical record

(LH-RH) The same substance as Follicle-Stimulating-Hormone Releasing Hormone (FSH-RH), both of which are actually Gonadotrophin-Releasing Hormone (GnRH or GRH). Confused? Imagine being an endocrinologist 20 years ago. These (This) are (is) a peptide secreted into the little portal system that drains from the hypothalamus to the pituitary. If it is surged hourly and not too strongly, the pituitary secretes LH and the ovaries secrete estrogen. If it is surged hourly and strongly, the estrogens rise drastically, the pituitary secretes FSH, you pop an egg, start the corpus luteum and begin progesterone secretion. The surge is now slowed to every four or five hours, not too strongly, and the pituitary secretes LH every four or five hours...and the ovaries make progesterone. The same hypothalamic hormone triggers different pituitary responses based on AMPLITUDE and FREQUENCY.... luteinizing-hormone releasing hormone

A statutory body in the United Kingdom that promotes the balanced development of medical and related biological research and aims to advance knowledge that will lead to improved health care. It employs its own research sta? in more than 40 research establishments. These include the National Institute for Medical Research, the Laboratory of Molecular Biology, and the Clinical Sciences Centre. Grants are provided so that individual scientists can do research which complements the research activities of hospitals and universities. There are several medical charities and foundations – for example, the Imperial Cancer Research Fund, the British Heart Foundation, the Nu?eld Laboratories and the Wellcome Trust which fund and foster medical research.... medical research council

1 A measure of association which quantifies the relationship between an exposure and outcome from a comparative study; also known as the cross-product ratio. 2 Comparison of the presence of a risk factor in a sample.... odds ratio

A site on the membrane surrounding a cell (see CELLS) that binds to the hormone OESTROGENS. This activates the cell’s reaction to the hormone. Anti-oestrogen drugs such as TAMOXIFEN used to treat breast cancer (see BREASTS, DISEASES OF) prevent the oestrogen from binding to these receptors.... oestrogen receptor

Love, Protection, Divination... orris root

Involves the use of non-numerical data, such as those collected in unstructured and in-depth interviews, focus group discussions, participant observation, participatory research, and the study of documents.... qualitative research

A radiological technique for detecting osteoporosis (see BONE, DISORDERS OF) in which a beam of X-rays is directed at the bone-area under investigation – normally the spine and hip – and the CALCIUM density measured. If the calcium content is low, preventive treatment can be started to reduce the likelihood of fractures occurring.... quantitative digital radiography

Involves the use of data in numerical quantities such as continuous measurements or counts.... quantitative research

A flowering spike or cluster where the flowers are borne along the peduncle on pedicels of similar length.... raceme

This artery arises from the brachial artery at the level of the neck of the radius. It passes down the forearm to the wrist, where it is easily palpated laterally. It then winds around the wrist to the palm of the hand to supply the ?ngers. (See ARTERIES.)... radial artery

Energy in the form of waves or particles. Radiation is mainly electromagnetic and is broadly classi?ed as ionising and non-ionising. The former can propel ions from an atom; these have an electrical charge and can combine chemically with each other. Ionisation occurring in molecules that have a key function in living tissue can cause biological damage which may affect existing tissue or cause mutations in the GENES of germ-cell nuclei (see GAMETE; CELLS). Non-ionising radiation agitates the constituent atoms of nuclei but is insu?ciently powerful to produce ions.

Ionising radiation comprises X-RAYS, GAMMA RAYS and particle radiation. X-rays are part of the continuous electromagnetic-wave spectrum: this also includes gamma rays, infra-red radiation, ultraviolet light and visible light. They have a very short wavelength and very high frequency, and their ability to penetrate matter depends upon the electrical energy generating them. X-rays that are generated by 100,000 volts can pass through body tissue and are used to produce images – popularly known as X-rays. X-rays, generated at several million volts can destroy tissue and are used in RADIOTHERAPY for killing cancer cells. Gamma rays are similar to X-rays but are produced by the decay of radioactive materials. Particle radiation, which can be produced electrically or by radioactive decay, comprises parts of atoms which have mass as well as (usually) an electrical charge.

Non-ionising radiation includes ultraviolet light, radio waves, magnetic ?elds and ULTRASOUND. Magnetic ?elds are used in magnetic resonance imaging (MRI) and ultrasound, which is inaudible high-frequency sound waves, and is used for both diagnoses and treatment in medicine.... radiation

An operation to remove a cancer, plus adjacent tissue and lymph nodes.... radical surgery

Inflammation of spinal nerve roots... radiculitis

Radiculopathy is damage to the roots of nerves where they enter or leave the SPINAL CORD. Causes include ARTHRITIS of the spine, thickening of the MENINGES, and DIABETES MELLITUS. Symptoms include pain, PARAESTHESIA, numbness and wasting of muscles supplied by the nerves. Treatment is of the underlying cause.... radiculopathy

An individual trained in the techniques of taking X-ray pictures (see X-RAYS) of areas of the body is known as a diagnostic radiographer. One who is trained to treat patients with RADIOTHERAPY is a therapeutic radiographer.... radiographer

Radionuclide is another word for a radioactive ISOTOPE. These isotopes are used in a scanning technique of body tissues. Di?erent types of tissue – and normal or abnormal tissues – absorb varying amounts of the isotopes; these di?erences are detected, recorded and displayed on a screen.... radionuclide

A cancer that responds to radiotherapy.... radiosensitive

Senecio jacobaea. N.O. Compositae.

Synonym: Dog Standard, Fireweed, Ragweed, St. James's Wort, Staggerwort, Stinking

Nanny.

Habitat: Pastures and waysides, especially near the sea-coast.

Features ? Stem erect, striate, tough, two to three feet high. Leaves alternate, lower lyrate-pinnatifid, stalked; upper bi-pinnatifid, sessile. Yellow flowers (July and August) florets of the ray smooth, of the disc hairy. Root consists of many long, thick fibres.

Part used ? Herb.

Action: Diaphoretic, detergent, antiseptic.

In coughs, colds, influenza, catarrhs, and for the relief of sciatica and rheumatic pains, wineglass doses of the ounce to pint decoction are taken as needed. Makes a good gargle, and is applied externally to ulcers and wounds. Ragwort ointment is prepared from the fresh herb and used for inflammation of the eyes.... ragwort

See CREPITATIONS.... râle

A drug used to prevent and treat postmenopausal osteoporosis (see under BONE, DISORDERS OF). Its action di?ers from hormone-replacement drugs in that it does not modify the symptoms of the MENOPAUSE.... raloxifene

A ridge or furrow between the halves of an organ.... raphe

Diminution in the density of a BONE as a result of withdrawal of calcium salts from it. (See BONE, DISORDERS OF – Osteoporosis.)... rarefaction

A criminal o?ence in which sexual intercourse takes place with an unwilling partner, female or male, under threat of force or violence. Reported rape cases have increased in number in recent years, but it is hard to know whether this is because the incidence of rape has increased or because the victims – women and men – are more willing to report the crime. A more sympathetic and understanding approach by the police, courts and society generally has resulted in the provision of greater support for victims who are usually severely traumatised psychologically as well as physically. It is argued that rape is motivated by a desire to dominate rather than simply an attempt to achieve sexual grati?cation. The majority of rapes are probably unreported because of the victims’ shame, anxiety about publicity and fear that the rapist will take reprisals. It is legally recognised that rape can happen within marriage. There are moves to make court proceedings less traumatic for victims, whose attackers are often known to them.

Anxiety, DEPRESSION and POST-TRAUMATIC STRESS DISORDER (PTSD) are common after rape: many victims are now given help by rape crisis counselling. A recent report suggests that in at least 50 per cent of reported rapes, the attacker was known to, or had been a friend of, the victim. The deliberate misuse of alcohol or drugs to reduce a potential victim’s resistance seems to be increasing (see DRUG ASSISTED RAPE; FLUNITRAZEPAM.)... rape

An infectious disease following the bite of a rat. There are two causative organisms – Spirillum minus and Actinobacillus muris – and the incubation period depends upon which is involved. In the case of the former it is 5–30 days; in the case of the latter it is 2–10 days. The disease is characterised by fever, a characteristic skin rash and often muscular or joint pains. It responds well to PENICILLIN.... rat-bite fever

A measure of the frequency of a phenomenon. In epidemiology, demography and vital statistics, a rate is an expression of the frequency with which an event occurs in a defined population. Rates are usually expressed using a standard denominator such as 1000 or 100 000 persons. Rates may also be expressed as percentages. The use of rates rather than raw numbers is essential for comparison of experience between populations at different times or in different places, or among different classes of persons.... rate

Limiting the availability of something (e.g. due to a shortage of the item itself or of resources with which to buy it).... rationing

Rubus idaeus. N.O. Rosaceae.

Synonym: Rubus strigosus, American Raspberry.

Habitat: Woods and heaths ; dry, gravelly or stony ground. Also cultivated in gardens. Features ? Stem erect, freely branched, three or four feet high, covered with small,

straight, slender prickles. Leaves stalked, pinnate, with two pairs of ovate leaflets and

larger terminal leaflet, rounded base, doubly serrate, pale green above, grey-white

down beneath, about three inches long by two inches broad. Small white, pendulous

flowers (May or June) in simple clusters. Astringent to the taste.

Part used ? Leaves.

Action: Astringent, stimulant.

The 1 ounce to 1 pint infusion is widely used as a mouth-wash and gargle, and for the cleansing of wounds and ulcers. Frequently combined with Slippery Elm as a poultice. With a little Ginger and Pennyroyal it is recommended for the stomach and bowel disorders of children.

Thomson and his immediate successors strongly advised the free drinking of the Raspberry leaves infusion for several months before confinement as an aid to parturition, and it is still much in demand for this purpose.... raspberry

See ERYTHROCYTES; BLOOD.... red blood cell

See MEIOSIS.... reduction division

Cooling... refrigerant

A course of treatment – possibly combining drugs, exercise, diet, etc. – designed to bring about an improvement in health.... regimen

Phragmites australis

Description: This tall, coarse grass grows to 3.5 meters tall and has gray-green leaves about 4 centimeters wide. It has large masses of brown flower branches in early summer. These rarely produce grain and become fluffy, gray masses late in the season.

Habitat and Distribution: Look for reed in any open, wet area, especially one that has been disturbed through dredging. Reed is found throughout the temperate regions of both the Northern and Southern Hemispheres.

Edible Parts: All parts of the plant are edible raw or cooked in any season. Harvest the stems as they emerge from the soil and boil them. You can also harvest them just before they produce flowers, then dry and beat them into flour. You can also dig up and boil the underground stems, but they are often tough. Seeds are edible raw or boiled, but they are rarely found.... reed

(1) Divided into specialist registrar and GP registrar, this is a training grade for NHS doctors. After a period in this grade – usually 3–6 years – they may be appointed as GP principals or gain a certi?cate of specialist training and be able to apply for NHS consultant posts (provided they have passed the appropriate higher examinations). In 2004 there were almost 15,000 specialist registrars in the UK and more than 1,800 GP registrars. Registrar numbers are also regulated by the government to achieve a balance between the numbers in training and the likely number of vacancies for career-grade doctors or dentists in the future.

(2) A public o?cial responsible for registering births, deaths, and marriages.... registrar

This is a treatment in which patients are helped to reduce their levels of anxiety by reducing their muscle tone. It can be used on its own or in conjunction with a broader PSYCHOTHERAPY regime. The technique guides people on how to cope with stressful situations and deal with phobias – see PHOBIA.... relaxation therapy

See ZANAMOVIR.... relenza

The term applied to the form of fever in which, during remissions (see REMISSION), the temperature falls, but not to normal.... remittent fever

See KIDNEYS.... renal tubule

A milk-coagulating ENZYME produced by the lining of the stomach. Rennin converts milk protein (caseinogen) into insoluble casein, thus ensuring that milk stays in the stomach for some time, during which it can be digested by various enzymes before passing into the small intestine.... rennin

Research that attempts to reproduce the findings of previous investigators so as to increase confidence in (or refute) those findings.... replication

The term “representative”, as it is commonly used, is undefined in the statistical or mathematical sense; it means simply that the sample resembles the population in some way. The use of probability sampling will not ensure that any single sample will be “representative” of the population in all possible aspects. A common fallacy lies in the unwarranted assumption that, if the sample resembles the population closely on those factors that have been checked, it is “totally representative” and no differences exist between the sample and the universal or reference population.... representative sample

A collective term for all the organs involved in sexual reproduction. In the female these are the OVARIES, FALLOPIAN TUBES, UTERUS, VAGINA and VULVA. In the male these are the testes (see TESTICLE), VAS DEFERENS, SEMINAL VESICLES, URETHRA and PENIS.... reproductive system

An alkaloid (see ALKALOIDS) obtained from the root of rauwol?a that has been and continues to be used as an anti-hypertensive (see HYPERTENSION) and a tranquillising agent.... reserpine

The additional amount of air that a person could breathe in or out if he or she were not using the full capacity of their LUNGS. (See also LUNG VOLUMES.)... reserve volume

The recipient of care in a residential care facility.... resident

The amount of air left in the LUNGS after an individual has breathed out as much as possible. It is a measure of lung function: for example, in a person with EMPHYSEMA the residual volume is increased. (See RESPIRATION; LUNG VOLUMES.)... residual volume

These are wax-containing plant oils, often secreted to fill in injured tissues, much like a blood clot, sometimes used to protect leaves from loss of water through evaporation or to render them unpalatable. (See BALSAMICS.)... resins

A term applied to infective processes, to indicate a natural subsidence of the INFLAMMATION without the formation of PUS. Thus a pneumonic lung is said to ‘resolve’ when the material exuded into it is absorbed into the blood and lymph, so that recovery takes place naturally; an in?amed area is said to resolve when the in?ammation diminishes and no abscess forms; a glandular enlargement is said to resolve when it decreases in size without suppuration. Resolution is also used to describe the extent to which individual details – for example, cell structures – can be identi?ed by the eye when using a light microscope.... resolution

Causing resolution of a tumour or swelling... resolvent

This may occur in adults as ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), or in newborn children, when it is also known as HYALINE MEMBRANE DISEASE. The adult syndrome consists of PULMONARY OEDEMA of non-cardiac origin. The process begins when tissue damage stimulates the autonomic nervous system, releases vasoactive substances, precipitates complement activation, and produces abnormalities of the clotting cascade – the serial process that leads to clotting of the blood (see COAGULATION). The activation of complement causes white cells to lodge in the pulmonary capillaries where they release substances which damage the pulmonary endothelium.

Respiratory distress syndrome is a complication of SHOCK, systemic SEPSIS and viral respiratory infections. It was ?rst described in 1967, and – despite advances with assisted ventilation

– remains a serious disease with a mortality of more than 50 per cent. The maintenance of adequate circulating blood volume, peripheral PERFUSION, acid-base balance and arterial oxygenation is important, and assisted ventilation should be instituted early.

In newborns the mechanism is diferent, being provoked by an inability of the lungs to manufacture SURFACTANT.... respiratory distress syndrome

A condition in which the patient experiences unpleasant sensations, and occasionally involuntary movements, in the legs when at rest, especially at night. No pathological changes have been identi?ed. It is sometimes indicative of iron-de?ciency ANAEMIA, but in many cases the cause remains a mystery and the variety of cures o?ered are a testimony to this. Some anti-epileptic drugs are said to help (see EPILEPSY).... restless legs syndrome

Having the power to restore or renew health ... restorative

An endonuclease ENZYME, extracted from BACTERIA, that is used to cut DNA into short segments – a process essential in GENETIC ENGINEERING.... restriction enzyme

See APPENDIX 1: BASIC FIRST AID. See also DNR.... resuscitation

Slowing down; developmental delay. Psychomotor retardation is a signi?cant slowing down of speech and activity which eventually leads to a person being unable to cope with daily activities or to maintain personal hygiene. It is a symptom of severe DEPRESSION.... retardation

Retching is an ine?ectual form of VOMITING.... retching

Any one of a collection of drugs that are derived from vitamin A (see APPENDIX 5: VITAMINS). They can be taken orally or applied topically, and affect the skin by causing drying and peeling, with a reduction in the production of SEBUM. These properties are useful in the treatment of ACNE and PSORIASIS.... retinoids

A pre?x signifying behind or turned backwards.... retro

An abnormal position of the UTERUS, occurring in about 20 per cent of women, in which its long axis is pivoted backwards in relation to the CERVIX UTERI and VAGINA instead of forwards.... retroversion

The periodic assessment of a doctor’s professional competence. Revalidation began in the UK in 2004, to ensure that those doctors on the Medical Register of the GENERAL MEDICAL COUNCIL (GMC) as active practitioners are capable of providing appropriate standards of medical care. The process depends, amongst other things, upon the doctor being able to demonstrate that he or she has maintained a continuing programme of professional development: ‘lifelong learning’.... revalidation

An ENZYME, usually found in retroviruses (see RETROVIRUS), that catalyses the manufacture of DNA from RNA, enabling the viral RNA to amalgamate with the DNA of the infected host.... reverse transcriptase

Causing revulsion in drawing away of blood from a pathological area to another area... revulsive

See BLOOD GROUPS.... rhesus factor

The surgical operation of cutting a nerve root, as, for example, to relieve the pain of TRIGEMINAL NEURALGIA.... rhizotomy

See RNA.... ribonucleic acid

Granules either found free within the cell, or attached to a reticular network within the cell’s endoplasm (the inner part of a cell’s cytoplasm

– see CELLS). Consisting of approximately 65 per cent RNA and 35 per cent PROTEIN, they are the sites where protein is made.... ribosome

A virus disease, caused by a phlebovirus and transmitted by mosquitoes, at one time con?ned to sub-Saharan Africa and predominantly found in domestic animals such as cattle, sheep and goats. The only humans affected were veterinary surgeons, butchers and others exposed to heavy infection by direct contact with infected animals; these usually recovered. In the 1970s the disease ?ared up in Egypt, probably owing to a more virulent virus. The illness in humans is characterised by fever, haemorrhages, ENCEPHALITIS and involvement of the EYE. An e?ective vaccine protects both animals and human beings against the disease (see IMMUNISATION).... rift valley fever

Sections of deoxyribonucleic acid (DNA) – the principal molecule in a cell carrying genetic information – that act as enzymes (see ENZYME). The function of a ribozyme is to transform the messages encoded in DNA into proteins (see PROTEIN), using its property of catalysing chemical reactions in a cell. Most ribozymes act only on other pieces of ribonucleic acid (RNA), editing the messenger type that carries instructions to the parts of the cell that makes proteins. This editing ability is being used by scientists researching ways of correcting faulty GENES which can cause inherited disorders. The aim is to persuade the ribozyme to inhibit the messenger RNA to prevent production of the faulty gene. Ribozymes might also be used to disrupt infectious agents, such as viruses, which rely on RNA to invade body cells.... ribozyme

The general term given to a group of microorganisms which are intermediate between BACTERIA and viruses (see VIRUS). They are the causal agents of TYPHUS FEVER and a number of typhus-like diseases, such as ROCKY MOUNTAIN SPOTTED FEVER, Japanese River fever, and scrub typhus. These micro-organisms are usually conveyed to man by lice, ?eas, ticks, and mites.

Visceral rickettsia is a disease transmitted by mites from an infected house mouse, which occurs in the USA, South Africa, Korea and the former Soviet Union. The causal organism is Rickettsia akari. The incubation period is 7–14 days and the characteristic features are fever, headache, and a non-irritating rash on the face, trunk and extremities. The disease is non-fatal and responds rapidly to TETRACYCLINES.... rickettsia

An antibiotic derived from Streptomyces mediterranei, rifampicin is a key component of the treatment of TUBERCULOSIS. Like ISONIAZID, it should always be included unless there is a speci?c contraindication. It is also valuable in the treatment of BRUCELLOSIS, LEGIONNAIRE’S DISEASE, serious staphylococcal (see STAPHYLOCOCCUS) infections and LEPROSY. It is also given to contacts of certain forms of childhood MENINGITIS.

Rifampicin is given by mouth; during the ?rst two months it often causes transient disturbance of LIVER function, with raised concentrations of serum transaminases, but usually treatment need not be interrupted. In patients with pre-existing liver disease more severe toxicity may occur, and liver function should be carefully monitored both before starting and during rifampicin treatment. It induces hepatic enzymes which accelerate the metabolism of various drugs including ANTICOAGULANTS, SULPHONYLUREAS, PHENYTOIN SODIUM, CORTICOSTEROIDS and OESTROGENS. The e?ectiveness of oral contraceptives is reduced and alternative family-planning advice should be o?ered.

Rifampicin should be avoided during pregnancy and breast feeding, and extra caution should be applied if there is renal impairment, JAUNDICE or PORPHYRIAS. Adverse effects include gastrointestinal symptoms, in?uenza-like symptoms, collapse and SHOCK, haemolytic ANAEMIA, acute ?ushing and URTICARIA; body secretions may be coloured red.... rifampicin

(Arabic) Resembling the white antelope

Rimah, Reema, Reemah, Ryma, Rymah, Rim, Reem, Reama, Reamah... rima

A local anaesthetic agent (see ANAESTHESIA) injected into the circumference of the base of a digit. It numbs the nerves of the ?nger or toe and so permits minor surgery to be performed. Care must be taken to avoid damage to local blood vessels which can lead to GANGRENE.... ring block

The probability that an event will occur.... risk

The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences.... risk assessment

The term is used in two ways. Firstly, it may comprise a list of infants whose obstetric and/or perinatal history suggests they might be at risk of illness or serious abnormality such as LEARNING DISABILITY.

Secondly – and more commonly termed the ‘At-risk register’ – this is a list held by social-service departments, and accessible to doctors in A&E departments, of children whom a local-authority social-services case conference has deemed to have been harmed or to be at risk of harm from mental, physical or sexual abuse (see also CHILD ABUSE).... risk register

The process of analysing and comparing, on a single scale, the expected positive (benefits) and negative (risks, costs) results of an action, or lack of an action.... risk-benefit analysis

The term used for describing the facial appearance when the muscles of the forehead and the face go into spasm in TETANUS, giving the e?ect of a sardonic grin.... risus sardonicus

A beta2-adrenoceptor-stimulating drug that relaxes uterine muscle (see UTERUS). It is used in selected women close to term to inhibit the onset of labour for at least 48 hours. This allows for the implementation of measures to improve the perinatal health of the infant, including making arrangements for transfer to a neonatal intensive-care facility. (See PREGNANCY AND LABOUR – Premature birth.)... ritodrine

An acetylcholinesterase inhibitor used in the treatment of ALZHEIMER’S DISEASE. Treatment should be under the supervision of a specialist and the drug should be started at a low dose because of potential side-effects.... rivastigmine

Also called root-canal therapy, this is the treatment given when the nerve of a tooth (see TEETH) has been exposed while the tooth is being prepared for a ?lling, or if it has died or become infected. The nerve debris is removed and, when the chamber is clear of infection, an inert material is inserted to seal o? the root.... root filling

Lindl.

Ayurvedic: Taruni-Kantaka (non- classical). (Flowers—crimson or pink.)

Unani: Chini Gulaab.

Folk: Kaantaa-Gulaab.

Action: Hips—applied to wounds, injuries, sprains and foul ulcers.

R. chinensis Jacq. and R. borboni- ana Desp. are synonyms of Rosa indica, found and cultivated throughout India. This variety is also known as Edward Rose or Kat Gulaab.... rosa macrophylla

(Greek) Resembling the beautiful and meaningful flower

Rasia, Rasine, Rasja, Rasya, Rosa, Rosella, Roselle, Rosena, Rosenah, Rosene, Rosetta, Rosette, Rosey, Rosheen, Rosie, Rosina, Rosine, Rosio, Rosita, Rosy, Roza, Roze, Rozele, Rozella, Rozene, Rozina, Rozsa, Rozsi, Rozsika, Rozy, Ruza, Ruzena, Ruzenka, Ruzha, Ruzsa, Rosai, Rosay, Rosee, Rosae, Roesia, Rohais, Rhosyn, Rois, Roisin, Ros, Russu, Ruusu, Rozeena, Rozyuka, Rhodia... rose

A transient EXANTHEM of toddlers. Mild malaise is followed by a RUBELLA-like rash. It is caused by herpes virus 6 (see HERPES VIRUSES).... roseola infantum

The protuberant anterior part of the scolex of certain tapeworms. May be unarmed or armed with rows of hooklets.... rostellum

A musculo-tendinous structure that helps to stabilise the shoulder-joint. The cu? may be damaged as a result of a fall; complete rupture requires surgical treatment and intensive PHYSIOTHERAPY.... rotator cuff

See ASCARIASIS.... roundworms

(Gaelic) Of the red-berry tree Rowann, Rowane, Rowanne, Rowana, Rowanna... rowan

A group of red blood cells arranged together like a roll of coins, usually only noticed on a slide under a microscope. Since red blood cells in a reasonably healthy person should have a mutually repelling membrane charge, this means that something like an inflammatory response or an elevation of liver-synthesized lipids (LDLs and VLDLs) is occurring. Inflammation makes the blood “sticky,” and the lipids from the liver lower the charges. Remember, of course, that I am talking about subclinical imbalances...such things as rouleau can accompany some pretty gnarly diseases. Our kind of rouleau can give you a headache or make your hands and feet cold because it’s hard to push rolls of coins through little bitty capillaries.... rouleau

See RESPIRATORY SYNCYTIAL VIRUS (RSV).... rsv

See ESR.... sedimentation rate

The ratio of one sex to another. Usually defined as the ratio of males to females.... sex ratio

Linn.

Family: Malvaceae.

Habitat: Throughout India, in moist places.

English: Common Bala.

Ayurvedic: Mahaabalaa, Mahaa- samangaa, Sahadevaa, Kshetrabalaa.

Unani: Bariyaara (red-flowered var.).

Siddha/Tamil: Athi Bala-chedi, Chitrmutti, Tennacham.

Action: Plant—used as a supporting drug in pulmonary tuberculosis, nervous diseases and rheumatism. Leaves—applied to swelling as paste. Stem-mucilage—demulcent and emollient. Used internally in skin diseases and as a diuretic and febrifuge.

The Ayurvedic Pharmacopoeia of India recommends the root in deficient spermatogensis and oedema.

Alkaloids, ephedrine, si-ephedrine and cryptolepine, are reported from aerial parts. The root contains 0.054% alkaloids, beta-phenethylamine, N- methyl-beta-phenethylamine, vasici- nol, vasicinone, vasicine, choline and betaine. These alkaloids are also present in the aerial parts.

Alcoholic extract of the root exhibited antibacterial and antipyretic activities.

Proteins, linoleic, malvlic and ster- culic acids have been reported from seeds.

Dosage: Root—3-6 g powder. (API, Vol. III.)... sida rhombifolia

The air carrying the voice produced in the LARYNX passes through the throat, mouth and nose. The shape and size of these structures will in?uence the timbre of the voice, or vocal resonance. This will vary from person to person and even within an individual; for example, with a cold.... vocal resonance

A test introduced for the diagnosis of SYPHILIS by examination of the blood. It has now been largely supplanted by other, more speci?c tests.... wassermann reaction

See AGGLUTINATION.... widal reaction

See: REFLUX. ... gastro-oesophageal reflux disease

Forced introduction of air into the lungs of someone who has stopped breathing (see respiratory arrest) or whose breathing is inadequate. As an emergency first-aid measure, artificial respiration can be given mouth-to-mouth or mouth-tonose, which can prevent brain damage due to oxygen deprivation; a delay in breathing for more than 6 minutes can cause death. Cardiac compressions may also be necessary if poor respiration has led to cessation of the heartbeat (see cardiopulmonary resuscitation). Artificial respiration can be continued by use of a ventilator (see ventilation).... artificial respiration

R. infantum. ‘Rash of Roses’ consists of small separate irregular rose-pink spots with a pale halo which appears after feverishness has abated. Spots that fade on pressure first appear on trunk and neck, spreading to the face and buttocks, remaining for a short duration – half to 2 days. This is the commonest cause of high fever in children under three. Causal agent: herpes virus, human, HH6. Differential diagnosis: from German Measles where rash accompanies fever. Internally: German Chamomile tea freely. See: SKIN, above entry.

Teething. Teas: Spearmint, Roman Chamomile, Peppermint. 1 heaped teaspoon to cup boiling water; infuse 15 minutes; frequent teaspoon doses. Alternative: place one Chamomile flower in feeding bottle. Essential oils: rub gums with diluted oils: Spearmint, German Chamomile, Peppermint or Mullein. Urinary Tract Infection, Cystitis or urethritis.

Teas: Horsetail, Couch Grass, Golden Rod, Rosehip. Dandelion coffee. For pus in the urine: 1-5 drops Tincture Myrrh in cup of warm water: Dose: 1-2 teaspoons thrice daily. Fullness under the eyes may indicate Bright’s Disease for which specialist opinion should be obtained without delay.

Diet. Wholegrain cereals, wholemeal bread, pasta, two servings fresh fruit and vegetables daily. Little lean meat, poultry, fish. Dairy products: yoghurt, cheese, milk in moderation. Fresh orange juice, raw fresh vegetable salads. Oatmeal (porridge oats) is sustaining to the nervous system.

Avoid: crisps, fizzy drinks, hamburgers, biscuits, chocolate, sugar-filled snacks, alcohol, strong tea and coffee.

Supplement. Most children may benefit from one zinc tablet weekly.

Medicine doses. See: DOSAGE.

Fish oils. As well as to help children guard against winter illnesses, Cod Liver oil supplements may help them later in life against arthritis, heart disease, psoriasis, eczema and other inflammatory disorders.

Aspirin. It is clear that a link exists between Reye’s syndrome and aspirin. Aspirin is not advised for minor viral illness in children. ... roseola

Both vegetable and animal tissues produce free radicals as a normal metabolic byproduct. They are found in many areas of human activity.

A radical is a group of atoms which can combine in the same way as single atoms to make a molecule. Free means uncombined. A free radical is a state in which a radical can exist before it combines – an incomplete molecule containing oxygen which has an uneven electrical charge. High energy oxygen atoms are known to form atheroma.

As well as being substances that take part in a process of metabolism, free radicals can be found in industrial fumes and cigarette smoke. They are oxidants and have an anti-bacterial effect. But their activity is not confined to bacteria alone. When produced in large amounts as in inflammation and infection, they may have a damaging effect upon the lining of blood vessels and other tissues. An excess is produced in ischaemic heart disease. They have been shown to be involved in jet lag, Alzheimer’s disease, rheumatoid arthritis, thrombosis, heart failure, cancer, irradiation sickness and a weak immune system. Damaging to the DNA, they are probably the greatest single cause of ill health. They hasten the ageing process. Vitamins A, C, E, being antioxidants and the mineral Selenium stimulate certain enzyme systems to limit damage done by these destructive elements.

Losing weight is believed to generate free radicals – a metabolic side-effect of dieting. See: ANTIOXIDANTS. ... free radicals

The administration of life-saving measures to a person who has suffered a cardiac arrest. A person in cardiac arrest is not breathing and has no detectable pulse or heartbeat. First, mouth-to-mouth resuscitation (see artificial respiration) is given; if this fails to restart breathing, repeated chest compressions, using the heel of

the hand, are applied to the lower breastbone until trained help arrives.

Both these measures are used to restore blood circulation to the brain.

Brain damage is likely if the brain is starved of oxygen for more than 3–4 minutes.... cardiopulmonary resuscitation

A protein produced in the body in response to inflammation.... c-reactive protein

A surgical procedure to replace all or part of a diseased hip joint with an artificial substitute. The replacement is most often carried out in older people whose joints are stiff and painful as a result of osteoarthritis. It may also be needed if rheumatoid arthritis has spread to the hip joint or if the top end of the femur is badly fractured (see femur, fracture of).... hip replacement

The body’s defensive reaction to microorganisms, cancer cells, transplanted tissue, and other substances or materials that are recognized as antigenic or “foreign”.

The response consists of the production of cells called lymphocytes, substances called antibodies, or immunoglobulins, and other substances and cells that act to destroy the antigenic material.

(See also immune system.)... immune response

See MRI.... magnetic resonance imaging

See Learning difficulties.... mental retardation

See artificial respiration.... mouth-to-mouth resuscitation

See rehydration therapy.... oral rehydration therapy

(PCR) A method of rapidly copying DNA sequences so that they can be analysed.... polymerase chain reaction

A term used to describe abnormalities associated with rickets or to refer to people or populations with rickets.... rachitic

A term for anything that is almost transparent to radiation, especially to X-rays and gamma radiation.... radiolucent

This term describes anything that blocks radiation, especially X-rays and gamma rays.

As many body tissues are radiolucent, some X-ray imaging procedures require the introduction of radiopaque substances into the body to make organs stand out clearly.... radiopaque

A colourless, odourless, tasteless, radioactive gaseous element produced by the radioactive decay of radium.... radon

An antidepressant drug that blocks the reuptake of noradrenaline (norepinephrine) within the nervous system.

Side effects include insomnia, sweating, and dizziness on standing.... reboxetine

A disorder of the blood vessels in which exposure to cold causes the small arteries supplying the fingers and toes to contract suddenly. This cuts off blood flow to the digits, which become pale. The fingers are more often affected than the toes. The cause is unknown, but young women are most commonly affected.

On exposure to cold, the digits turn white due to lack of blood. As sluggish blood flow returns, the digits become blue; when they are warmed and normal blood flow returns, they turn red. During an attack, there is often tingling, numbness, or a burning feeling in the affected fingers or toes. In rare cases, the artery walls gradually thicken, permanently reducing blood flow. Eventually painful ulceration or even gangrene may develop at the tips of the affected digits.

Diagnosis is made from the patient’s history. Treatment involves keeping the hands and feet as warm as possible. Vasodilator drugs or calcium channel blockers may be helpful in severe cases. (See also Raynaud’s phenomenon.)... raynaud’s disease

The passage of blood from the rectum or anus. The blood may be red, dark brown, or black. It may be mixed with, or on the surface of, faeces or passed separately, and there may be pain. Haemorrhoids are the most common cause of rectal bleeding. Small amounts of bright red blood appear on the surface of faeces or on toilet paper. Anal fissure, anal fistula, proctitis, or rectal prolapse may also cause rectal bleeding.Cancer of the colon (see colon, cancer of) or the rectum (see rectum, cancer of), or polyps can also cause bleeding. Disorders of the colon such as diverticular disease may cause dark red faeces. Black faeces (melaena) may be due to bleeding high in the digestive tract. Bloody diarrhoea may be due to ulcerative colitis, amoebiasis, or shigellosis. Diagnosis may be made from a rectal examination, from proctoscopy, sigmoidoscopy, colonoscopy, or a double-contrast barium X-ray examination.

rectal examination Examination of the anus and rectum, performed as part of a general physical examination, to assess symptoms of pain or changes in bowel habits, and to check for the presence of tumours of the rectum or prostate gland. rectal prolapse Protrusion outsid.

nent in elderly people. If the prolapse is large, leakage of faeces may occur.

Treatment is with a fibre-rich diet.

Surgery may also be performed.... rectal bleeding

Bulging inwards and downwards of the back wall of the vagina as the rectum pushes against weakened tissues in the vaginal wall.

A rectocele is usually associated with a cystocele or a prolapsed uterus (see uterus, prolapse of).

There may be no symptoms, or the rectocele may cause constipation.

Pelvic floor exercises may help.

If not, an operation to tighten the tissues at the back of the vagina may be recommended.... rectocele

An action that occurs automatically and predictably in response to a particular stimulus, independent of the will of the individual.

In the simplest reflex, a sensory nerve cell reacts to a stimulus, such as heat or pressure, and sends a signal along its nerve fibre to the central nervous system. There, another nerve cell becomes stimulated and causes a muscle to contract or a gland to increase its secretory activity. The passage of the nerve signal.

from original sensation to final action is called a reflex arc.

Reflexes may be inborn or conditioned. Some inborn reflexes occur only in babies (see reflex, primitive). Inborn reflexes include those that control basic body functions, such as contraction of the bladder after it has filled beyond a certain point, and are managed by the autonomic nervous system. Conditioned reflexes are acquired through experience in a process called conditioning.

Several simple reflexes, such as the knee-jerk, are tested in a physical examination. Changes in the reflexes may indicate damage to the nervous system. The examination of vital reflexes controlled by the brainstem is the basis for diagnosing brain death.... reflex

A form of complementary medicine in which the practitioner massages parts of the patient’s feet in an attempt to treat disorders affecting other areas of the body.... reflexology

An abnormal backflow of fluid in a body passage due to failure of the passage’s exit to close fully.

A common type of reflux is regurgitation of acid fluid from the stomach (see acid reflux).... reflux

A term used in psychoanalytic theory to describe the process of returning to a childhood level of behaviour, such as thumb-sucking.... regression

A condition in which there is a combination of urethritis, reactive arthritis, and conjunctivitis. There may also be uveitis. Reiter’s syndrome is more common in men.

The syndrome is caused by an immune response and usually develops only in people with a genetic predisposition. Most patients have the -B27 tissue type (see histocompatability antigens). The syndrome’s development is induced by infection: usually nongonococcal urethritis, but sometimes bacillary dysentery. Reiter’s syndrome usually starts with a urethral discharge, which is followed by conjunctivitis and then arthritis. The arthritis usually affects 1 or 2 joints (usually the knee and/or ankle) and is often associated with fever and malaise. Attacks can last for several months. Tendons, ligaments, and tissue in the soles of the feet may also become inflamed. Skin rashes are common.

Diagnosis is made from the symptoms.

Analgesic drugs and nonsteroidal antiinflammatory drugs relieve symptoms but may have to be taken for a long period.

Relapses occur in about 1 in 3 cases.... reiter’s syndrome

A condition in which the kidneys are unable to excrete normal amounts of acid made by the body.

The blood is more acidic than normal, and the urine less acidic.

Causes include kidney damage due to disease, drugs, or a genetic disorder; but in many cases the cause is unknown.

The acidosis may result in osteomalacia, kidney stones (see calculus, urinary tract), nephrocalcinosis, and hypokalaemia (an abnormally low level of potassium in the blood).... renal tubular acidosis

An oral hypoglycaemic drug used either alone or in combination with metformin in the treatment of type 2 diabetes mellitus. Repaglinide stimulates the release of insulin. Side effects may include abdominal pain, diarrhoea or constipation, nausea, and vomiting.... repaglinide

(RSI) An overuse injury that affects keyboard workers and musicians, causing weakness and pain in the wrists and fingers.... repetitive strain injury

See ventilator.... respirator

Blockage of an artery supplying blood to the retina, most commonly due to thrombosis or embolism, The disorder can result in permanent blindness or loss of part of the field of vision, depending on the artery affected and whether or not the condition can be treated quickly enough.... retinal artery occlusion

Separation of the retina from the outer layers at the back of the eye. Detachment may follow an eye injury but usually occurs spontaneously. It is usually preceded by a retinal tear, and is more common in highly myopic (shortsighted) people and in people who have had cataract surgery.

The detachment is painless. The first symptom is either bright flashes of light at the edge of the field of vision, accompanied by floaters, or a black “drape” obscuring vision.

Urgent treatment is required and usually involves surgical repair of the underlying tear. If the macula (site of central vision) has not been detached, the results can be excellent.... retinal detachment

Blockage of a vein carrying blood away from the retina.

It usually results from thrombosis in the affected vein, and is more common in people who have glaucoma.

Retinal vein occlusion may cause visual disturbances, glaucoma, or blindness.... retinal vein occlusion

An inherited condition in which there is degeneration of the rods and cones of the retina at the back of both eyes.

The 1st symptoms appear during or after adolescence and include night blindness.

Tests show a ring-shaped area of blindness which, over some years, extends to destroy an increasing area of the visual field, though central vision is retained, often for many years.

Opthalmoscopy reveals several masses of black pigment corresponding to the areas of visual loss.

Affected individuals and their parents should have genetic counselling.... retinitis pigmentosa

Also called retinopathy of prematurity, a condition that mainly affects the eyes of premature infants. The usual cause is high concentrations of oxygen being given as part of the treatment for respiratory distress. Excess oxygen causes the tissues at the margin of the retina to shut down their blood vessels. When oxygen concentrations return to normal, the affected tissues may send strands of new vessels and fibrous scar tissue into the vitreous humour. This may interfere with vision and cause retinal detachment. Laser treatment may be used.... retrolental fibroplasia

A brain disorder, thought to be a genetic disorder, that only affects girls. Symptoms usually occur when the child is 12–18 months old. Acquired skills, such as walking and communication skills, disappear and the girl becomes progressively handicapped, perhaps with signs of autism. There are repetitive writhing movements of the hands and limbs, and inappropriate outbursts of crying or laughter. There is no cure for Rett’s syndrome and sufferers need constant care and attention. Parents of an affected child should receive genetic counselling.... rett’s syndrome

A rare disorder in which brain and liver damage follow a viral infection. Children over 15 are rarely affected. The cause is unknown, but aspirin seems to be a predisposing factor to developing the condition and is therefore not recommended for children.

The disorder starts as the child recovers from the infection. Symptoms include uncontrollable vomiting, lethargy, memory loss, and disorientation. Swelling of the brain may cause seizures, disturbances in heart rhythm, coma, and cessation of breathing.

Brain swelling may be controlled by corticosteroid drugs and by intravenous infusions of mannitol. Dialysis or blood transfusions may be needed. If breathing stops, a ventilator is used.

The death rate is around 10 per cent, and higher for those who have seizures, lapse into deep coma, and stop breathing.

Permanent brain damage may occur.... reye’s syndrome

Destruction of muscle tissue accompanied by the release of myoglobin into the blood. The commonest cause is a severe, crushing muscle injury (see crush syndrome). Other causes include polymyositis and, rarely, excessive exercise. There is usually temporary paralysis or weakness of the affected muscle. Except in cases of severe injury, the condition clears up without treatment.... rhabdomyolysis

A very rare cancerous muscle tumour. Treatment is by surgical removal, radiotherapy, and anticancer drugs.... rhabdomyosarcoma

Any of the flat, curved bones that form a framework for the chest and a protective cage around the heart, lungs, and other underlying organs. There are 12 pairs of ribs, each joined at the back of the ribcage to a vertebra. The upper 7 pairs, known as “true ribs”, link directly to the sternum by flexible costal cartilage.

The next 2 or 3 pairs of “false ribs” connect indirectly to the sternum by means of cartilage attached to the cartilage of the ribs above.

Between and attached to the ribs are thin sheets of muscle (intercostal muscles) that act during breathing.

The spaces between the ribs also contain nerves and blood vessels.... rib

The chemical name of vitamin B2 (see vitamin B complex).... riboflavin

The stiffening of muscles that starts 3–4 hours after death.

It is usually complete after about 12 hours; the stiffness then disappears over the next 48–60 hours.

Physical exertion before death makes rigor mortis begin sooner.

The sooner rigor mortis begins, the quicker it passes.

These facts are used to help assess the time of death.... rigor mortis

See onchocerciasis.... river blindness

One of the 2 specialized types of nerve cell within the retina of the eye that convert light energy into nerve impulses. The rods are very sensitive and can respond to very dim light. (See also cone.)... rod

The acting out of a role (the pattern of behaviour expected in a given situation).

The phrase “sick role” describes the type of passive behaviour expected and allowed of a patient; people with social or emotional problems may unconsciously adopt this role to gain sympathy and understanding.... role-playing

A dental procedure performed to save a tooth in which the pulp (see pulp, dental) has died or become untreatably diseased, usually as the result of extensive dental caries.

The pulp is removed through a hole drilled in the crown. An antibiotic paste and a temporary filling are packed in. A few days later, the filling is removed and the canals are checked for infection. When no infection is detected the cavity is filled and the roots are sealed with cement. If the cavity is not filled completely, periodontitis may occur.

Treated teeth may turn grey but their appearance can be restored by bonding (see bonding, dental), fitting an artificial crown (see crown, dental), or by bleaching (see bleaching, dental).... root-canal treatment

A type of virus that is one of the causes of gastroenteritis, especially in young children.... rotavirus

A rubber sheet used to isolate 1 or more teeth during certain dental procedures. The dam acts as a barrier against saliva and prevents the inhalation of debris.... rubber dam

Another name for measles.... rubeola

A testis that is drawn up.... testis, retractile

Another name for neurofibromatosis.... von recklinghausen’s disease

n. an agent that reduces tension and strain, particularly in muscles (see muscle relaxant).... relaxant

The probability of an event in a population as contrasted with relative risk. See “relative risk”.... absolute risk

A measure of treatment effect that compares the probability (or mean) of a type of outcome in the control group with that of a treatment group.... absolute risk reduction

A risk that has minimal detrimental effects or for which the benefits outweigh the potential hazards.... acceptable risk

A family of research methodologies which pursue action (or change) and research (or understanding) at the same time.... action research

Formerly known as adult respiratory distress syndrome. A form of acute respiratory failure in which a variety of di?erent disorders give rise to lung injury by what is thought to be a common pathway. The condition has a high mortality rate (about 70 per cent); it is a complex clinical problem in which a disproportionate immunological response plays a major role. (See IMMUNITY.)

The exact trigger is unknown, but it is thought that, whatever the stimulus, chemical mediators produced by cells of the immune system or elsewhere in the body spread and sustain an in?ammatory reaction. Cascade mechanisms with multiple interactions are provoked. CYTOTOXIC substances (which damage or kill cells) such as oxygen-free radicals and PROTEASE damage the alveolar capillary membranes (see ALVEOLUS). Once this happens, protein-rich ?uid leaks into the alveoli and interstitial spaces. SURFACTANT is also lost. This impairs the exchange of oxygen and carbon dioxide in the lungs and gives rise to the clinical and pathological picture of acute respiratory failure.

The typical patient with ARDS has rapidly worsening hypoxaemia (lack of oxygen in the blood), often requiring mechanical ventilation. There are all the signs of respiratory failure (see TACHYPNOEA; TACHYCARDIA; CYANOSIS), although the chest may be clear apart from a few crackles. Radiographs show bilateral, patchy, peripheral shadowing. Blood gases will show a low PaO2 (concentration of oxygen in arterial blood) and usually a high PaCO2 (concentration of carbon dioxide in arterial blood). The lungs are ‘sti?’ – they are less e?ective because of the loss of surfactant and the PULMONARY OEDEMA.

Causes The causes of ARDS may be broadly divided into the following:... acute respiratory distress syndrome (ards)

Love, Happiness... adam & eve roots

Permanent fixtures or alterations to a home to help someone get about or manage better (distinguished from ‘aids’ or ‘equipment’, which are more portable).... adaptation (of residence)

A record concerned with administrative matters, such as length of stay, details of accommodation, or billing.... administrative record

The sites in the body on which ADRENALINE and comparable stimulants of the SYMPATHETIC NERVOUS SYSTEM act. Drugs which have an adrenaline-like action are described as being adrenergic. There are ?ve di?erent types of adrenergic receptors, known as alpha1, alpha2, beta1, beta2 and beta3 respectively. Stimulation of alpha receptors leads to constriction of the bronchi, constriction of the blood vessels with consequent rise in blood pressure, and dilatation of the pupils of the eyes. Stimulation of beta1 receptors quickens the rate and output of the heart, while stimulation of beta2 receptors dilates the bronchi. Beta3 receptors are now known to mediate so-called non-shivering thermogenesis, a way of producing heat from specialised fat cells that is particularly relevant to the human infant.

For long it had been realised that in certain cases of ASTHMA, adrenaline had not the usual bene?cial e?ect of dilating the bronchi during an attack; rather it made the asthma worse. This was due to its acting on both the alpha and beta adrenergic receptors. A derivative, isoprenaline, was therefore produced which acted only on the beta receptors. This had an excellent e?ect in dilating the bronchi, but unfortunately also affected the heart, speeding it up and increasing its output – an undesirable e?ect which meant that isoprenaline had to be used with great care. In due course drugs were produced, such as salbutamol, which act predominantly on the beta2 adrenergic receptors in the bronchi and have relatively little e?ect on the heart.

The converse of this story was the search for what became known as BETA-ADRENOCEPTORBLOCKING DRUGS, or beta-adrenergic-blocking drugs. The theoretical argument was that if such drugs could be synthesised, they could be of value in taking the strain o? the heart – for example: stress ? stimulation of the output of adrenaline ? stimulation of the heart ? increased work for the heart. A drug that could prevent this train of events would be of value, for example in the treatment of ANGINA PECTORIS. Now there is a series of beta-adrenoceptor-blocking drugs of use not only in angina pectoris, but also in various other heart conditions such as disorders of rhythm, as well as high blood pressure. They are also proving valuable in the treatment of anxiety states by preventing disturbing features such as palpitations. Some are useful in the treatment of migraine.... adrenergic receptors

A residence which offers housing and personal care services to a number of residents. Services (such as meals, supervision and transportation) are usually provided by the owner or manager. Usually 24-hour professional health care is not provided on site. See also “assisted living facility”.... adult care home / residential facility

Any undesirable or unwanted consequence of a preventive, diagnostic or therapeutic procedure.... adverse event / reaction

Rosewater; the hydrosol of the distillate of rose petals; a byproduct of making rose essential oil; may also contain other ingredients, including alcohol, glycerine, coloring or flavoring agents and preservatives; may be attributed therapeutic properties and used for physical illness treatments and spiritual cleansing rituals.... agua de rosas

When a new drug is introduced, it has usually been studied only in relatively few patients – typically 1,500. If n patients have been studied, and no serious effects observed, there is still a chance of a serious adverse e?ect occurring in the general population as frequently as 3/n (1:500).

Adverse effects can be divided into types. First, those which are closely related to the concentration of the drug and accord with what is known of its PHARMACOLOGY. These so-called type A (augmented pharmacological) effects are distinguished from type B (bizarre) effects which are unpredictable, usually rare, and often severe. ANAPHYLAXIS is the most obvious of these; other examples include bone-marrow suppression with CO-TRIMOXAZOLE; hepatic failure (see HEPATITIS) with SODIUM VALPROATE; and PULMONARY FIBROSIS with AMIODARONE. A more comprehensive classi?cation includes reactions type C (chronic effects), D (delayed effects – such as teratogenesis or carcinogenesis) and E (end-of-dose effects – withdrawal effects). Examples of adverse reactions include nausea, skin eruptions, jaundice, sleepiness and headaches.

While most reported adverse reactions are minor and require no treatment, patients should remind their doctors of any drug allergy or adverse e?ect they have suffered in the past. Medical warning bracelets are easily obtained. Doctors should report adverse effects to the authorities – in the case of Britain, to the Committee on Safety of Medicines (CSM), using the yellow-card reporting machinery.... adverse reactions to drugs

Miq. Hiern

Synonym: A. elaegnoidea (A. Juss.) Benth.

Milnea roxburghiana (Miq.) Wight and Arn.

Family: Meliaceae.

Habitat: Western Ghats, tropical forests in the hills of Andhra Pradesh, Karnataka, Kerala and Andaman and Nicobar islands.

Ayurvedic: Priyangu (var.)

Siddha/Tamil: Gnaazhal. (Dried flowers of Myristica malabarica Lam. are also used as Priyangu.)

Action: Fruit—cooling (in febrile complaints), antipyretic, astringent, antidiarrhoeal, antidysenteric, anti-inflammatory (seeds used for painful micturition). Fruits are also used for treating obstinate skin diseases and tumours.

Bisamide alkaloids of the leaves exhibit anticancer activity (by inhibiting the growth of vinblastine-resistant KB cells).

... aglaia roxburghiana

Beauv.

Synonym: Triticum repens L.

Family: Gramineae; Poaceae.

Habitat: The western Himalayas and Kashmir at altitudes between 2,700 and 3,600 m.

English: Couch grass, dog grass, wheat grass.

Action: Demulcent (used in cystitis, nephritis), aperient, diuretic and urinary antiseptic, anticholesterolaemic.

Key application: In irrigation therapy for inflammatory diseases of the urinary tract and for the prevention of kidney gravel. (German Commission E, The British Herbal Pharmacopoeia.) It is contraindicated in oedema due to cardiac or renal insufficiency.

The juice of rhizomes is used for cystitis, nephritis, scirrhous liver; decoction for tonsils and as an adjuvant for cancer; also used for gout and rheumatism, and chronic skin disorders.

The rhizome contains triticin, a carbohydrate allied to starch, a fruc- tosan polysaccharide, inositol, manni- tol; volatile oil up to about 0.05%, consisting mainly of agropyrene; vanillin glucoside; mucilage, gum, large quantities of silica; iron, minerals, vitamins, K salt. Agropyrene is reported to have broad antibiotic properties. Extracts show uric acid solvent properties. Agropyrene is antifungal.... agropyron repens

Protection... ague root

See APPENDIX 1: BASIC FIRST AID.... artificial respiration

In a total population, the proportion of disease incidence, or risk of the disease, that can be attributed to exposure to a specific risk factor; the difference between the risk in the total population and the risk in the unexposed group.... attributable risk

When a sharp body is drawn along the sole of the foot, instead of the toes bending down towards the sole as usual, the great toe is turned upwards and the other toes tend to spread apart. After the age of about two years, the presence of this re?ex indicates some severe disturbance in the upper part of the central nervous system. The Babinski re?ex may occur transiently during COMA or after an epileptic ?t and need not indicate permanent damage.... babinski reflex

Linn.

Family: Annonaceae.

Habitat: Native to the West Indies. Cultivated in Bengal, Assam, Khasi Hills and southern India.

English: Bullock's Heart, Common Custard Apple.

Ayurvedic: Raamphala.

Siddha/Tamil: Aninuna.

Folk: Luvuni.

Action: Leaves—insecticide, an- thelmintic, styptic, externally used as suppurant. Unripe and dried fruit—antidysenteric. Bark— powerful astringent, used as antidysenteric and vermifuge.

Rootbark, leaves and stems gave iso- quinoline alkaloids. Two acetogenins, annoreticuin and isoannoreticuin, isolated from the leaves, were found to be selectively cytotoxic to certain human tumours.

The leaves and stems also gave al- kaloids—dopamine, salsolinol and co- claurine.

Annona reticulata, Annona muri- cata, Annona squamosa and Annona cherimola are known as Raampha- la, Lakshman-phala, Sitaa-phala and Hanumaan-phala, respectively.... annona reticulata

willd.

Family: Asparagaceae.

Habitat: Native to Europe and West Asia.

English: Asparagus, Sparrow grass.

Ayurvedic: Shataavari, Vari, Shatviryaa, Shatmuuli, Shatpadi, Bhiru, Naaraayani, Bahusutaa, Atirasaa.

Unani: Haliyun.

Family: Asparagaceae.

Habitat: Found wild in tropical and subtropical parts of India, including the Andamans and ascending in the Himalayas to 1,500 m.

English: Indian asparagus.

Ayurvedic: Shataavari, Shatmuuli, Atirasaa, Bahusutaa, Shatpadi, Shatviryaa, Bhiru, Indivari, Vari. (Substitute for Medaa, Mahaamedaa.)

Unani: Sataavar.

Siddha/Tamil: Thanneervittan kizhangu, Sataavari Kizhangu.

Action: Used as a galactagogue and for disorders of female genitourinary tract; as a styptic and ulcer-healing agent; as an intestinal disinfectant and astringent in diarrhoea; as a nervine tonic, and in sexual debility for spermatogenesis.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of the tuberous root in gout, puerperal diseases, lactic disorders, haematuria, bleeding disorders and also recommends it for hyperacidity.

The plant contains saponins—sha- tavarins I-IV. Shatavarin IV is a glycoside of sarsasapogenin. The saponin in doses of 20-500 mcg/ml produces a special blockade of syntocinon (oxy- tocin)-induced contraction of rat, guinea-pig and rabbit uteri in vitro and in situ. It also blocks the uterine spontaneous motility.

The dried root yields sitosterol; 4,6- dihydroxy-2-O-(2' hydroxyisobutyl) benzaldehyde and undecanyl cetano- ate, and contains a large amount of saccharine matter, mucilage and miner- als—Ca (0.172), Cu (0.033), Na (14.60), K (8.32), Mg (0.169), Mn (0.0074), Ni (0.105) and Zn (0.072) mg/g(dry weight).

The root was found to reduce gastric emptying time comparable to that of metoclopramide. (J Postgrad Med, 1990, 36(2), 91-94).

The root extracts exhibited antiallergic activity in animal studies.

The root, when fed orally, acted as immunomodulator against induced sepsis and peritonitis in rats and mice.... asparagus racemosus

Lindl.

Synonym: A. belladonna auct. non L.

Family: Solanaceae.

Habitat: Kashmir and Himachal Pradesh up to 2,500 m.

English: Indian Belladonna, Indian Atropa.

Ayurvedic: Suuchi.

Unani: Luffaah, Luffaah-Barri, Yabaruj, Shaabiraj.

Action: Highly poisonous; sedative, narcotic, anodyne, nervine, antispasmodic (used in paralysis); parkinsonism; encephalitis; carcinoma; spastic dysmenorrhoea; whooping cough, spasmodic asthma; colic of intestines, gall bladder or kidney, spasm of bladder and ureters; contraindicated in enlarged prostate.

Key application: In spasm and colic-like pain in the areas of the gastrointestinal tract and bile ducts. (German Commission E, The British Herbal Pharmacopoeia.) It is contraindicated in tachycardiac arrhythmias, prostate adenoma, glaucoma, acute oedema of lungs.

A. belladonna L. (European sp. Belladonna, Deadly Nightshade) is cultivated in Kashmir and Himachal Pradesh.

The herb contains tropane (tropine) or solanaceous alkaloids (up to 0.6%), including hyoscamine and atropine; flavonoids; coumarins; volatile bases (nicotine).

Tropane alkaloids inhibit the para- sympathetic nervous system, which controls involuntary bodily activities; reduces saliva, gastric, intestinal and bronchial secretions, and also the activity of urinary tubules. Tropane alkaloids also increase the heart rate and dilate the pupils. These alkaloids are used as an additive to compound formulations for bronchitis, asthma, whooping cough, gastrointestinal hy- permotility, dysmenorrhoea, nocturnal enuresis and fatigue syndrome.

Atropine provides relief in parkin- sonism and neurovegetative dystonia.

The root is the most poisonous, the leaves and flowers less, and the berries the least. (Francis Brinker.)

Dosage: Leaf, root—30-60 mg powder. (CCRAS.)... atropa acuminata royle ex

Rubus species

Description: These plants have prickly stems (canes) that grow upward, arching back toward the ground. They have alternate, usually compound leaves. Their fruits may be red, black, yellow, or orange.

Habitat and Distribution: These plants grow in open, sunny areas at the margin of woods, lakes, streams, and roads throughout temperate regions. There is also an arctic raspberry.

Edible Parts: The fruits and peeled young shoots are edible. Flavor varies greatly.

Other Uses: Use the leaves to make tea. To treat diarrhea, drink a tea made by brewing the dried root bark of the blackberry bush.... blackberry, raspberry, and dewberry

Lamk

Family: Caesalpiniaceae.

Habitat: Sub-Himalayan tracts from Ravi eastwards, ascending to 1,000 m. in the Uttar Pradesh, West Bengal and Central and South India.

Ayurvedic: Ashmantaka, Kanchini.

Unani: Kachnaar.

Folk: Aapataa (Maharashtra), Kachnaala.

Action: Bark—highly astringent, anti-inflammatory (used in glandular inflammations, skin diseases, ulcers), cholagogue. Leaves—anthelmintic; with onion for diarrhoea. Flowers—used in haemorrhages, piles; also in cough. Seed—antibacterial.

Octacosane, beta-amyrin and beta- sitosterol have been isolated from the bark. EtOH (50%) extract of seeds exhibited anticancer activity.... bauhinia racemosa

Roxb.

Synonym: B. semla Wunderlin.

Family: Caesalpiniaceae.

Habitat: Northwestern Himalayas up to 1500 m, also in Orissa, Madhya Pradesh and Andhra Pradesh.

Siddha: Nirpa (Telugu).

Folk: Semalaa, Kathmahuli. Gum— Thaur

Action: Gum—emmenagogue, diuretic. (Gum resembles Gum arabic; used as an external application for sores). Protein isolated from seeds—hypoglycaemic, hypoc- holesterolaemic in young, normal as well as alloxan-induced diabetic albino rats.

The bark contains quercetin-3-O- beta-D-glucoside and rutin.... bauhinia retusa

Red Tea has gained popularity around the world due to its anti-viral, anti-microbial and anti-inflammatory properties. Often made under the name of „red tea” are Rooibos tea and Honeybush tea, because of their fiery shades similar to the color red. The constituents of Red Tea are basically antioxidants such as aspalathin and nothofagin. But red tea is also rich in vitamins and minerals: calcium, copper, iron, magnesium, manganese, potassium, sodium, vitamin C and zinc. It does not contain caffeine and it can be safely taken by people with kidney problems. How To Make Red Tea Brewing Rooibos Tea To brew Rooibos Tea, you will have to heat the water until it just begins to boil. Take it off the heat and pour it over a teaspoon of rooibos leaves or tea bag. Cover it and let the tea steep for about 4-6 minutes. You can either enoy rooibos tea as it is, or you can add honey, sugar or milk. Brewing Honeybush Tea To make Honeybush Tea, start by infusing 2 tablespoons of dried honeybush herbs in a liter of boiled water for about 20 minutes. After that, strain the Honeybush Tea and enjoy! To really maximize its health benefits, try not to add any sweetener or milk. Red Tea Benefits

• Due to its antioxidant content, Red Tea may lower the risk of developing tumors and cancer.
• Helps treat allergies like eczema, fever or asthma.
• Keeps your skin healthy.
• Strengthens your immune system.
• Provides relaxation, calming the nervous system.
• Helps control blood pressure.

Red Tea Side Effects

• Red tea is not recommended for pregnant or breastfeeding women. The herb can harm both infant or fetus.
• Young children should not drink red tea since the herb may have adverse reactions for young patients.
• People who suffer from diabetes should not consume red tea. The herb can drastically lower blood sugar levels.

 Red Tea is an amazing tea with a lot of health benefits. Make sure you read the side effects listed above and experience only its benefits!... benefits of red tea

Colloquial term for Hapalochlaena spp.... blue-ringed octopus

(Dennst.) Alston.

Synonym: B. patens Benth.

Family: Euphorbiaceae.

Habitat: The tropical Himalayas and Deccan peninsula.

Ayurvedic: Bahuprajaa, Kaamboji (doubtful synonym).

Folk: Kaali Kamboi (Gujarat).

Action: Used as a galactagogue (as a supporting drug in herbal compound formulations). Spasmogenic.... breynia retusa

... camellia -riches

A test for the adequacy of blood circulation by pressing on the skin and seeing how long it takes for the colour to return. (See PERFUSION.)... capillary return

A combination of mouth to mouth resuscitation (E.A.R.) to oxygenate the blood, and external chest compression (E.C.C.) to compress the heart to help pump this artificially oxygenated blood around the body to maintain tissue oxygen concentration and prevent death.... cardio-pulmonary resuscitation

(Linn.) Spreng.

Family: Euphorbiaceae.

Habitat: Throughout India up to an altitude of 1,000 m, except in very dry regions.

Ayurvedic: Mahaaviraa, Asana (Asana is equated with Pterocarpus marsupium Roxb., the Indian Kino tree.)

Siddha/Tamil: Mulluvengai.

Folk: Gondani, Gondui, Khaajaa.

Action: Bark—astringent, used in the form of a liniment in rheumatism. Paste of the stem bark is applied to wounds.

The bark contains 16-40% tannin. Presence of a triterpene ketone in the bark is reported. The bark exhibited hypotensive properties in pharmacological trials. The extract of the bark significantly increased the mean survival time of mice infected intracere- brally with vaccinia virus. Ripe fruit pulp contains beta-sitosterol and gallic and ellagic acids.... bridelia retusa

Nowadays, burdock tea is largely consumed all over the world. It is successfully used to improve appetite and digestion, but not only. Burdock Tea description Burdock is a plant from the same family as the sunflower, which can grow up to five feet high. In the summer, the seeds are cropped and the roots are dug up. In traditional Chinese medicine, but not only, it is combined with other herbs to treat upper-respiratory tract infections. Burdock root is known to be a blood purifier, clearing several problems from the body’s systems. Burdock can be taken as infusion, decoction, extract, tincture and ointment. Burdock tea is the resulting beverage from brewing the abovementioned plant. Burdock Tea brewing To prepare Burdock tea:

• Pour boiling water over the desired amount of herbs.
• Cover and let them steep 10 to 20 minutes.
• Strain off the herbs using a tea strainer or coffee filter.

It is essential to use good quality water and it is recommended to drink it slowly. Burdock Tea benefits Burdock tea has been successfully used to:

• soothe the skin and gastrointestinal tract
• improve appetite and digestion
• reduce liver damage
• mildly lower blood sugar (hypoglycemic effect)
• purify the blood
• fight the effects of rheumatism
• treat some kidney disorders
• counter bronchial cough and other irritations of the pulmonary tract

Burdock Tea side effects Burdock tea is not advised to be consumed by pregnant or nursing women. Burdock tea is a medicinal remedy for a large array of diseases. Studies have revealed its efficiency in dealing with liver and kidney ailments, as well as its soothing effects for the skin.... burdock tea: a health remedy

Linn.

Synonym: C. roxburghii Griff.

Family: Palmae; Arecaceae.

Habitat: Central and South India.

English: Rotang, Rattan, Chair Bottom Cane.

Ayurvedic: Vetra, Abhrapushpa.

Siddha/Tamil: Pirambu.

Action: Astringent, antidiarrhoeal, anti-inflammatory (used in chronic fevers, piles, abdominal tumours, strangury), antibilious, spasmolytic. Wood—vermifuge.

The plant is used in convulsions and cramps. The presence of a saponin in the stem, an alkaloid in the leaves and a flavonoid in the root is reported.... calamus rotang

A small box-jellyfish with a single tentacle in each corner. Common in non-tropical areas such as Western Australia and South Australia, the sting is usually mild, but occasionally may cause severe skin pain. Commonly known as the Jimble.... carybdea rastoni

See Cebolla.... cebolla roja

A method for the determination of health insurance premiums that spreads the risk among members of a large community and establishes premiums based on the utilization experience of the whole community. For a set of benefits, the same rate applies to everyone regardless of age, gender, occupation or any other indicator of health risk.... community rating

A review that occurs during the course of patient treatment. Concurrent review enables the medical practitioner or other health care provider to evaluate whether the course of treatment is consistent with expectations for the usual management of a clinical case. The review may also facilitate early identification of negative consequences of treatment (e.g. complications, failure to respond to therapy) that will affect the length of the care episode and outcomes.... concurrent review

The development of a speci?c response by an individual to a speci?c stimulus. The best-known conditioned re?ex is the one described by Ivan Pavlov, in which dogs that became accustomed to being fed when a bell was sounded salivated on hearing the bell, even if no food was given. The conditioned re?ex is an important part of behavioural theory.... conditioned reflex

The use of life-saving measures of mouth-tomouth resuscitation and external cardiac compression massage in a person who has collapsed with CARDIAC ARREST. Speedy restoration of the circulation of oxygenated blood to the brain is essential to prevent damage to brain tissues from oxygen starvation. The brain is irreversibly damaged if it is starved of oxygen for more than 4–5 minutes. Someone whose heart has stopped will be very pale or blue-grey (in particular, round the lips) and unresponsive; he or she will not be breathing and will have no pulse. It is important to determine that the collapsed person has not simply fainted before starting CPR. The procedure is described under car-diac/respiratory arrest in APPENDIX 1: BASIC FIRST AID. In hospital, or when paramedical sta? are attending an emergency, CPR may include the use of a DEFIBRILLATOR to apply a controlled electric shock to the heart via the chest wall.... cardiopulmonary resuscitation (cpr)

(L.) G. Don.

Synonym: Vinca rosea L. Lochnera rosea (L.) Reichub.

Family: Apocynaceae.

Habitat: Commonly grown in Indian gardens.

English: Madagascar Periwinkle (Vinca major L. Pich. and Vinca minor Linn. are known as Greater Periwinkle and Lesser Periwinkle respectively).

Folk: Sadaabahaar, Nayantaaraa, Nityakalyaani.

Action: The cytotoxic dimeric alkaloids, present in Madagascar Periwinkle, Catharanthus roseus L. Don, Vincea rosea L., and used for the treatment of certain type of cancer, have not been found in V. major.

Catharanthus roseus (Madagascar Periwinkle) : cytostatic, anti-neoplas- tic, slows down growth of cells by su- pressing immune response. Vinblas- tine and Vincristine are said to prolong remission of leukaemia to more than five years. These chemotherapeutic agents are toxic to the nervous system. Vinblastine is also used for breast cancer and Hodgkin's disease.

Vinca major L. Pich. (Greater Periwinkle): astringent, anti-haemorrha- gic; used for menorrhagia and leu- corrhoea. Contains indole alkaloids including reserpinine and serpentine; tannins.

Vinca minor Linn. (Lesser Periwinkle): astringent; circulatory stimulant. Leaves—stomachic and bitter. Root— hypotensive. Used for gastric catarrh, chronic dyspepsia, flatulence; also for headache, dizziness, behaviours disorders. A homoeopathic tincture is given for internal haemorrhages.... catharanthus roseus

Cause-of-death ranking for adults is based on the List of 72 Selected Causes of Death, HIV Infection, and Alzheimer’s Disease. The List was adapted from one of the special lists for mortality tabulations recommended for use with the International Classification of Diseases, ninth revision. Two group titles – “Major cardiovascular diseases” and “Symptoms, signs, and ill-defined conditions” – are not ranked based on the list of 72 selected causes. In addition, category titles that begin with the words “other” and “all other” are not ranked. The remaining category titles are ranked according to number of deaths to determine the leading causes of death. When one of the titles that represents a subtotal is ranked (for example, unintentional injuries), its component parts are not ranked (in this case, motor vehicle crashes and all other unintentional injuries).... cause-of-death ranking

(Linn.) Nutt.

Family: Ranunculaceae.

Habitat: Temperate Himalayas from Kashmir to Bhutan up to at 3,000-4,000 m.

English: Black Cohosh Root, Black Snake Root.

Folk: Cohosh, Jiuenti (Punjab).

Action: Sedative, anti-inflammatory, antitussive, diuretic, emmenagogue. Used in homoeopathy for rheumatic diseases of nervous, hysterical women, suffering from uterine affections; also for locomotor ataxia.

Key application: In climacteric (menopausal), neurovegetative ailments, premenstrual discomfort and dysmenorrhoea. (German Commission E, ESCOP.)

The rhizome contains triterpene gly- cosides (including actein, cimigoside, cimifugine and racemoside; isofla- ones (including formononetin; isofer- ulic acid; volatile oil, tannin.

Pharmacological studies have shown that the menthol extract binds to oestrogen receptors in vitro and in rat uteri; this activity is thought to be due to the presence of formononetin. Racemoside exhibited antiulcer activity in mice. Isoferulic acid lowered body temperature in rats.

The rhizome is hypotensive in animals; a central nervous system depressant and antispasmodic in mice; causes peripheral vasodilation in human. Also exhibits anti-inflammatory (The British Herbal Pharmacopoeia) and hy- poglycaemic activity.

Actein has been studied for use in treating peripheral arterial disease. (Expanded Commission E Monographs.)

Clinically, the rhizome and root constituents of Black Cohosh does not seem to affect hormonal levels, such as estradiol, LH, FSH and pro- lactin. (Natural Medicines Comprehensive Database, 2007.)

Cimicifuga foetida L. root is used in bronchial and rheumatic diseases. Aqueous EtOH extract is used in cosmetic preparations for protecting skin; also used for preventing oral diseases and bad breath.

White Cohosh, used for urinogen- ital disorders, is equated with Actea pachypoda, synonym A. alba, A. rubra. Blue Cohosh has been identified as Caulophyllum thalictroides. It is toxic and abortifacient.... cimicifuga racemosa

A community which provides several levels of housing and services for older people, ranging from independent living units to nursing homes, on one site but generally in separate buildings.... continuing care retirement community

Roem. & Schult.

Family: Boraginaceae.

Habitat: Rajasthan, Gujarat, Deccan and Karnataka.

English: Sebestan (smaller var.)

Ayurvedic: Laghu-shleshmaataka, Lisodaa.

Siddha/Tamil: Naruvili.

Folk: Gondi.

Action: See C. myxa.

Bark—astringent; decoction is used as a gargle.... cordia rothii

Initially driven by anxiety about the possibility of medical negligence cases, clinical risk management has evolved into the study of IATROGENIC DISEASE. The ?rst priority of risk managers is to ensure that all therapies in medicine are as safe as possible. Allied to this is a recognition that errors may occur even when error-prevention strategies are in place. Lastly, any accidents that occur are analysed, allowing a broader understanding of their cause. Risk management is generally centred on single adverse events. The threat of litigation is taken as an opportunity to expose unsafe conditions of practice and to put pressure on those with the authority to implement change. These might include senior clinicians, hospital management, the purchasing authorities, and even the Secretary of State for Health. Attention is focused on organisational factors rather than on the individuals involved in a speci?c case.... clinical risk management

Have you ever thought that if you remove the corn silk from corn combs, you can use it as a remedy? While many people may not be familiar with this type of tea, in fact corn silk tea was used for a long time even by Native Americans as a remedy for heart problems, malaria or urinary tract infections. More about Corn silk tea Corn silk is in fact the thin, hair-like strands that cover the corn cob. These silky yellowish strands which form the stigma collect pollen to fertilize the corn, and they’re also used to make a healing tea. In corn silk there can be found many important components like flavonoids, allantoin, mucilage, saponins, vitamins C and K and potassium. Corn silk may also be combined with other herbs to increase its healing powers and range of medicinal uses. It’s also available in prepackaged teabags, or in a dried supplement form. Powdered corn silk is a common ingredient in face powders, due to its soothing qualities. Corn silk tea has a slightly sweet taste. If you decide to collect it in order to make a tea, make sure that the plants were not sprayed with pesticides. Brew corn silk tea In order to make a tasty healthy corn silk tea it is usually recommended to use fresh corn silk. If you don’t have it at your hand, the dried one works just fine. To prepare the infusion, use 2 teaspoons of fresh corn silk or 2.5 g of dried one and pour 1 cup of boiled water over it. Let it seep for 10 - 15 minutes and it is ready to serve. Corn silk tea benefits Corn silk tea has many health benefits for adults and for children. The most important benefit of this tea is for disorders in the urinary system : infections, cystitis, as well as bladder infections or gonorrhea. If you want your children to stop wetting their beds give them corn silk tea. Corn silk tea is also diuretic, demulcent, has anti-inflammatory properties and it fights kidney stones. Corn silk tea may help detoxify and flush out accumulated toxins in the body. Corn silk tea contains vitamin K, which has been shown to improve the body’s blood clotting process. Corn silk tea has also been shown to lower blood pressure, relieve arthritis pains, and help in the treatment of jaundice and prostate disorders. When applied topically, corn silk tea can help heal wounds and skin ulcers. Corn silk tea side effects In most cases, corn silk tea is suitable for daily consumption without special warnings. However, in rare cases, in you are allergic to corn, you may develop a skin rash. Corn silk tea can also decrease the level of potassium in your blood. So you should avoid it if you already have low potassium levels, problems with blood pressure, or diabetes. It is not recommended for children, during pregnancy or breastfeeding. Corn silk tea is safe to be included in your diet, but in order to enjoy its benefits, do not exceed 3 cups a day.... corn silk tea remedy

Instinctive closing of the eyelids when the surface of the cornea (see EYE) is lightly touched with a ?ne hair.... corneal reflex

A cough induced by intestinal, gastric or uterine irritation, and not from respiratory causes.... cough, reflex

In 2002 the UK government set up this new statutory council with the aim of improving consistency of action across the eight existing regulatory bodies for professional sta? involved in the provision of various aspects of health care. These bodies are: General Medical Council; General Dental Council; General Optical Council; Royal Pharmaceutical Society of Great Britain; General Chiropractic Council; General Osteopathic Council; Health Professions Council; and Nursing and Midwifery Council.

The new Council for Healthcare Regulatory Excellence will help to promote the interests of patients and to improve co-operation between the existing regulatory bodies – providing, in e?ect, a quality-control mechanism for their activities. The government and relevant professions will nominate individuals for this overarching council. The new council will not have the authority to intervene in the determination by the eight regulatory bodies of individual ?tness-to-practise cases unless these concern complaints about maladministration.... council for healthcare regulatory excellence

Any of a wide variety of repositories (often computerized) for observations and related information about a group of individuals, a disease, an intervention or other events or characteristics, typically organized for easy search and retrieval.... database (or register)

See DRUG ASSISTED RAPE.... date rape

(Latin) A goddess of Rome... dea roma

An indicator used in population studies to measure the portion of the population which is economically dependent on active age groups. It is calculated as the sum of the 0-14 year-olds and the over 60 or 65 year-olds, depending on the working age limit considered, divided by the number of people aged between 15 and 59 or 64, respectively.... dependency ratio

Roxb.

Family: Convolvulaceae.

Habitat: A parasitic climber common throughout India up to 3,000 m.

English: Doddar.

Ayurvedic: Amarvalli.

Unani: Kasoos.

Action: See C. epithymum.

The seeds contain amarbelin and kaempferol; stem gave cuscutin, cuscu- tatin, beta-sitosterol, luteolin, bergenin and kaempferol. The parasitic plant accumulates alkaloids from the host plant. The climber growing on Mangi- era indica has been found to contain mangiferin.... cuscuta reflexa

Linn.

Family: Cyperaceae.

Habitat: Throughout India, as a weed upto 2,000 m.

English: Nut Grass.

Ayurvedic: Musta, Mustaa, Mus- taka, Abda, Ambuda, Ambhoda, Ambodhara, Bhadra, Bhadraa, Bhadramusta, Bhadramustaa, Bhadramustaka, Ghana, Jalada, Jaldhara, Meghaahvaa, Nirada, Vaarida, Vaarivaaha, Payoda, Balaahaka. Ganda-Duurvaa (var.).

Unani: Naagarmothaa, Saad-e-Kufi.

Siddha/Tamil: Koraikkizhangu.

Folk: Mothaa.

Action: Carminative, astringent, anti-inflammatory, antirheumat- ic, hepatoprotective, diuretic, antipyretic, analgesic, hypoten- sive, emmenagogue and nervine tonic.

Used for intestinal problems, indigestion, sprue, diarrhoea, dysentery, vomiting and fever; also as a hypoc- holesterolaemic drug and in obesity.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicated the use of the rhizome in rheumatism, inflammations, dysuria, puerperal diseases and obesity.

The tuber is rich in Cu, Fe, Mg and Ni. Beta-sitosterol, isolated from the tubers, exhibits significant anti- inflammatory activity against carra- geenan- and cotton pellet-induced oedema in rats; the activity is comparable to hydrocortisone and phenylbutazone when administered intraperi- toneally.

The alcoholic and aqueous extracts of the tubers possess lipolytic action and reduce obesity by releasing enhanced concentrations of biogenic amines from nerve terminals of the brain which suppress the appetite centre. Presence of eudalne group of ses- quiterpenic compounds of sesquiter- pene alcohol, isocyperol is said to play an important role in lipid metabolism.

An alcoholic extract of the plant exhibits liver-protective activity against CCL4-induced liver damage in mice.

Methanolic extract of the plant stimulates the production of melanin in cultured melanocytes. (Plant extract is used in preparations used for pigmentation of skin and hair, also in suntan gels.) Aqueous-alcoholic extract of the tuber exhibited hypotensive, diuretic, antipyretic and analgesic activities. These are attributed to a triterpenoid.

The essential oil (0.5-0.9%) from the tubers contains mainly sesquiterpenes.

C. platystilis Br. is equated with Kaivarta-mustaka.

Dosage: Rhizome—3-6 g powder; 20-30 ml decoction. (API Vol. III.)... cyperus rotundus

Rafin.

Synonym: Poinciana regai Bojer ex Hook.

Family: Caesalpiniaceae.

Habitat: Native to Madagascar; grown in gardens and avenues for ornamental purposes and for shade.

English: Flamboyant Flame tree, Gold Mohur.

Ayurvedic: Gulmohar (var.) White Gold Mohur is equated with Delonix elata Gamble, synonym Poinciana elata Linn.

Siddha: Vadanarayana, Pe- rungondrai, Mayarum. White Gulmohar. (Tamil)

Action: Bark—antiperiodic, febrifuge. Plant—antirheumatic, spasmogenic. Flowers (aqueous and alcoholic extract)—active against roundworm.

White Gulmohar trunk-bark yielded asparagine and aspartic acid. Flowers gave iso-quercetin.

Delonix regia bark gave leucocyani- din; bark and leaves contain tannin, lu- peol and beta-sitosterol, and free OH- proline as major amino acid. Flower anthers are a rich source of zeaxanthin.... delonix regia

A system used for payment under prospective payment systems. It classifies treatments by diagnosis, measuring the relative complexity of a hospital procedure and accounting for the resources used in the procedure. The system accounts for principal diagnosis, secondary diagnosis, surgical procedures, age, sex and presence of complications.... diagnosis-related group

1 Represents classes of hospital patients with similar clinical characteristics. DRGs form a clinical grouping system which describes hospital discharges according to medical condition. 2 A system used for payment under prospective payment systems. It classifies treatments by diagnosis, measuring the relative complexity of a hospital procedure and accounting for the resources used in the procedure. The system accounts for principal diagnosis, secondary diagnosis, surgical procedures, age, sex and presence of complications.... diagnosis-related group (drg)

An advance directive based on the premise that a person may prefer to die than live when the quality of life available after cardiopulmonary resuscitation (CPR) is likely to be worse than before. In such circumstances, a patient has the right not to be resuscitated and to be allowed to die.... do not resuscitate order

DC.

Family: Compositae; Asteraceae.

Habitat: The Western Himalayas from Kashmir to Garhwal.

Unani: Daarunaj Aqrabi Hindi.

Action: The root is reported to prevent giddiness caused during high attitude ascents.

The root yields a gum-resin, used in gargle water as stimulant, astringent and in toothpaste. Root—used in rheumatism. Leaves—carminative.... doronicum roylei

If you want to try a special type of herbal tea, there’s Oregon grape root tea! It has a slightly bitter taste, but that shouldn’t discourage you. It also has plenty of health benefits which are bound to keep you healthy. Read to find out more about Oregon grape root tea! About Oregon Grape Root Tea Oregon grape root tea is made from the root of the Oregon grape. The plant is an evergreen shrub which grows along the North American west coast. The plant can grow up to 5m tall. The leaves are similar to those of holly, and the stems and twigs are thick and corky. The flowers are yellow-colored and bloom in late spring. The fruits are small, purplish-black, with a dusty appearance, and they contain large seeds. The Oregon grape is in no way related to normal grapes. The name of the tree comes from the similarity of its berries to the grapes’ berries. Constituents of Oregon Grape Root Tea It is not surprising that the root is used to make Oregon grape root tea. The root is actually the part of the tea which contains the most active constituents. A cup of Oregon grape root tea contains many alkaloids (berberine) and phytochemicals, as well as tannins. How to prepare Oregon Grape Root Tea It isn’t difficult to make a cup of Oregon grape root tea. Place one teaspoon of dried root in a cup filled with boiling water. Let it steep for about 10-15 minutes. Once the steeping time ends, remove the dried herbs from the cup. If Oregon grape root tea is too bitter for your taste, you can add honey or sugar to sweeten it. Oregon Grape Root Tea Benefits Thanks to its important constituents, Oregon grape root tea brings you many health benefits. First of all, Oregon grape root tea is used in the treatment for dyspepsia (indigestion) and diarrhea, and it helps you fight intestinal parasites. It also increases the speed to the flow of bile, which makes it useful in the treatment for gallbladder pain, gallstones, hepatitis, and jaundice. The alkaloids found in Oregon grape root tea help treat typhoid, tuberculosis in its early stage, and various digestive disorders. It can even help with small problems, such as stomach cramps and abdominal pains. It also works as a potential anti-carcinogenic, speeding up the recovery from chemotherapy and radiation therapies. Oregon grape root teacan work as a lymphatic and liver stimulating blood cleanser. It is good for your liver as it helps release stacked away iron from the liver into the blood stream. It might also help you fight tumors in the bladder and colon. Oregon grape root tea can help you even when it’s applied topically. It is useful when treating psoriasis, eczema, athlete’s foot, acne, and other fungal infections. It also helps in easing inflammation, irritation, and itching of the skin. Oregon Grape Root Tea Side Effects First, it’s not recommended that you drink Oregon grape root tea if you are pregnant. If you do, it might cause uterine contractions. It is also best that you not consume Oregon grape root tea if you’ve gotchronic gastrointestinal irritation or inflammation. It will only worsen the symptoms. Be careful with how much Oregon grape root tea you drink. Don’t have more than six cups of tea a day, and don’t drink for more than 7 consecutive days. If you drink too much Oregon grape root tea, you’ll get the following symptoms: headaches, loss of appetite, vomiting, diarrhea, insomnia, dizziness, and irregular heartbeats. Even if it has a slightly bitter taste, Oregon grape root tea shouldn’t be forgotten. Its many health benefits can help you, if needed.... discover oregon grape root tea

These are swellings on the dorsal roots of spinal nerves just proximal to the union of the dorsal and ventral nerve roots. They are situated in the inter-vertebral foramina and contain the cell bodies of sensory neurones. (See SPINAL COLUMN; SPINAL CORD.)... dorsal root ganglia

Also known as ‘date rape’, this is an unwelcome phenomenon in which an intending rapist undermines a potential victim’s resistance by giving her a hypnotic drug such as benzodiazepine. The British National Formulary warns that ?unitrazepam (Rohypnol®) tablets may be particularly subject to abuse – perhaps given to the unsuspecting victim in an alcoholic drink so the sedative e?ect is greatly enhanced.... drug assisted rape

A formal programme for assessing drug prescription and use patterns. DURs typically examine patterns of drug misuse, monitor current therapies, and intervene when prescription or utilization patterns fall outside pre-established standards. DUR is usually retrospective, but can also be performed before drugs are dispensed.... drug utilization review (dur)

When a woman is treated for infertility it is necessary to nurture human embryos for a few days (until the ?rst cell divisions of the fertilised egg have occurred) in a specialised laboratory. More eggs are fertilised than are usually needed because not all fertilisations are successful. Surplus embryos may be frozen for use in later attempts to implant an embryo in the womb. Research has been done on very early embryos but the practice is controversial and some countries have either forbidden it or imposed tight restrictions. In the UK such research is controlled by the government Human Fertilisation & Embryology Authority (see ASSISTED CONCEPTION).... embryo research

This is a procedure in which a catheter (see CATHETERS) is passed via an ENDOSCOPE into the AMPULLA OF VATER of the common BILE DUCT. The duct is then injected with a radio-opaque material to show up the ducts radiologically. The technique is used to diagnose pancreatic disease as well as obstructive jaundice.... endoscopic retrograde cholangiopancreatography (ercp)

The collection of extensive narrative data on many variables over an extended period of time in a naturalistic setting in order to gain insights not possible using other types of research. For this type of research, observations are undertaken at particular points of time. Data would include observations, recordings and interpretations of what is seen.... ethnographic research

Rhodiola tea is a delicious, mellow herbal tea. With its plant growing in cold, mountainous regions, this tea has various important health benefits. Find out more about rhodiola tea! About Rhodiola Tea Rhodiola tea is made from the rhodiola rosea plant. It grows in cold, mountainous areas, such as the Arctic, the mountains of Central Asia, the Rocky Mountains, and European mountains (Alps, Pyrenees, Carpathian Mountains). It is also known by the names golden root, rose root, Aaron’s rod, arctic root, king’s crown, lignum rhodium, and orpin rose. Rhodiola is a perennial plant with spikes of green leaves. The shoots can grow up to 35cm, and each bear a single yellow flower, which blooms during the Arctic summer. How to prepare Rhodiola Tea It takes awhile to prepare rhodiola tea, but it should be worth it. To enjoy a cup, you have to follow a few steps. For one cup, you need about 5 g of rhodiola root. Put that into a cup of freshly boiled water and let it brew for about 4 hours. Once the time is up, filter the liquid and your tea. Add honey or fruit juice if you want to sweeten the flavor. Rhodiola Tea Constituents Rhodiola rosea has lots of active constituents. Some of the important ones include rosavin, rosin, rosarin, rhodioloside, tyrosol, and salidroside. In its composition, we can also find phenolic antioxidants: proanthocyanidins, quercetin, gallic acid, chlorogenic acid, kaempferol. As rhodiola tea is made from the rhodiola rosea plant, these constituents are transferred to the tea, as well. Rhodiola Tea Benefits The most important health benefits of rhodiola tea are related to your mental state. It helps if you’re feeling depressed; it improves your mood and fills you with energy. It also reduces fatigue and stress, and it’s bound to make you feel more relaxed. Generally, it helps enhance your mental functions, including your memory. By reducing stress levels, rhodiola tea also reduces the amount of stress hormones which can cause heart problems. Rhodiola tea regulates your heartbeats and fights against heart arrhythmias. Men can drink rhodiola tea if they’ve got erectile dysfunction; this tea is often included in the treatment. It’s useful for women too, as it helps lose weight and can therefore be drunk when on a diet. At the same time, it can also help with anaemia. You should drink rhodiola tea to help you with muscle recovery after exhaustive exercising. This tea increases the level of enzymes, RNA, and proteins needed.Rhodiola tea can help if you’ve got a cold or the flu. Interestingly, it will also help you if you’ve got altitude sickness. Rhodiola Tea Side Effects Even if rhodiola tea has so many health benefits, there are a few side effects you should be careful with, too. It is best not to be consumed by pregnant women, or those who are breastfeeding. In both cases, rhodiola tea can affect the baby. Even if rhodiola tea is used to treat depression, it is not good when it comes to bipolar disorder. Make sure you talk with your doctor first if you’re not sure whether you should drink rhodiola tea or not. Also, as rhodiola tea is used to enhance your energy, you should not drink it in the evening or even worse, before going to bed. It might lead to insomnia. Rhodiola tea should be on your list of ‘teas to drink’. You don’t have to worry when on a diet, as it will also help you lose weight. Just make sure you won’t get any side effects and you’re safe to drink it!... drink more rhodiola tea!

(Wall.) Hurusawa.

Synonym: Putranjiva roxburghii Wall.

Family: Euphorbiaceae.

Habitat: Wild and cultivated throughout tropical India.

Ayurvedic: Putrajivaka, Sutajva, Putrakamanjari.

Siddha/Tamil: Karupali, Irukolli.

Action: Leaves, fruits and stones of fruits are given in colds and fevers, also in rheumatic affections. Rosaries, made ofhard stones of the fruit, are placed around the necks of children to protect them from diseases.

The seed kernel yield 0.5% of a sharp- smelling essential oil of the mustard oil type. The oil contains isopropyl and 2-butyl isothiocyanates as the main constituents and 2-methyl-butyl isoth- iocyanate as minor component. Anad- ditional glucoside, glucocleomin, has been found in the seed kernels. A glu- cosidic pattern similar to that in the seeds is reported in the shoots and roots. The fruit pulp contains a large proportion of mannitol and small quantities of a saponin glucoside and alkaloid.

The alkaloid is also present in a small quantity in the stones of the fruit.

Dosage: Seed, leaf, bark—3-6 g powder. (CCRAS.)... drypetes roxburghii

A method of adjusting health plan premiums based on historical utilization data.... experience rating

The use of expired (used) air blown from a rescuer into the airway and lungs of an unconscious victim who is not breathing, sufficient to sustain his life.... expired air resuscitation

Assessment of victims of major trauma must include maintenance of their airways and breathing. Any false teeth, vomitus and foreign bodies should be removed, and the response to digital stimulation of the posterior pharyngeal wall – the ‘gag re?ex’ – assessed. Even with a normal gag re?ex, the airway may be seriously threatened if vomiting occurs. During the initial stages of resuscitation, careful and constant supervision of the airway is essential, with a high-volume sucker immediately available. If the gag re?ex is absent or impaired, an endotracheal tube should be inserted (see ENDOTRACHEAL INTUBATION).... gag reflex

Burm. f.

Family: Myrsinaceae.

Habitat: Throughout India.

English: Embelia.

Ayurvedic: Vidanga, Krmighna, Krmihara, Krmiripu, Chitratandula, Jantughna, Jantunaashana, Vella, Amogha.

Unani: Baobarang, Barang Kaabuli.

Siddha/Tamil: Vaayuvidangam.

Action: Ascaricidal, anthelmintic, carminative, diuretic, astringent, anti-inflammatory, antibacterial, febrifuge. Used in diseases of chest and skin. Active principles are found to be oestrogenic and weakly progestogenic. Root—bechic, antidiarrhoeal. Seed—spermicidal, oxytocic, diuretic. The plant is also used for its blood purifying properties. It is an ingredient in cough syrups, preparations for anaemia, genitourinary tract infections, diarrhoea and diseases of the liver.

Embelin, isolated from the berries, shows significant anti-implantation and post-coital antifertility activity. (Successful trials have been carried out at the National Institute of Immunology, New Delhi on human beings.) It is found to be a potential male antifer- tility agent. Spermatogenesis has been impaired and sperm count reduced to the level of infertility. The antisper- matogenic changes are found to be reversible without any toxic effects.

Aqueous and EtOH extract of the fruit—anthelmintic against earthworms. Fruit powder (200 mg/kg), taken with curd on empty stomach, expelled tapeworm within 6-24 h. The treatment was also found effective in giardiasis. EtOH (50%) of the plant was found slightly active against E.coli. Di-salts of embelin—an- thelmintic. Amino salts exhibited less side effects than embelin. The effect of di-isobutyl amino derivatives lasted up to 10 h, also showed anti-inflammatory, hypotensive and antipyretic activities.

Berries gave quinones—embelin, ra- panone, homoembelin, homorapnone and vilangin.

Dosage: Fruit—5-10 g powder. (API Vol. I.)... embelia ribes

C. B. Clarke, non-Roxb.

Synonym: E. tsjeriam-cottam A. DC.

Family: Myrsinaceae.

Habitat: Throughout greater part of India.

Ayurvedic: Vidanga (allied species) Substitute for Embelia ribes.

Folk: Baayabirang.

Action: Fruit—antispasmodic, carminative, anthelmintic, antibacterial. Powdered fruit—used in dysentery. Plant—used in weak pulse rate.

EtOH (50%) extract of aerial parts exhibit slightly hypotensive activity. Stem contains embelin. See Embelia ribes.... embelia robusta

G. Don.

Synonym: Centaurium roxburghii (G. Don) Druce.

Family: Gentianaceae.

Habitat: Sub-tropical and temperate regions.

Ayurvedic: Kiraat-tikta (related species), Yavatiktaa (related species) (A substitute for Swertia chirayita.)

Folk: Khet-chiraayataa.

Key application: Erythraea centaurium—in loss of appetite and peptic discomfort. (German Commission E.)... erythraea roxburghii

Berg.

Family: Euphorbiaceae.

Habitat: Native to Morocco.

English: Euphorbium.

Unani: Farfiyuun, Afarbiyuun.

Action: A drastic purgative, irritant, vesicant and toxic, proinflammatory. Internal use of the drug has been abandoned.

Dried latex gave diterpene esters; derivatives of 12-deoxyphorbol, which are pro-inflammatory, tumour promoting and cause platelet aggregation; exhibit co-carcinogenic activity.... euphorbia resinifera

The involuntary regurgitation of stomach contents or surface acids into the throat, with heartburn; it can be simple or serious.... gastroesophageal reflux

(Hebrew) Refers to the pomegranate press... gath-rimmon

(Linn.) I. M. Johnson.

Synonym: G. reniformis D. Don.

Family: Rubiaceae.

Habitat: Assam, Western Ghats and Andaman Islands.

Folk: Karintakaali (Kerala).

Action: Properties are similar (though inferior) to those of Ipeac (Cephaelis ipecacuanha A. Rich.).... geophila repens

Healing, Health ... goats rue

These are drugs that block the action of HISTAMINE at the H2 receptor (which mediates the gastric and some of the cardiovascular effects of histamine). By reducing the production of acid by the stomach, these drugs – chie?y cimetidine, ranitidine, famotidine and nizatidine – are valuable in the treatment of peptic ulcers (healing when used in high dose; preventing relapse when used as maintenance therapy in reduced dose), re?ux oesophagitis (see OESOPHAGUS, DISEASES OF), and the ZOLLINGERELLISON SYNDROME. These drugs are now being supplanted by PROTON-PUMP INHIBITORS and HELICOBACTER PYLORI eradication therapy. (See also DUODENAL ULCER.)... h2 receptor antagonists

See DEPILATION.... hair, removal of

If you haven’t tried reishi tea until now, you should get some. Made from a “cure-all” herb, reishi tea has plenty of health benefits and helps you stay healthy with every gulp. About Reishi Tea Reishi tea is made form reishi, which is considered the best and most superior of all Chinese herbs. Reishi is a polypore mushroom which can be found growing in dark forests, on deciduous trees and logs. It is soft, corky, and flat, and has a conspicuous red-varnished cap, kidney-shaped, and with pores underneath it. It is classified based on its color and shape, and each variety protects and nourishes a different body organ. The classification is the following: white (lungs and skin), purple (joints), red (heart), green (liver), black (brain and kidney), and yellow (spleen). How to prepare Reishi Tea For a cup of reishi tea, you need about 5 grams of dried reishi mushroom herbs. Add them to the necessary amount of water for one cup and boil for about 10 minutes. Then, let the mixture steep for 2-3 hours, before you strain it to remove the herbs. If you don’t like the taste too much or you think it’s too bitter, you can add honey or fruit juice to sweeten it. Reishi Tea Constituents Reishi tea gets many of its health benefits thanks to the active constituents found in the reishi mushroom - the tea’s main ingredient. Some of them include triterpenes (ganoderic acids), polysaccharides, alkaloids, lactones, mannitol and coumarin. Also, reishi tea has various vitamins, proteins, and minerals. Reishi Tea Benefits Reishi tea is an important element in the fight against cancer. It helps by enhancing the human ability to fight abnormal cells and, consequently, it can improve the synthesis of proteins and nucleic acid. It also protects the cells against further damage, and it helps alleviate the pain and discomfort caused by chemotherapy. Drinking reishi tea will keep the heart diseases away, as it lowers bad cholesterol levels and blood pressure. It helps strengthen the immune system, and it will also slow down the aging process by nurturing the cells in your body. Not only is reishi tea good for your immune system, but it also helps your nervous system. This tea is bound to help you relax, by soothing the mind and sedating the nerves. It will also help you sleep properly during the night. You can drink reishi tea if you’ve got problems with coughing or asthma. It protects your liver, therefore it is recommended to persons who suffer from acute and chronic hepatitis. Besides this, it also helps with diabetes, skin allergy, and duodenal ulcers. Reishi Tea Side Effects You might have an allergic reaction to reishi tea. If you end up with an upset stomach, or you feel your mouth, nose and/or throat dry, you might have an allergic reaction. Stop drinking reishi tea and contact your doctor, just in case. Other side effects you might get when drinking reishi tea include dizziness, nosebleeds, sore bones, gastrointestinal distress, or irritated skin. It is best not to drink reishi tea if you’re taking blood thinning medication (aspirin, warfarin). The tea might intensify the effects of the medicine. It is also considered that this tea may interfere with immunosuppressive drugs or even organ transplants.   According to the Chinese, the reishi mushroom is a plant which can bring “the dying back to life”. Reishi tea has quite similar properties too, as it comes with many health benefits. This should encourage you to drink reishi tea every day!... enjoy a cup of reishi tea!

Boiss.

Family: Euphorbiaceae.

Habitat: Western Himalaya from Kumaon to Nepal.

Ayurvedic: Snuhi, Snuk, Sehunda, Gudaa (Substitutes.) (Adhogudaa of Ayurvedic medicine and Bana- muuli of folk medicine have been equated with Euphorbia acaulis Rox.)

Unani: Thuuhar

Folk: Thor, Surai.

Action: Latex—cathartic, anthelmintic.

The latex yield euphol, cycloeu- calenol, an inseparable mixture of four tetra-and four tri-esters of macrocyclic diterpene ingenol, octacosanol, tetra- cosanol, beta-sitosterol, stigmasterol, alpha-amyrin and campesterol. The plant gave ingenol.

The latex is a valuable source of in- genol esters. Ingol is a macrocyclic diterpene and is of therapeutic interest due to its antileukemic properties. Fractionation of the latex gave ingol- 12-acetate and 8-tigloyl-12-acetate. The acylation of ingol-12-acetate yielded derivatives which inhibit the growth of the basophilic leukaemia cells in rats.... euphorbia royleana

All the means available for the operation of the health system, including manpower, buildings, equipment, supplies, funds, knowledge and technology.... health resources

The process of gathering, analysing and comparing an individual’s prognostic health characteristics with a standard age group, thereby predicting the likelihood that a person may develop a health problem.... health risk appraisal

A chemical, psychological, physiological, social, environmental or genetic factor or conditions that predisposes an individual to the development of a disease or injury.... health risk factor

The multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviours affect access to health care, the quality and cost of health care, and ultimately health and well-being. Its research domains are individuals, families, organizations, institutions, communities and populations.... health services research

Research dealing with the entire health system or only part of it, the object being to ensure that the system is optimally planned and organized and that programmes are carried out by the health system infrastructure efficiently and effectively and with appropriate technology.... health systems research

Individual outcome measure that extends beyond traditional measures of mortality and morbidity to include such dimensions as physiology, function, social activity, cognition, emotion, sleep and rest, energy and vitality, health perception and general life satisfaction (some of these are also known as health status, functional status or quality-of-life measures).... health-related quality-of-life (hrql) measure

It you want to drink a special type of herbal tea, try the rose petal tea. It is aromatic, with a pleasant taste, and you’re bound to enjoy it. It also has important health benefits. Find out more about rose petal tea! About Rose Petal Tea Rose petal tea is made from the petals of a flower most adored by many women: the rose. This woody perennial plant has over 100 species which grow in Asia, Europe, North America, and northwest Africa. Roses grow as a group of erect shrubs, acting like climbing plants. Its stems often have small, sharp thorns. The leaves are oval-shaped with sharply-toothed edges, and they’re about 10cm long. The fruit is called rosehip; it is ripe from late summer to autumn, and it is edible. The flowers usually have 5 petals with two distinct lobes; they are usually pink, white, red, or yellow. You can make tea both from the rose petals and from the rose’s fruit, the rosehip. How to prepare Rose Petal Tea When making rose petal tea, first make sure that the petals you use are free of pesticides. Roses from gardens and flower shops are usually treated with pesticides, and shouldn’t be used to make rose petal tea. To enjoy rose petal tea, add about two handfuls of properly washed and dry rose petals to a pot with water for three cups of tea. Leave the pot over medium heat for 5 minutes, or until the petals have lost their original color, becoming darker. Stream to remove the petals and sweeten, if necessary, with honey or fruit juice. Rose Petal Tea Components Rose petal tea gets many active components from the rose petals: cyclic monoterpene alcohols, geraniol, citronellol and nerol are just a few important ones. It also includes long-chain hydrocarbons (nonadecane, heneicosane). These active components lead to the many health benefits rose petal tea has. Rose Petal Tea Benefits Rose petal tea helps strengthen your immunity, and can be part of the treatment for colds. It is useful if you’ve got a fever, a runny nose, a sore throat, or bronchial congestion. Also, it helps clean your body of toxins. Drinking rose petal tea can help during menstrual periods, if you’ve got a heavy menstrual flow. It can also reduce menstrual cramps, and helps regulate your period. Rose petal tea is often used to treat diarrhea and dysentery. It can also help you fight against depression, fatigue and insomnia. Rose petal tea also acts as a digestive aid, as it protects the gastrointestinal tract. It is often used to treat constipation, gastroenteritis, diarrhea, and dysentery; the tea also nourishes the gastric mucosa. You can drink rose petal tea to treat urinary tract infections, as well. Rose Petal Tea Side Effects No important side effects of rose petal tea have been noted. Still, it is considered best not to drink more than 5 cups of tea a day. If you drink too much, you might get some of these symptoms: headaches, loss of appetite, vomiting, diarrhea, insomnia, dizziness, and irregular heartbeats. Spoil yourself with a delicious cup of rose petal tea! Not only will you enjoy its taste, but its health benefits, as well.... enjoy a cup of rose petal tea

Linn.

Synonym: F. glomerata Roxb.

Family: Moraceae.

Habitat: Throughout India. Grows wild in forests and hills. Often found around subterranean water streams.

English: Cluster Fig, Country Fig.

Ayurvedic: Udumbara, Sadaaphala, Hema-daudhaka, Jantuphala, Yagyaanga.

Unani: Anjir-e-Aadam, Anjir-e- Ahmak, Gular.

Siddha/Tamil: Atthi.

Action: Astringent and antiseptic; used in threatened abortions, menorrhagia, leucorrhoea, urinary disorders, skin diseases, swellings, boils, haemorrhages. Unripe fruits—astringent, carminative, digestive, stomachic; used in diarrhoea, dyspepsia, dysentery, menorrhagia and haemorrhages. Ripe fruits—antiemetic, also

used in haemoptysis. Root and fruit—hypoglycaemic. Bark— decoction is used in skin diseases, inflammations, boils and ulcers.

The Ayurvedic Pharmacopoeia of India recommends the use of the bark in lipid disorders and obesity.

Leaves and fruit contain gluacol. The fruit also contains beta-sitosterol, lupeol acetate, friedelin, higher hydrocarbons and other phytosterols.

Petroleum ether extract of the stem bark significantly reduced blood sugar level of rats with streptozotocin- induced diabetes. It completely inhibited glucose-6-phosphate dehydrogenase from rat liver. Extracts of fruit and latex did not show any significant effect on blood sugar level of diabetic rats, they inhibited only glucose-6- phosphate but not arginase from rat liver.

An alcoholic extract of the bark has been found to be very effective in reducing blood sugar in alloxan-induced diabetic albino rats. It helped in improving the damaged beta cells of islets of Langerhans, thus exerting permanent blood sugar lowering effect.

The ethanolic extract of seeds also showed hypoglycaemic activity.

Lignin, the main fiber constituent of the fruit, prevented the rise in serum cholesterol levels of some extent. Fresh whole fruits, used as a source of dietary fibre, exhibited more hypoc- holesterolemic activity than pure cellulose.

Dosage: Bark—20-30 g for decoction. (API Vol. I.)... ficus racemosa

See under MENOPAUSE.... hormone replacement therapy(hrt)

Array of hosts susceptible to infection with an agent.... host range

The study of the interrelationships between humans, the tools they use, and the environment in which they live and work.... human-factor research

The reporting and tracking of adverse incidents by care providers.... incidence monitoring and reporting

Linn.

Family: Moraceae.

Habitat: Sub-Himalayan tracts, West Bengal, Central and South India; planted throughout India as an avenue tree.

English: Peepal, Bot-tree.

Ayurvedic: Ashvattha, Bodhidru, Bodhivrkisha, Sebya, Chalapa- tra, Gajabhaksha, Kshiradruma, Peeppal.

Unani: Peepal.

Siddha/Tamil: Arasu, Ashvatham.

Action: Bark—astringent, antiseptic, alterative, laxative, haemostatic, vaginal disinfectant (used in diabetes, diarrhoea, leucorrhoea, menorrhagia, nervous disorders; also in skin diseases.) Applied externally on unhealthy ulcers and wounds. Leaves and twigs— laxative.

The bark contains beta-sitosteryl-D- glucoside. Vitamin K, n-octacosanol, methyl oleanolate, lanosterol, stigmas- terol, lupen-3-one are reported from the stem bark.

A hypoglycaemic response is reported for beta-sitosterol-D-glucoside obtained from the bark.

Aerial roots are given to women, also used in prescriptions, for inducing conception. The dried fruits are used as a uterine tonic.

The fruits contain 4.9% protein having the essential amino acids, isoleu- cine and phenylalanine. The chloroform extract of fruits exhibited anti- tumour and antibacterial activities in bioassays.

Various plant parts are included in formulations used for menorrha- gia, metrorrhagia, blood dysentery, bleeding piles, haematuria and haemorrhages.

Dosage: Bark, fruit—50-100 ml decoction. (CCRAS.)... ficus religiosa

Hook.

Family: Liliaceae.

Habitat: Western temperate Himalaya from Kashmir to Kumaon at 2,700-4,35 m.

Ayurvedic: Kshira-Kaakoli, Viraa, Kaayasthikaa, Vaaysoli.

Action: Used in the treatment of asthma, bronchitis and tuberculosis. (Withania somnifera is a substitute for Kaakoli and Kshira-Kaakoli.)

The bulbs gave alkaloids—peimine, peimisine, peimiphine, perminine, permidine and permitidine. The bulbs also gave neutral compounds—prope- imin and a sterol. The plant gave kash- mirine.

Dosage: Bulb—3-6 g powder. (CCRAS.)... fritillaria roylei

Roth.

Synonym: G. lucida Roxb.

Family: Rubiaceae.

Habitat: Central India and Deccan Peninsula.

Ayurvedic: Naadihingu (related species), Jantuka.

Unani: Dikaamaali.

Siddha/Tamil: Kambil, Kumbai, Dikkamalli.

Action: Gum—antimicrobial, anthelmintic; used in skin diseases. Gum gave flavonoids—gardenins, wagonin derivatives, de-Me- tangeretin, nevadensin, hexacosyl- p-coumarate. See G. gummifera.... gardenia resinifera

A disorder in which the contents of the STOMACH back up into the OESOPHAGUS because the usual neuromuscular mechanisms for preventing this are intermittently or permanently failing to work properly. If persistent, the failure may cause oesophagitis (see OESOPHAGUS, DISEASES OF). If a person develops HEARTBURN, regurgitation, discomfort and oesophagitis, the condition is called gastro-oesophageal re?ux disease (GORD) and sometimes symptoms are so serious as to warrant surgery. Gastrooesophageal re?ux is sometimes associated with HIATUS HERNIA.

Gastro-oesophageal disease should be diagnosed in those patients who are at risk of physical complications from the re?ux. Diagnosis is usually based on the symptoms present or by monitoring the production of acid using a pH probe inserted into the oesophagus through the mouth, since lesions are not usually visible on ENDOSCOPY. Severe heartburn, caused by the lining of the oesophagus being damaged by acid and PEPSIN from the stomach, is commonly confused with DYSPEPSIA. Treatment should start with graded doses of one of the PROTON PUMP INHIBITORS; if this is not e?ective after several months, surgery to remedy the re?ux may be required, but the effects are not easily predictable.... gastro-oesophageal reflux

A designated site or contact for locating needed services or care for older adults.... information and referral service

The groin – that area of the body where the lower part of the abdomen meets the upper thigh. The inguinal ligaments extend on each side from the superior spines of the iliac bones to the pubic bone. It is also called Poupart’s ligament (see diagram of ABDOMEN).... inguinal region

The ability of a mosquito or other insect to survive contact with an insecticide in quantities that would normally kill a mosquito of the same species.... insecticide resistance

Links between generations which often involve exchanges of support.... intergenerational relations / contract

A list of diagnoses and identifying codes used by medical practitioners and other health care providers. The coding and terminology provide a uniform language that permits consistent communication on claim forms. Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classification of causes of death in successive revisions of the ICD may introduce discontinuities in cause of death statistics over time.... international statistical classification of diseases and related health problems, tenth revision (icd-10)

Linn.

Family: Geraniaceae.

Habitat: Western Himalayas from Kashmir to Garhwal at 2,0002,700 m.

English: Herb-Robert Geranium.

Action: Haemostatic, astringent, antidiarrhoeic, styptic, antidiabetic.

The herb has a disagreeable odour and a bitter, saline and astringent taste. Applied externally as a resolvent to tumours.

In Western herbal, the herb is used for diarrhoea, to improve functioning of liver and gallbladder and to prevent the formation of calculi.

The herb contains several flavonoids including rutin. A ethanolic extract can inhibit the growth of E. coli, P. aeruginosa and S. aureus.... geranium robertianum

The central portion of a distribution, calculated as the difference between the third quartile and the first quartile; this range includes about one half of the observations in the set, leaving one quarter of the observations on each side.... interquartile range

Synthetic organic substances, capable of exchanging ions – cationic or anionic – from the contents of the intestine. Originally used in the prevention of OEDEMA, they have been superseded in this role by the modern DIURETICS, and are now used chie?y in the treatment of HYPERKALAEMIA. They are usually taken by mouth or as an ENEMA.... ion exchange resins

An autoimmune (rheumatoid factor) inflammation of the iris. This is a face of rheumatoid arthritis seldom diagnosed, along with rheumatoid otitis. Although antiinflammatory drugs may be necessary, I would recommend starting off with simple things like Arctium, Rumex crispus and Taraxacum, along with alkalizing teas such as Nettles, Red Clover and Alfalfa (oops...I mean Urtica, Trifolium and Medicago). If they don’t help enough you can STILL take the drugs.... iritis, rheumatoid

Wall. ex DC.

Family: Oleaceae.

Habitat: Western Peninsula, from Konkan southwards to Kerala.

Ayurvedic: Vana-mallikaa.

Siddha/Tamil: Erumaimullai, Kattumalligei, Uyyakondan.

Action: Leaf—used in eczema.... jasminum rottlerianum

Having a perfectly clear skin can be tricky, especially if you have oily skin. However, drinking tea - the right type - can help with this problem. Find out more about the teas for acne! How teas for acne can help While classical medication or skin lotions can help a lot, tea counts as a natural solution for solving acne problems. Whether applied topically or drunk, various types of tea can improve your skin condition. Applied topically, it has a direct effect on the skin, especially on the oily type. Other types of tea, the kinds that help you relax, also reduce stress, which often causes breakouts. Some help with acne scars, as well. Tea for acne Spearmint tea is one type of tea you can drink in order to get rid of acne, as it helps regulate hormones. It prevents breakouts and slowly works to reduce the number of zits on your face. You can get the same results if you drink rooibos tea, licorice tea, burdock tea, echinacea tea, sarsaparilla tea, or ginseng tea . Drinking one of these teas, 2-3 cups a day, is bound to lead to pleasing results when it comes to getting rid of acne. Chamomile tea helps you relax, which reduces stress - a common cause for acne. While drinking it does not have a direct effect on acne, it can help reduce this skin problem. Tea for acne scars In some cases, acne can leave nasty scars behind. Once you get rid of acne, you can start focusing on how to get rid of the scars, as well. In this case, green tea can help. It can be drunk or applied topically - brew some green tea and use it to rinse your face or just as a face lotion. Side effects of tea for acne Despite the benefits of teas for acne, their consumption can lead to a few side effects, as well. Spearmint tea can lead to unwanted stomach problems (diarrhea) and headaches; it can also cause your menstruation to be late. It all depends on the amount of spearmint tea you drink, which varies from one person to another. Using green tea may lead to side effects related to its caffeine content. If you know caffeine does not do you any good, be careful with the amount of green tea you drink or use. The symptoms you might get include dizziness, insomnia, loss of appetite and irritability. For skin problems, try one of the various teas for acne. Consuming or using tea counts as a natural remedy, so give it a try!... get rid of acne with tea

Thw.

Synonym: G. cuspidata Kurz.

Family: Ulmaceae.

Habitat: Northeastern parts of India and in Deccan Peninsula.

Siddha/Tamil: Kodaittani.

Folk: Narakyaa-ood (Maharashtra, Indian bazar).

Action: Blood-purifier in itch and cutaneous eruptions; mixed with lemon juice, applied externally.

The wood contains a skatole and silica (0.86-1.2%).

Family: Aizoaceae.

Habitat: Drier parts of Northern and Western India and Deccan Peninsula.

Ayurvedic: Elavaaluka (var.). (Prunus cerasus Linn., Rosaceae, is the accepted source of Elavaaluka.)

Folk: Baalu-ka-saag, Morang, Sareli.

Action: Anthelmintic. Fresh herb is used for taenia.

The plant contains triacontane, do- triacontane, myristone, sugars, and flavonoids.... gironniera reticulata

Each of the two KIDNEYS ?lters a large volume of blood – 25 per cent of cardiac output, or around 1,300 ml – through its two million glomeruli (see GLOMERULUS) every minute. The glomeruli ?lter out cell, protein, and fat-free ?uid which, after reabsorption of certain chemicals, is excreted as urine. The rate of this ultra?ltration process, which in health is remarkably constant, is called the glomerular ?ltration rate (GFR). Each day nearly 180 litres of water plus some small molecular-weight constituents of blood are ?ltrated. The GFR is thus an indicator of kidney function. The most widely used measurement is CREATININE clearance and this is assessed by measuring the amount of creatinine in a 24-hour sample of urine and the amount of creatinine in the plasma; a formula is applied that gives the GFR.... glomerular filtration rate (gfr)

A ‘protective’ cough occurring as a result of irritation of the LARYNX – for example, a small particle of food may be accidentally ‘inhaled’ into the larynx, which reacts with an expulsive cough to prevent the food from entering the lungs.... laryngeal reflex

Pupillary constriction in the EYE in response to light. The direct light re?ex involves pupillary constriction in the eye into which a light is shone; the consensual light re?ex is the pupillary constriction that occurs in the other eye. The a?erent or inward pathway of the re?ex is via the optic nerve, and the e?erent or outward pathway is via the occulomotor nerve.... light reflex

Rehd.

Family: Orchidaceae.

Ayurvedic: Jivaka-Rshabhaka (bulbs of Microstylis wallichi Lindl. and M. musifera, also of other orchids, are sold as Jivaka-Rshabhaka).

Action: Used in age-sustaining and invigorating tonics.... lipasis rostrata

These drugs reduce the amount of low-density LIPOPROTEINS, which transport CHOLESTEROL and triglycerides (see TRIGLYCERIDE) in the blood, or raise the concentration of high-density lipoproteins. The aim is to reduce the progression of ATHEROSCLEROSIS and therefore help prevent coronary heart disease (see HEART, DISEASES OF). These drugs should be combined with reducing other risk factors for raised lipid concentrations, such as a high-fat diet, smoking and obesity. Lipid-regulating drugs include STATINS, ?brates, anion-exchange resins, and NICOTINIC ACID, which may be used singly or in combination under careful medical supervision (see HYPERLIPIDAEMIA).... lipid-regulating drugs

Goat’s Rue Tea is a popular tea known for being an aphrodisiac, helping with male impotence. It is a perennial shrub that grows in parts of Europe, Eastern Russia, Iran and Asia. Goat’s rue (galega officinalis) has green leaves that are made up of lance-shaped leaflets and has pink flowers that grow in spikes. The constituents of goat’s rue are galegine, saponins, tannins, bitters, grlycosides, alkaloids and chromium. How To Make Goat’s Rue Tea To brew goat`s rue tea, place 1 teaspoon of the dried goat’s rue leaves and stems in 1 cup of boiled water. Let the mix steep for about 15 minutes and after that, strain it into your cup. You can drink Goat’s Rue Tea twice a day. Goat’s Rue Tea Benefits

• It is considered safe for breastfeeding women to drink Goat`s RueTea since it is said that it facilitates the proper flow of breast milk. However, consult your doctor before drinking this tea.
• Helps treat several bladder problems.
• Helpful in the treatment of diabetes since it can lower blood sugar.
• Regulates menstruation.
• Helpful in treating snakebites and intestinal parasites.
• Alleviates fever.
• Helps treating rheumatism.

Goat’s Rue Tea Side Effects

• Stop drinking Goat’s Rue Tea if you are experiencing nausea, vomiting or sweating.
• It may interfere with the effects of some medications.
• Avoid over-consumption!

Goat’s Rue Tea is an excellent tea, with many health benefits, being used especially as an aphrodisiac!... goat`s rue tea

Gravel Root Tea is known for its diuretic, astringent and anti-inflammatory properties. Gravel root (eupatorium purpureum) is a perennial plant that can grow up to 5 feet tall, having pointed oblong leaves and small pink flowers. It grows in North America, from southern Canada through Florida. The main constituents of gravel root are tannins, flavonoids and bitter principles. How To Make Gravel Root Tea To brew Gravel Root Tea, you will need to boil 1 teaspoon of gravel root in a cup of water. Let the mix stand for about 10 minutes. Optionally you can add sugar or honey, depending on your preferences. Gravel root tea can be drank 3 times a day! Gravel Root Tea Benefits

• Helps prevent the formation of kidney and bladder stones.
• Effective in treating gout.
• Relieves fever by encouraging sweating.
• Treats various urinary problems.
• Helps relieve constipation.
• Reduces stomach acidity.
• In some cases, it can act as an anti-inflammatory, reducing swelling.

Gravel Root Tea Side Effects

• Due to the fact that Gravel Root Tea contains chemicals called hepatotoxic pyrrolizidine alkaloids (PAs), it may block blood flow and cause liver damage.
• Pregnant women should avoid drinking Gravel Root Tea since it can produce birth defects. Also, if you are breastfeeding, do not drink gravel root tea, because the chemicals (PAs) can affect the breast-milk and harm the baby.
• Do not apply gravel root on wounds or broken skin. The chemicals can be absorbed quickly through broken skin and can lead to dangerous body-wide toxicity.

Gravel Root Tea makes and excellent choice, having a lot of health benefits. Just make sure you avoid drinking too much gravel root tea in order to stay away from its side effects!... gravel root tea

A summary and interpretation of research findings reported in the literature. It may include unstructured qualitative reviews by single authors as well as various systematic and quantitative procedures, such as meta-analysis.... literature review

(Hebrew) One who does not receive mercy... lo-ruhamah

The lower back, five segments of the spinal chord and column, between the sacrum and thoracic regions.... lumbar region

A natural hormone released by the HYPOTHALAMUS gland in the BRAIN. It stimulates the release of GONADOTROPHINS from the PITUITARY GLAND; these control the production of the sex hormones (see ANDROGEN; OESTROGENS).... luteinising hormone-releasing hormone (lhrh)

... lyssa is another term for rabies.

See MRI.... magnetic resonance imaging(mri)

See “rehabilitation”.... maintenance rehabilitation

Research on all aspects of health, the factors affecting it, and ways of promoting, protecting and improving it. It is an essential part of national health development. It includes medical and biomedical research relating to a wide variety of medical matters and involving various life sciences, such as molecular biology and biophysics; clinical research, which is based on the observation and treatment of patients or volunteers; epidemiological research, which is concerned with the study and control of diseases and of situations that are suspected of being harmful to health; and socioeconomic and behavioural research, which investigates the social, economic, psychological and cultural determinants of health and disease with a view to promoting health and preventing disease. Often a multidisciplinary combination of the above kinds of research is needed to solve a health problem.... health research

DC.

Synonym: H. quadriloculare (Roxb.) D. Schum.

Habitat: Gujarat, Madhya Pradesh, Maharashtra, Andhra Pradesh, Karnataka, Tamil Nadu.

Ayurvedic: Waarasa.

Siddha/Tamil: Barokalagoru.

Folk: Pullunga, Paatang (Maharashtra).

Action: Tar extracted from wood— used in skin diseases. Leaf juice— applied externally on toe sores and in chilblain.

The flowers gave hentriacontane and allantoin; the leaves contain ursolic acid and sitosterol. The seeds contain a saponin (rhamnoside), lupeol, beta- sitosterol, stigmasterol and cubulin. The essential oil from flowers exhibits antimicrobial activity.... heterophragma roxburghii

Linn.

Family: Malvaceae.

Habitat: Native of China; grown in gardens throughout India.

English: Rose-of-China, Shoe- flower, Chinese Hibiscus.

Ayurvedic: Japaa, Javaa, Odrapush- pa, Rudrapushpa, Arunaa.

Unani: Gul-e-Gurhal.

Siddha/Tamil: Semparuthi.

Action: Flower—used in impo- tency, bronchial catarrh. Flower and bark—emmenagogue. Leaf— stimulates expulsion of placenta after childbirth; laxative, anodyne. Flower and root—used in menorrhagia.

The plant contains the cyclopro- panoids, methyl sterculate, methyl- 2-hydroxysterculate, 2-hydroxystercu- late, malvalate and beta-sitosterol.

The major anthocyanin in the flower is cyanidin 3-sophoroside. The flower nectar is rich in amino acids, mainly aspartic acid and asparagin. During pollination, the amino acid concentration increases substantially.

Flower powder exhibited anti-inflammatory activity in male albino rats with carrageenan-induced rat paw oedema. The aqueous extract of the plant showed antitumour activity against sarcoma 180 ascites.

An aqueous extract of flowers reduced the duration of oestrus cycle in experimental albino rabbits. The alcoholic extract of flowers showed antiimplantation activity. The benzene extract of flowers, on oral administration, terminated pregnancy in experimental animals.

Flower buds are used in the treatment of vaginal and uterine discharges.

Oral administration of flower extract to rats affected spermatogenesis and endocrine function of testis.

In diabetic patients, a flower bud is given daily up to 10 days or until the level of blood sugar is reduced to tolerable limits.

The white-flowered var. of Japan (cultivated all over India in garden) is equated with Hibiscus syriacus Linn. (Rose of Sharon, Shrubby Althaea). The white flower is an oriental drug used as demulcent and antidiarrhoeal. The bud yields mucilage which consists mainly of partially acetylated acidic polysaccharides. The aqueous extract of the petals causes vasorelaxation of the isolated rat arota via both endo- thelium-dependent and -independent mechanisms. The petals contain anthocyanin pigments.

The cortex and bark exhibit antifun- gal acitivity.

The bark gave canthin-6-one and a fatty acid fraction consisting of lauric, myristic and palmitic acids.

Dosage: Flower—10-20 g paste. (CCRAS.)... hibiscus rosa-sinensis

A system under which medical practitioners or other health professionals are required by law to inform health authorities when a specified event occurs (i.e. a medical error or the diagnosis of a certain disease). See also “incidence monitoring and reporting”.... mandatory reporting

Wight.

Family: Asclepiadaceae.

Habitat: Western and Eastern Himalayas, Simla and Kumaon, hills of Assam.

Ayurvedic: Muurvaa (var.).

Folk: Maruaa-bel. Khaarchu (Garhwal).

M. hamiltonii Wight (sub-Himalayan tract and adjacent plains of Ut- tar Pradesh and Bihar) has also been equated with a Muurvaa var. It is known as Moran-adaa in folk medicine.... marsdenia roylei

A method of obtaining X-ray photographs of the chests of large numbers of people. It has been used on a large scale as a means of screening the population for pulmonary TUBERCULOSIS. It is no longer used in the United Kingdom.... mass miniature radiography

Divination... meadow rue

Rose honey; used in home remedies; sometimes given to children when teething or if they have an infection in the mouth.... miel de rosa

Linn.

Family: Elaeagnaceae.

Habitat: North-west Himalayas at 2,350-5,000 m.

English: Seabuckthorn, Sand Thorn.

Folk: Dhurchuk, Chumaa, Tarwaa (Uttar Pradesh), Sirmaa (Punjab, Ladakh).

Action: Fruit—astringent, anti- diarrhoeal, stomachic, antitussive, antihaemorrhagic.

Sea Buckthorn preparations are used internally for stomach ulcer, duodenal ulcer and other illnesses of the alimentary organs; externally in cases of burns, bedsores and other skin complications induced by the treatment with X-rays and other radiations.

The berries contain polyphenols, 3,4-dihydroxy benzoic acid and p- coumaric acid. They are an important source of vitamins for people living in cold, long winter regions; contain high concentration of vitamin A (carotene 30-40 mg), B1, B2, B6, C (50-600 mg) and E (160 mg/100 g).

The plant is an effective antioxidant and shows protective effect on smooth muscles of rabbits in vitro. The methanolic extract of the berry showed scavenging activity on chemically generated superoxide radicals.

The leaves contain flavonoids, iso- rhamnetin and astragalin; the bark gave serotonin.... hippophae rhamnoides

Lour.

Synonym: Adelia neriifolia Heyne ex Roth.

Family: Euphorbiaceae.

Habitat: Eastern, Central and Peninsular India, up to 700 m.

Ayurvedic: Paashaana-bheda (substitute), Kshudra Paashaana- bheda.

Siddha/Tamil: Kattu Alari.

Action: Root—diuretic, spasmolytic, antilithic. Used for urinary discharges. Leaf and stem— depurative. Leaf and fruit—used in skin diseases.

The roots gave alpha-spinasteryl acetate. The fatty acid from the fat of roots gave myristic, palmitic, stearic and oleic acids.... homonoia riparia

Indigo Root Tea has been known for many years due to its antiseptic, astringent, antibiotic, emetic and antibacterial properties. Wild indigo (baptisia tinctoria) is a herbaceous annual plant that can be recognized by its branching stems and bluish green leaves. Its flowers usually bloom during May and September and they pose as bright yellow flowers. The constituents of Indigo Root Tea are flavonoids, isoflavones, alkaloids, coumarins and polysaccharides. They usually are active when the indigoo root is made into a decoction or used as a tincture. How To Make Indigo Root Tea If you want to make Indigo Root Tea, simply place a handful of indigo root in a cup of boiling water for about 10-15 minutes. After that, take it out of the heat and let it stand for about 3 minutes. Indigo Root Tea Benefits

• Strenghtens the immune system.
• Can speed recovery from the common cold.
• Helps heal wounds and cuts.
• Treats respiratory infections such as pharyngitis and tonsilitis.
• Heals sore thorat.
• Helps reduce fever.
• Helps in the treatment of chronic fatigue syndrome when combined with echinacea.

Indigo Root Tea Side Effects

• Taking in large doses, Indigo Root Tea can cause nausea, diarrhea, voming or asphyxiation.
• Pregnant and breastfeeding women should avoid drinking Indigo Root Tea.
• People with auto-immune disorders should not drink Indigo Root Tea.

Indigo Root Tea is an amazing tea with many health benefits. Just make sure you don’t drink too much indigo root tea, in order not to experience any of its side effects!... indigo root tea

The number of deaths of infants under one year of age. The IMR in any given year is calculated as the number of deaths in the ?rst year of life in proportion to every 1,000 registered live births in that year. Along with PERINATAL MORTALITY, it is accepted as one of the most important criteria for assessing the health of the community and the standard of the social conditions of a country.

The improvement in the infant mortality rate has occurred mainly in the period from the second month of life. There has been much less improvement in the neonatal mortality rate – that is, the number of infants dying during the ?rst four weeks of life, expressed as a proportion of every 1,000 live births. During the ?rst week of life the main causes of death are asphyxia, prematurity, birth injuries and congenital abnormalities. After the ?rst week the main cause of death is infection.

Social conditions also play an important role in infant mortality. In England and Wales the infant mortality rate in 1930–32 was: Social Class I (professional), 32·7; Social Class III (skilled workers), 57·6; Social Class V (unskilled workers), 77·1. Many factors come into play in producing these social variations, but overcrowding is undoubtedly one of the most important.

1838–9 146 1950–52 30 1851–60 154 1960–62 22 1900–02 142 1970–72 18 1910–12 110 1980–82 12 1920–22 82 1990–92 7 1930–32 67 1996 6·2 1940–42 59 1999 5.8 2000 5.6

It is thus evident that for a reduction of the infant mortality rate to the minimum ?gure, the following conditions must be met. Mothers and potential mothers must be housed adequately in healthy surroundings, particularly with regard to safe water supplies and sewage disposal. The pregnant and nursing mother must be ensured an adequate diet. E?ective antenatal supervision must be available to every mother, as well as skilled supervision during labour (see PREGNANCY AND LABOUR). The newborn infant must be adequately nursed and fed and mothers encouraged to breast feed. Environmental and public-health measures must be taken to ensure adequate housing, a clean milk supply and full availability of medical care including such protective measures as IMMUNISATION against diphtheria, measles, poliomyelitis and whooping-cough. (See also PERINATAL MORTALITY.)... infant mortality rate (imr)

A primitive REFLEX ACTION occurring in newly born infants in response to a sudden movement or noise. Also known as the startle re?ex, the baby will throw its arms and legs wide and sti?en its body. This is followed by ?exion of the arms and legs. The re?ex disappears by four months; its persistence suggests a possible neurological condition such as CEREBRAL PALSY.... moro reflex

Also called NIDDM (Non-Insulin-Dependent Diabetes) and Type II (Type II), it generally means you make your own insulin, you eat too many calories, your storage cells are filled and are taking no more fuel, your liver is stuck in a rut and keeps making more glucose out of everything you eat, your brain has no control over its consumption of glucose, but you have run out of places to put it so you pee it out, sweat it out, etc. etc. Also called Adult-onset Diabetes. An Internist may cry out in dismay at this simplification, and there are many subtle distinctions between the various types, as well as a number of distinct hereditary considerations. This, however, is the glossary of an herbalist, and this is the common picture of the Type II person that herbs will help.... insulin-resistant diabetes

Hook. f.

Synonym: I. royleana auct. non-DC.

Family: Compositae; Asteraceae.

Habitat: Temperate and Alpine Himalayas from Chitral to Nepal at 1,500-4,200 m.

English: Elecampane.

Ayurvedic: Pushkaramuula, Pushkara, Paushkara, Padmapatra, Kaashmira, Kushtha-bheda.

Action: Antispasmodic, stomachic, antihistaminic, expectorant, anticatarrhal. Used for asthma, chronic bronchitis and pulmonary disorders.

Key application: Inula helenium— as expectorant. (The British Herbal Pharmacopoeia.)

Roots are used in Kashmir as adulterant of Saussurea lappa.

The root contains a volatile oil, about 1-4%; major constituents being in- ulin (10.0) and sesquiterpene lactones, mainly alantolactone, isoalantolactone and their dihydro derivatives. Alan- tolactone and others in the mixture known as helenalin (sesquiterpene lactones) are toxic constituents of the root.

Alantolactone is anti-inflammatory in animals and has been shown to stimulate the immune system. It is also hypotensive and anthelmintic in animals; antibacterial and antifungal in vitro It irritates mucous membranes. It is used as an anthelmintic in Europe and UK.

Plant extract showed potent antispasmodic effect against bronchial spasm induced by histamine and various plant pollens.

The root, when combined with Commiphora mukul gum-resin, acts as a hypolipidaemic agent, exhibits beta- blocking activity and beneficial effect in myocardial ischaemia.

The roots also exhibit sedative and blood pressure lowering activity.

The European species is equated with Inula helenium Linn.

Dosage: Root—1-3 g powder. (API Vol. IV.)... inula racemosa

Choisy.

Synonym: Merremia emarginata (Burm. f.) Hallier f. M. gangetica (L.) Cufod.

Family: Convolvulaceae.

Habitat: In damp places in upper Gangetic plains; Bihar, Bengal, Peninsular India.

Ayurvedic: Aakhuparni, Aakhu- parnika, Muusaakarni, Aakhukarni. Undurukarnikaa. (Also equated with Dravanti.)

Siddha/Tamil: Yelikkaadhukeerai, Perettaikkirai.

Action: Deobstruent, diuretic, alterative. Used for rheumatic affections, neuralgia, headache, skin diseases and urinary affections.

Evolvulus nummularis Linn. (Con- volvulaceae) is also known as Muusa- akarni (Muusaakaani) and is used for cutaneous affections.... ipomoea reniformis

Linn.

Family: Juglandaceae.

Habitat: Native to Iran; now cultivated in Kashmir, Himachal Pradesh., Khasi Hills and the hills of Uttar Pradesh.

Ayurvedic: Akshoda, Akshoda- ka, Akshota, Shailbhava, Pilu, Karparaal, Vrantphala.

Unani: Akhrot.

Siddha/Tamil: Akrottu.

Action: Leaves and bark— alterative, laxative, antiseptic, mild hypoglycaemic, anti-inflammatory, antiscrofula, detergent. An infusion of leaves and bark is used for herpes, eczema and other cutaneous affections; externally to skin eruptions and ulcers. Volatile oil— antifungal, antimicrobial.

Key application (leaf) ? In mild, superficial inflammation of the skin and excessive perspiration of hands and feet. (German Commission E.). When English Walnuts (Juglans regia) are added to low fat diet, total cholesterol may be decreased by 412% and LDL by 8-16%. (Natural Medicines Comprehensive Database, 2007.)

Walnut hull preparations are used for skin diseases and abscesses.

Walnut is eaten as a dry fruit. Because of its resemblance to the brain, it was thought, according to the "doctrine of signatures", to be a good brain tonic. Walnuts are also eaten to lower the cholesterol levels.

From the volatile oil of the leaves terpenoid substances (monoterpenes, sesquiterpenes, diterpene and triter- pene derivatives) and eugenol have been isolated. Fatty acids, including geranic acid; alpha-and beta-pinene, 1,8,cincole, limonene, beta-eudesmol and juglone are also important constituents of the volatile oil.

The leaves contain napthoquinones, mainly juglone. The root bark gave 3, 3',-bis-juglone and oligomeric ju- glones. Unripe fruit husk also gave napthoquinones.

The kernels of Indian walnuts contain 15.6% protein, 11% carbohydrates, 1.8% mineral matter (sodium, potassium, calcium, magnesium, iron, copper, phosphorus, sulphur and chorine). Iodine (2.8 mcg/100 g), arsenic, zinc, cobalt and manganese are also reported. Kernels are also rich in vitamins of the B group, vitamin A (30 IU/100 g), and ascorbic acid (3 mg/100 g).

The juice of unripe fruits showed significant thyroid hormone enhancing activity (prolonged use of such extract may cause serious side effect).

White Walnut, Lemon Walnut, Butternut, Oilnut of the USA is equated with Juglans cineraria L. The inner bark gave napthoquinones, including juglone, juglandin, juglandic acid, tannins and an essential oil.

Butternut is used as a dermatologi- cal and antihaemorrhoidal agent. Ju- glone exhibits antimicrobial, antipara- sitic and antineoplastic activities.

Dosage: Dried cotyledons—10-25 g (API, Vol. II.)... juglans regia

Linn.

Family: Zingiberaceae.

Habitat: Throughout India in wet or humid shaded areas.

Ayurvedic: Bhuumi-champaka, Bhuu-champaka, Hallakam.

Siddha/Tamil: Karunkuvalai.

Folk: Bhui-champaa.

Action: Tuber—antitumour. Used for swellings (removes blood clot), mumps and wounds.

Tubers gave crotepoxide and beta- sitosterol. The oil contained chavicol, cineole.... kaempferia rotunda

Wight & Arn.

Synonym: K. candel (L.) Druce.

Family: Rhizophoraceae.

Habitat: Costal forests of eastern and western Peninsulas, the Sunderbans (West Bengal).

Siddha/Tamil: Thuvar kandan.

Folk: Rasunia (Orissa), Guria (Bengal).

Action: Bark—used with ginger or long pepper and rose water for diabetes (aqueous or alcoholic extracts of the bark did not exhibit any effect on the blood sugar of normal or alloxan-diabetic rabbits).

The Bark contains 17.3% tannin and 13.5% non-tans. Novel proanthocyani- din dimers and trimers—all containing a phenylpropionoid substituent in the upper flavan unit, along with pro- pelargonidin dimers and procyanidin trimers of common types, have been isolated from the bark.... kandelia rheedii

(Poir) Baill.

Synonym: Phyllanthus reticulatus Poir.

Family: Euphorbiaceae.

Habitat: All over India; also grown as a hedge plant.

Ayurvedic: Kaamboji.

Folk: Panjuli.

Action: Plant—spasmolytic, hypotensive, antiviral. Fruit— astringent, used in inflammations. Leaves—astringent, antidiarrhoeal, diuretic. Root bark—astringent, attenuant, diuretic.

The leaves contain beta-sitosterol, friedelin and its derivatives, glochi- donol and betulinic acid. Betulin, glochidonol, friedelin, octacosanol, taraxeryl acetate, taraxerone and beta- sitosterol are obtained from the root.... kirganelia reticulata

DC.

Synonym: L. heyneana DC.

Family: Compositae; Asteraceae.

Habitat: Many parts of India, as a common weed.

Folk: Undir-chaa-kaan (Maharashtra).

Action: Diuretic, slightly aperient. Used as a diuretic in calculous affections, also for chronic obstruction of liver and bowels.

A smaller var., found in western Ut- tar Pradesh, Rajasthan, Saurashtra and the Deccan Penninsula, is equated with L. remotiflora DC.... lactuca runcinata

Retz.

Synonym: L. speciosa (L.) Pers. L. reginae Roxb.

Family: Lythraceae.

Habitat: Tropical Himalaya, and Assam, Western and Eastern Ghats, up to 1,000 m.

English: Pride of India, Queen's Flowers, Queen Crape Myrtle.

Siddha/Tamil: Kadalai, Pumaruttu.

Folk: Jaarul. Kramuk and Arjun are confusing synonyms.

Action: Seed—narcotic. Root— astringent, stimulant, febrifuge. Fruit—used for aphthae of the mouth. Leaves—purgative, diuretic, deobstruent. Bark—an infusion is given in diarrhoea and abdominal pain.

A decoction of the leaves, also of dried fruits, is used like tea for diabetes mellitus in Philippines. Mature leaves and fruits, in fresh condition, exhibit hypoglycaemic activity experimentally The potency decreases on storing the material.

The leaf extract, when administered as powder and as tannin-free extract, showed hypoglycaemic activity in mice. Amino acids constitute the insulin-like principle. The plant contains triterpenoids, colocolic acid and maslinic acid. Colocolic acid is known to possess hypoglycaemic activity.

Leaves contain lageracetal and sitos- terol. Ellagitannins have been isolated from fruits and leaves.... lagerstroemia flos-reginae

Any substance producing a negative response in mosquitoes, causing them to avoid a close approach (such as alighting on the skin of a host animal or entering a treated room). (See also DEET).... mosquito repellent

See APPENDIX 1: BASIC FIRST AID.... mouth-to-mouth respiration

More than one risk factor for the development of a disease or other outcome is present and their combined presence results in an increased risk. The increased risk may be due to the additive effects of the risks associated with the separate risk factors, or to synergism.... multiple risk / causation

Geographic areas or multi-unit buildings that are not restricted to persons over a specified age, but which have evolved over time to include a significant number (typically, over 50%) of residents who are aged 60 and over.... naturally occurring retirement communities

Roxb.

Family: Labiatae.

Habitat: Plain and hills of Kumaon and Punjab, extending westwards to Afghanistan. Imported into India from Persia.

Unani: Baalango, Tukhm-e- Baalango.

Folk: Tuut-malangaa.

Action: Seed—cooling, diuretic, sedative; given internally as a soothing agent during urinary troubles, also for cough. A poultice of seeds is applied to abscesses, boils and inflammations. (Seeds are not to be used as a substitute for Plantago sp.)

Seeds contain linoleic, oleic, palmitic and stearic acids; beta-sitosterol. Gum contains L-arabinose, D-galac- tose, L-rhamnose, pentosans, protein, uronic anhydride. Amino acids are also found in the plant.... lallemantia royleana

W. & A.

Family: Asclepiadaceae.

Habitat: Sub-Himalayan tracts of Punjab and Uttar Pradesh and Deccan Peninsula up to an altitude of 900 m.

Ayurvedic: Jivanti; Jivaniya, Jiva- pushpa, Hemavati, Jivana. Shaaka- shreshtha, Payaswini, Maangalya, Madhusravaa. (Guduuchi, Medaa, Kaakoli and Vrkshaadani are also known as Jivanti.) (Haimavati is equated with Orris Root and Hemapushpa with Sarca asoca flower.)

Siddha/Tamil: Keerippaalai.

Folk: Dodishaak (Gujarat).

Action: Plant—stimulant and restorative. Improves eyesight. Found useful in the treatment of habitual abortion. Leaves and roots used in skin diseases.

The herb contains «-triacontane, cetyl alcohol, beta-sitosterol, beta- amyrin acetate, lupanol 3-O-digluco- side and lepitidin glycoside.

Stigmasterol and lipoid fraction of the plant exhibited estrogen mimetic effects.

Alcoholic extract of roots and leaves show antibacterial activity against Gram-positive and Gram-negative bacteria.

Intravenous administration of aqueous extract of stems has a pronounced and hypotensive action in anaesthetized dogs.

Dosage: Root—3-6 g powder. (CCRAS.)... leptadenia reticulata

Linn.

Synonym: M. neglecta Wall.

Family: Malvaceae.

Habitat: Simla, Kumaon and plains of North India.

English: Round-leaved Mallow, Drawf Mallow, Cheese Cake Flower.

Ayurvedic: Suvarchalaa.

Unani: Khubhaazi, Gul-Khair.

Action: Leaves—demulcent, emollient; used in glycosuria, stomach disorders and as emmenagogue; used as poultice for maturing abscesses. Seeds—demulcent; prescribed in bronchitis, cough, inflammation of the bladder and haemorrhoids.

Marshmallow (Althaea officinalis) is a different herb.... malva rotundifolia

The meeting of the care needs of the client.... need responsiveness

See REVERSE TRANSCRIPTASE INHIBITOR.... nucleoside reverse transcriptase inhibitor

Data recorded by nurses concerning the nursing care given to the patient, including judgement of the patient’s progress.... nursing record

A measure of the use of facilities, most often inpatient health facility use, determined by dividing the number of patient days by the number of bed days (or places) available, on average, per unit of time, multiplied by 100.... occupancy rate

Most staphylococci (see STAPHYLOCOCCUS) have now evolved resistance to benzylpenicillin (see PENICILLIN) because of their ability to produce PENICILLINASE. Cloxacillin and ?ucloxacillin are antibiotics still e?ective against most staphylococci; at one time methicillin was used to combat resistant strains, but in hospital environments bacteria acquired immunity to this powerful drug (now withdrawn from use) and to cloxacillin. RIFAMPICIN, VANCOMYCIN, TEICOPLANIN and temocillin are still active against most penicillinase-producing gram-negative bacteria (see GRAM’S STAIN). There is, however, a growing threat to health because of the rise in the number of antibiotic-resistant bacteria, particularly in hospitals. The bacteria themselves are not more virulent than others, but the di?culty in treating them with a safe and e?ective antibiotic mean that they are more dangerous. It is likely that lapses in normal hygienic practice – such as frequent hand-washing – has resulted in an increase in MRSA disease.... methicillin-resistant staphylococcus aureus (mrsa)

These drugs produce partial or complete paralysis of skeletal muscle (see under MUSCLE – Structure of muscle). Drugs in clinical use are all reversible and are used to help insert a breathing tube into the TRACHEA (endotracheal tube) during general ANAESTHESIA and ARTIFICIAL VENTILATION OF THE LUNGS. They may be broadly divided into depolarising and nondepolarising muscle relaxants. Depolarising muscle relaxants act by binding to acetylcholine receptors at the motor end-plate where nerves are attached to muscle cells, and producing a more prolonged depolarisation than acetylcholine, which results in initial muscle fasciculation (overactivity) and then ?accid paralysis of the muscle. The only commonly used depolarising drug is succinylcholine which has a rapid onset of action and lasts approximately three minutes. Non-depolarising muscle relaxants bind to the acetylcholine receptors, preventing acetylcholine from gaining access to them. They have a slower onset time and longer duration than depolarisers, although this varies widely between di?erent drugs. They are competitive antagonists and they may be reversed by increasing the concentration of acetylcholine at the motor end-plate using an anticholinesterase agent such as neostigmine. These drugs are broken down in the liver and excreted through the kidney, and their action will be prolonged in liver and renal failure. Other uses include the relief of skeletal muscle spasms in TETANUS, PARKINSONISM and spastic disorders. The drugs dantrolene and diazepam are used in these circumstances.... muscle relaxants

Roxb. ex Salisb.

Synonym: N. nouchali Burm. f. N. lotus Hook. f. Thoms non L.

Family: Nymphaeaceae.

Habitat: Throughout the warmer parts of India.

English: Indian Red Water-lily.

Ayurvedic: Kumuda, utpala (red-flowered var.).

Siddha/Tamil: Alli-tamarai, Vellam- bal.

Action: Flower—astringent, cardiac tonic; used in palpitation of heart. Rhizomes—used for dysentery and dyspepsia.... nymphaea rubra

This is the essential initial treatment for DIARRHOEA, and is particularly valuable for dehydrated children in developing countries ill with diseases such as CHOLERA. A litre of water containing one teaspoonful of salt and eight of sugar, taken by mouth, is readily absorbed. It replaces salts and water lost because of the diarrhoea and usually no other treatment is required.

In developed countries ORT is useful in treating gastroenteritis. There are a number of proprietary preparations, often dispensed as ?avoured sachets, including Dioralyte® and Rehydrate®.... oral rehydration therapy (ort)

Research on measures of changes in outcomes, that is, health status and satisfaction, resulting from specific interventions.... outcome research

The proportion of female mosquitoes that have laid eggs at least once. Use for age-grading a mosquito population.... parous rate

A process in which the researcher facilitates analysis by a range of stakeholder groups of the themes being investigated.... participatory research

See REFLEX ACTION.... patellar reflex

Standardized tools to determine patient characteristics and abilities, what assistance they need and how they may be helped to improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, interviews with the patient, other informants (e.g. family members) and direct observation.... patient assessment (resident)

A set of rights, privileges, responsibilities and duties under which individuals seek and receive health care services. As patients’ rights are often not explicit, the composition of the set varies from country to country and over time.... patients’ rights

The process by which manuscripts submitted to a publisher or research applications are evaluated by experts in appropriate fields (usually anonymous to the authors) to ensure quality.... peer review (in research)

Linn.

Family: Osmundaceae.

Habitat: The Himalayas, Khasi hills and the Western Ghats at altitudes of 1,500-3,000 m.

English: Royal Fern.

Action: Fern—antispasmodic, astringent, an aqueous extract is administered for intestinal gripe; used externally in rheumatism; also prescribed in muscular debility Fonds enter into diuretic drinks used for treating body swellings. Root—mucilaginous, styptic, stimulant.

The rhizomes contain phenolic, gallic, caffeic, p-coumaric, vanillic, salicylic, p-hydroxybenzoic and ferulic acids and catechol tannins (2.8%) which are responsible for fern's astringent activity. Biological activity of these tannins corresponds to that of 10% tannic acid.... osmunda regalis

Linn. non-Roxb. & auct.

Vigna radiata (Linn.)

Family: Papilionaceae; Fabaceae.

Habitat: Extensively cultivated all over India.

English: Greengram, Golden Gram.

Ayurvedic: Mudga, Mungalya.

Unani: Moong.

Siddha/Tamil: Pattishai-payaru.

Action: Used as a pulse. Soup is given as a diet to patients of enlarged liver and spleen, and after recovery from acute illness. A poultice of it is used for checking secretion of milk and reducing distention of the mammary glands.... phaseolus radiatus

Sarg.

Synonym: P. longifolia Roxb.

Family: Pinaceae.

Habitat: The Western and Eastern Himalayas.

English: Long-leaved Pine, Three- leaved Pine, Chir Pine.

Ayurvedic: Sarala, Pita-vriksha, Surabhidaaruka, Dhuupavriksha, Namasu. Oleo-resin—Shriveshtaka, Ghandh-Birojaa.

Unani: Sanobar-ul-Hindi. Oleoresin—Gandh-Bihrojaa, Qinn, Berzad.

Siddha/Tamil: Simaidevadaru.

Action: Needle, needle oil— decongestant, expectorant, antiseptic. Oil—used in cough and cold remedies, particularly inhalations and in rubefacients for rheumatism and muscle stiffness. Resin— expectorant, antiseptic, antipruritic.

The essential oil from oleoresin contains chiefly alpha-and beta-pinene; carene and longifoline.

Pinus pinaster Ait (Cluster Pine, Maritime Pine) has been successfully grown in Kulu, Manali and Rahini. German Commission E recognized the efficacy of the needle-oil in catarrhal diseases of the upper and lower respiratory tract (internally, as well as externally).

Dosage: Heartwood, root—1-3 g powder. (API, Vol. III.)... pinus roxburghii

Service provision targets established by an authority on a population basis.... planning ratio

Asclepias tuberosa. N.O. Asclepiadaceae.

Synonym: Butterfly Weed, Tuber Root, Wind Root.

Habitat: Moist, loamy soil. Indigenous to U.S.A

Features ? Stem two to three feet high, contains milky juice. Root, wrinkled longitudinally, light brown outer surface, whitish internally ; fracture tough, irregular. Rootstock knotty, faintly ringed. Acrid taste.

Part used ? Root.

Action: Diaphoretic, expectorant, antispasmodic.

Chest complaints; acts directly on the lungs, and stimulates sweat glands. Relaxes capillaries, relieving strain on heart and lungs. Reduces pain and assists breathing in pleurisy. Infusion of 1 ounce of the powdered root with 1 pint of boiling water is taken in wineglass doses, to which a teaspoonful of composition powder (Myrica compound) may be added with advantage.... pleurisy root

The area on the centre and towards the left side of the chest, lying in front of the heart.... precordial region

quotient using as the numerator, the number of persons sick or portraying a certain condition, in a stated population, at a particular time, regardless of when that illness or condition began, and as the denominator, the number of persons in the population in which they occurred.... prevalence rate

The enforcement of certain rules of conduct among its members by a professional community.... professional self-regulation

The systematic assessment of the relevance, adequacy, progress, efficiency, effectiveness and impact of a programme.... programme evaluation / review

A measure of the relative contribution to total mortality by a specific cause and these are expressed as number of deaths assigned to the state cause in a calendar year per 1000 total deaths in that year.... proportional mortality rate (pmr)

Pleurisy root tea is an aromatic herbal tea which you are bound to enjoy. The indigenous Indians used to drink it a lot, especially thanks to its health benefits. About Pleurisy Root Tea Pleurisy root tea is made from the roots of the pleurisy plant, also known as the butterfly weed. The plant grows in North America. It can grow up to 1m tall, with multiple stems and spirally-arranged, spear-pointed leaves that are 5-12cm long. Clusters of orange or yellow flowers bloom during summertime, attracting butterflies, insects and birds. The plant can be found growing on dry, open fields, under direct sunlight. How to prepare Pleurisy Root Tea If you want to enjoy a cup of pleurisy root tea, add a teaspoon of dried, chopped roots to a cup of freshly boiled water. Let it steep for 10-15 minutes before straining it to remove the herbs. Sweeten it with honey or fruit juice, if necessary. Pleurisy Root Tea Benefits Pleurisy root contains various active constituents, such as glycosides, resins, amino acids, volatile oil, glucosidal principal, lupeol, and alkaloids. They are transferred to the pleurisy root tea, as well. Because if this, the tea has lots of important health benefits. Pleurisy root tea is often included in treatments for various respiratory ailments and pulmonary infections, for example pleurisy, asthma, bronchitis or pneumonia. It helps alleviate pain and congestion by reducing the mucus thickness in the lungs and enabling the patient to expel the blockage. Drinking pleurisy root tea helps both with fevers and detoxification, as it stimulates sweating and perspiration. It is also useful as an herbal treatment for colds and influenza. You can also drink pleurisy root tea if you’ve got problems with diarrhea, dysentery, chronic rheumatism, colic, muscle tension and spasm. Pleurisy root tea can also be used topically. You can soak a clean cloth with the tea and use it to treat swellings, bruises, lameness, wounds and skin ulcers. Pleurisy Root Tea Side Effects If you’re pregnant, you shouldn’t drink pleurisy root tea. It may cause uterine contractions, which could lead to miscarriages. Also, it is safer not to drink this tea if you’re breast feeding. Children shouldn’t drink pleurisy root tea either, because of the small amount of cardiac glycosides. You should be careful with the amount of pleurisy root tea you drink if you’ve got cardiovascular problems or you’re taking cardiac glycosides. Also, if you’re taking any other medication, check with your doctor if it’s safe to drink pleurisy root tea. Don’t drink more than 3-4 cups of pleurisy root tea a day. If you drink too much, it might lead to symptoms such as intestinal cramping, nausea, vomiting, and diarrhea. Pleurisy root tea is ideal for an everyday beverage. It has many health benefits and only a few side effects. Once you try it, you’ll surely enjoy it!... pleurisy root tea - tea of the indigenous indians

Linn.

Family: Apocynaceae.

Habitat: Native to Mexico; grown throughout India.

English: Red Jasmine.

Ayurvedic: Kshira Champaka (red-flowered var.).

Action: Root bark—used in blennorrhagia. Flower—bechic (used in pectoral syrups). Bark— a decoction is used in venereal diseases and leprosy.

The bark contains cytotoxic iridoids (including fulvoplumierin which also inhibits the growth of Mycobacterium tuberculosis) and the lignin, lirioden- drin.

The plant contains the triterpene rubrinol which showed antibacterial activity against Gram-positive and Gram-negative bacteria, including Pseudomonas aeruginosa (a causative agent responsible for infecting burns, wounds, urinary tract and infection in cystic fibrosis) and Pseudomonas pseu- domallei (which causes melioidosis or pseudoglandess).

The herb contains cardiac glycosides which have a narrow-margin of safety. (Sharon M. Herr.)... plumeria rubra

Phytolacca decandra. N.O. Phytolaccaceae.

Synonym: Garget, Pigeon Berry.

Habitat: U.S.A. Cultivated on a sm.ill scale in England for medicinal purposes.

Features ? The root is obtainable in longitudinally split pieces or in transverse slices. Ringed, brownish-grey externally, hard and whitish inside; fibrous fracture. Berries purplish-black, nearly globular, ten carpels, each containing one lens-shaped seed.

Part used ? Root, berries.

Action: Alterative, cathartic.

Chronic rheumatism and skin diseases. Of some use in dyspepsia. Action of root stronger than berries. For rheumatism the root is often compounded with Black Cohosh and Wintergreen.

Preparation and dosage vary considerably with the condition of the root. Thurston, Hammer and other physio-medical practitioners recommend that only the green root should be used, owing to, rapid deterioration. These herbalists use the fresh root largely in hardening of the liver and reduced biliary flow.... poke root

(Arabic) A great leader Raidah, Raida, Ra’ida, Raa’idah... ra’idah

(Hebrew) An unspoiled child Rananah, Ranana, Raanana, Rananna, Raananna... raananah

(Arabic) Resembling a pale cloud Raabab... rabab

(Hebrew) The fourth-born child Raba, Rabba, Rabbah... rabah

(German) Resembling a raven Rabeah... rabea

(Egyptian / Arabic) Born in the springtime / of the gentle wind Rabia, Raabia, Rabi’ah, Rabi... rabiah

Wall.

Synonym: Drypetes roxburghii (Wall.) Hurusawa.Family: Euphoriaceae.

Habitat: Throughout tropical India, wild and cultivated as an avenue tree.English: Child-life tree, Indian Amulet Plant, Spurious Wild Olive.Ayurvedic: Putranjiva, Putrajivaka, Putrajiva, Yashtipushpa, Arth- saadhanaSiddha/Tamil: Karupali Garbhadaa and Garbhakaraa are misleading synonyms.Folk: Jiyaapotaa.

Action: Fruit—powered (deseeded) fruits are used against cough, cold and sprue. Rosaries of hard stones are used for protecting children from infections. (Due to misleading nomenclature, the "conception-promoting" property has been attributed to the drug in folk medicine. Its use is possible in vaginal infections and genitourinary diseases, or skin eruptions during pre-conception stage.)The seed kernel on steam distillation yield 0.5% of a sharp-smelling essential oil of the mustard oil type. The oil contains isopropyl and 2-butyl isothio- cyanates as the main constituents and 2-methyl-butyl isothiocyanate as a minor component. The iso-thiocyanates are produced on enzymic hydrolysis of glycosidic progenitors present in the kernels, viz. glucoputranjivin, gluco- cochlearin and glucojiaputin respectively. An additional glucoside, gluco- cleomin has been identified in the seed kernel, it affords a non-volatile mustard oil, cleomin. A glycosidic pattern similar to that in the seed is reported in the shoots and roots.The fruit pulp contains a large proportion of mannitol and small quantities of saponin glucosides and alkaloids.The seed coat gave putranjivoside, putranoside A, B, C and D, beta- sitosterol and tis beta-D-glucoside.The leaves gave amentoflavone and its derivatives, beta-amyrin and its palmite, polyphenols, putranjiva sa- ponin A,B,C, and D and stigmasterol.The bark contains friedelin, friede- lanol, friedelanone, friedelan-3,7-di- one (putranjivadione), 3-alpha-hydro- xy friedelan- 7-one (roxburgholone), carboxylic acid, putric acid, putran- jivic acid.The essential oil from leaves showed mild antifungal activity against Rhizoctonia solani.

... putranjiva roxburghii

Linn.

Family: Pyrolaceae.

Habitat: North-Western and eastern Himalaya at altitudes of 2,700-3,000 m. and in Khasi and Jaintia hills up to 1,500 m.

Action: Plant—astringent and antilithic. Used for healing wounds. A decoction of the plant is prescribed against profuse menses, bloody stools, haemorrhages and ulcers in urinary passages. The whole herb is used in traditional chinese medicine for the treatment of arthritis.

The plant contains ursolic acid, chi- maphilin, hyperin, quercetin, myri- cetin and gallic acid. Chimaphilin and ursolic acid inhibit carrageenan- induced oedema in rat paw. Other constituents act as protective antioxi- dants.... pyrola rotundifolia

(Hebrew) A vain or empty woman Racah, Racca, Raccah... raca

(Hindi) Born of the creation Rachanna, Rashana, Rashanda, Rachna... rachana

(Hebrew) The innocent lamb; in the Bible, Jacob’s wife

Rachael, Racheal, Rachelanne, Rachelce, Rachele, Racheli, Rachell, Rachelle, Rachil, Raechel, Raechell, Raychel, Raychelle, Rashell, Rashelle, Raychel, Rechell, Rakel... rachel

Pain in the vertebral column... rachialgia

(English) Of the red cliffs Radcleff, Radclef, Radclif, Radclife, Radclyffe, Radclyf, Radcliphe, Radclyphe... radcliffe

(English) An elfin counselor Radell, Radel, Radele, Radella, Radela, Raedself, Radself, Raidself... radella

(Arabic) One who is content; satisfied

Radeya, Radhiya, Radhiyah, Radhia, Radhiah, Radhea, Radheah... radeyah

(Hindi) A successful woman; in Hinduism, one of Krishna’s consorts Radhah, Radhika, Radhikah, Radheeka, Radhyka, Radheaka... radha

(Roxb.) K. Schum.

Synonym: Bignonia xylocarpa Roxb. Stereospermum xylocarpum (Roxb.) Wt.

Family: Bignoniaceae.

Habitat: Gujarat, Karnataka, Tamil Nadu.

English: Padri tree.

Siddha/Tamil: Vedanguruni, Pathiri.

Folk: Paadiri. Kharsing, Kadashing, Bairsinge (Maharashtra).

Action: Plant—antiseptic. Resin— used for the treatment of skin diseases. Rootbark—bitter, astringent; used as substitute for Stereospermumpersonatum (Hassk.) D. Chatterjee and S. suaveolens DC. (Trumpet-Flower, Yellow Snake tree, also known as Padri).

The leaves gave flavonoids, dinatin and its glycoside. Roots yielded O- acetyl oleanolic acid, stigmasterol and a red pigment, radermachol.... radermachera xylocarpa

Neuralgia of the nerve roots... radiculalgia

Substances which absorb X-RAYS, rather than transmitting them, appear white on X-ray ?lm and are described as radio-opaque. This is true of bones, teeth, certain types of gall-stones, renal stones and contrast media used to enhance the accuracy of radiographic imaging.... radio-opaque

See ISOTOPE.... radioactive isotopes

Protection, Lust ... radish

(Slavic) Hardworking for the people

Radilla, Radinka, Radmila, Redmilla, Radilu... radmilla

(Arabic) From the mountain in Medina

Radwah, Radhwa, Radhwah... radwa

(English) Form of Rachel, meaning “the innocent lamb”

Raedell, Raedine, Raelaine, Raelani, Raelee, Raeleen, Raelena, Raelene, Raelina, Raella, Raelyn, Raelynn, Raelynne, Raenisha, Ray, Raye, Rayette, Raylene, Raylina, Rayma, Raynelle, Rayona, Rayla, Raynesha, Raynisha, Raylyn, Raylynn, Raelin... rae

... raegan, ragan, raygan, reganne, regann, regane, reghan, reagan, reaghan, reegan

(Spanish) A beautiful and unique woman

Raekah, Rayka, Raika, Raykah, Raikah... raeka

(Arabic) One who is happy and prosperous

Rafah, Raafa, Raffa, Raffah... rafa

(Hebrew) Form of Raphaela, meaning “the divine healer” Rafelah, Rafellah, Rafella, Rafele, Rafelle... rafela

(Gaelic) A prosperous lady; wealthy Raffertey, Rafferti, Raffertie, Raffertee, Raffertea... rafferty

(Arabic) An exalted woman Rafia, Rafi’ah, Rafee’a, Rafeea, Rafeeah, Rafiya, Rafiyah... rafi’a

(Arabic) A pleasant companion; a sweetheart

Rafigah, Rafeega, Rafeegah, Rafyga, Rafygah... rafiga

(African) A beloved friend Rafikie, Rafiky, Rafikey, Rafikee, Rafikea, Raficki, Rafickie, Raficci... rafiki

(Arabic) A pleasant young woman... raghd

(English) In Arthurian legend, Gawain’s wife

Ragnal, Ragnalle, Ragnalla, Ragnale, Ragnala, Ragnallia, Ragnallea... ragnall

(Swedish) Feminine form of Ragnar; one who provides counsel to the army

Ragnarah, Ragnarra, Ragnaria, Ragnarea, Ragnari, Ragnarie, Ragnary, Ragnarey, Ragnaree... ragnara

(Norse) One who gives beautiful advice

Ragnfride, Ragnfrida, Ragna, Ragnfryd, Ragnfryde, Ragnfryda, Ragni, Ragnie, Ragny, Ragney, Ragnee, Ragnea... ragnfrid

(Norse / Teutonic) One who provides counsel in battle / an all-knowing being

Ragnild, Ragnhilda, Ragnhilde, Ragnilda, Ranillda, Renild, Renilda, Renilde, Reynilda, Reynilde, Ragnilde... ragnhild

Courage ... ragweed

(Hebrew) A trustworthy and helpful woman

Rahabe, Rahabb, Rahaba, Rahabah... rahab

(Arabic) Born during the springtime Rahii, Rahy, Rahey, Rahee, Rahea, Rahie... rahi

(Hebrew) Form of Rachel, meaning “the innocent lamb” Rahill, Raaheel, Rahille, Rahila, Rahilla, Raheela, Rahel, Rahelle... rahil

(Arabic) A compassionate woman; one who is merciful Rahima, Raheema, Raheemah, Raheima, Rahiema, Rahyma, Rahymah, Raheama, Raheamah... rahimah

(Arabic) Filled with grace Rahimate, Rahimata, Rahimatia, Rahymateh, Rahymata... rahimateh

(Japanese) One who is trustworthy... rai

(Polish) Form of Regina, meaning “a queenly woman”

Raenah, Raene, Rainah, Raine, Rainee, Rainey, Rainelle, Rainy, Reina, Reinella, Reinelle, Reinette, Reyna, Reynalda, Reynelle, Reyney, Reine, Ranee, Reia... raina

(American) As colorful as the rainbow; symbolizing promise Rainbowe, Raynbow, Raynebow, Raynebowe, Reinbow, Reinbowe... rainbow

(Hebrew / Greek) As beautiful as the rose / one who is carefree Raisabel, Raisse, Raiza, Raizel, Rayzel, Ra’isa, Raisie, Raizie, Raisi, Raizi, Rayzi, Rayzie, Ra’eesa... raisa

(French) A great thinker Raisa, Raissah, Rayssa, Raysa, Raison, Rayson, Raeson, Raessa... raissa

Means “root of (plant name)”; look up the plant name following this description of the plant part used.... raíz de

(Arabic) One who is filled with hope Rajah... raja

(Hindi) Born at night; in Hinduism, another name for the goddess Kali Rajanie, Rajany, Rajaney, Rajanee, Rajanae, Rajni, Rajnie, Rajny, Rajney, Rajnee, Rajnea, Rajanea... rajani

(Arabic) A lustrous woman Rakshanda, Rakhshonda, Rakshonda, Rakshona, Rakhsha, Raksha... rakhshanda

(Hebrew) From the shore town Rakkathe, Rakkatha, Rakath, Rakathe, Rakatha, Rakkon, Rakon, Rakkona, Rakona... rakkath

(English) From the clearing of roe deer

Raileigh, Railey, Raley, Rawleigh, Rawley, Raly, Rali, Ralie, Ralee, Rawli, Rawlie, Rawlee, Rawly... raleigh

Abnormal sounds in the lungs, either from excess secretions or the narrowing of the bore by inflammation or congestion.... rales

(English) Feminine form of Ralph; wolf counsel Raphine, Ralpheene, Ralpheyne, Ralfina, Ralfeene, Ralfine... ralphina

(Hebrew) One who is exalted Ramah, Ramath, Ramatha, Ramathe... rama

Means “branch of (plant name)”; this would include the leaves and stem of the plant; look up the plant name which follows this description of the plant part used.... rama de

(Spanish) A sensible and thoughtful woman

Ramirah, Rameera, Rameerah, Rameira, Ramiera, Ramyrah, Ramyra, Rameirah, Ramierah, Rameara, Ramearah... ramira

Means “small branch or sprig of (plant name)”; look up the plant name which follows this description of the plant part used.... ramita de

Inflammation of a nerve root... ramitis

(African) A prophetess Ramlah, Ramli, Ramlie, Ramly, Ramley, Ramleigh, Ramlee, Ramlea... ramla

(Spanish) Feminine form of Ramon; one who offers wise protection Ramee, Ramie, Ramoena, Ramohna, Ramonda, Ramonde, Ramonita, Ramonna, Ramowna, Remona, Remonna, Romona, Romonda, Romonde, Romonia, Raimunda, Raimonda, Raimona... ramona

(English) From the raven island; from the island of wild garlic Ramsay, Ramsie, Ramsi, Ramsee, Ramsy, Ramsea... ramsey

(Hindi) An elegant and beautiful woman

Ramyah, Ramiya, Ramiyah, Ramia, Ramiah... ramya

(Arabic) An eye-catching woman; to gaze upon

Ranah, Ra’naa, Rand, Raniyah, Ranarauna, Ranaraunaa, Raunaa... rana

(Irish) A charming woman; one who is prosperous

Ranalt, Rathnait, Ranaite, Rathnaite, Ranalta... ranait

(English) Feminine form of Randall; shielded by wolves; form of Miranda, meaning “one who is worthy of admiration”

Randa, Randee, Randelle, Randene, Randie, Randy, Randey, Randilyn, Randilynn, Randilynne... randi

A sample that is arrived at by selecting sample units such that each possible unit has a fixed and determined probability of selection.... random / random sample

The sampling process whereby each unit in the population has an equal chance of being selected.... random sampling

The tendency for the estimated magnitude of a parameter (e.g. based upon the average of a sample of observations of a treatment or intervention effect) to deviate randomly from the true magnitude of that parameter. Random variation is independent of the effects of systematic biases. In general, the larger the sample size, the lower the random variation of the estimate of a parameter. As random variation decreases, precision increases.... random variation / random error

A method of comparing the results between two or more groups of patients intentionally subjected to di?erent methods of treatment – or sometimes of prevention. Those subjects entering the trial have to give their informed permission. They are allocated to their respective groups using random numbers, with one group (controls) receiving no active treatment, instead receiving either PLACEBO or a traditional treatment. Preferably, neither the subject nor the assessor should know which ‘regimen’ is allocated to which subject: this is known as a double-blind trial.... randomised controlled trial

A technique of assigning subjects to intervention and control groups that is based only on chance distribution. It is used to diminish selection bias.... randomization

Poir.

Synonym: R. spinosa Poir. R. brandisii Gamble. R. longispina W. & A. R. tomentosa W. & A. non Blume. Xeromphis spinosa Keay.

Habitat: Assam, Naga and Khasi Hills, Travancore and the Andamans.

English: Common Emetic Nut.

Ayurvedic: Madana, Chhardana, Pindi, Shalayaka, Vishapushpaka.

Unani: Mainphal, Jauz-ul-Qai.

Siddha/Tamil: Marukkaaraikai, Madkarai.

Folk: Mainphal.

Action: Fruit—nervine, calmative, antispasmodic, emetic, anthelmintic, abortifacient. Used as a substitute for ipecacuanha.

The Ayurvedic Pharmacopoeia ofIn- dia recommends the dried fruit in chlorosis, common cold, rhinitis and obstinate skin diseases.

The activity of the drug is attributed to the presence of saponins which occur to the extent of 2-3% in fresh fruits and about 10% in dried whole fruit. The saponins are concentrated mostly in the pulp. A mixture of two saponins, viz. randialic or neutral saponin and randialic acid or acid saponin has been isolated from the pulp. On complete hydrolysis both the saponins yield oleanolic acid as sapogenin. Ursosaponin, isolated from the ethanolic extract of the dried whole fruit, gave ursolic acid and glucose. Randianin, isolated from the fruit, gave a haemolytic triterpe- noid saponin.

In experimental animals, the drug caused haemolysis both in vitro and in vivo. Crude saponin fraction showed haemolytic, molluscidal and immuno- stimulating activities.

Oleanolic acid 3-glucoside, isolated from the seed, exhibited anti-arthritic activity in exudative and proliferative phases of inflammation in rats.

Dosage: Fruit—0.5-1.0 g powder for decoction, 3-6 g for induction vomiting. (API, Vol. I.)... randia dumetorum

DC.

Synonym: Catunaregam uliginosa (Retz.) Sivarajan.

Family: Rubiaceae.

Habitat: Southern, Central and Eastern India, including Assam and Sikkim.

Ayurvedic: Pindaalu, Pinditaka.

Siddha/Tamil: Wagatta, Perunkarai.

Folk: Mainphal, Pindaar, Pendraa, Pendhar.

Action: Unripe fruit—astringent. Root—diuretic; used for biliousness, diarrhoea and dysentery

Unripe fruits are roasted and used as a remedy for dysentery and diarrhoea. The root, boiled in purified butter, is also prescribed for dysentery and diarrhoea.

The fruits, like those of Randia spinosa, contain a toxic saponin of oleanolic acid. They also contain leu- cocyanidin and mannitol. The flowers yield an essential oil similar to Gardenia oil.... randia uliginosa

In statistics, the difference between the largest and smallest values in a distribution. In common use, the span of values from smallest to biggest.... range

(Hebrew) A lovely singer; a queenly woman

Rania, Ranice, Ranique, Ranit, Ranica, Ranita, Ranite, Ranith, Ranitta, Raanee, Rane, Ranie... rani

(American) Form of Danielle, meaning “God is my judge” Ranele, Ranelle, Raniele, Raniela, Raniella, Raniel... ranielle

(Indian) Feminine form of Ranjit; a charming and delightful woman Ranjitah, Ranjyta, Ranjytah, Ranjeeta, Ranjeetah... ranjita

(Norse) A house woman Rannveig, Ranveiga, Ranveige, Ronnaug, Ronaug... ranveig

(Gaelic) Form of Rachel, meaning “the innocent lamb” Raonaide, Raonaida, Raonayd, Raonayde, Raonaild, Raonailde, Raonailda, Raoghnailt... raonaid

(French) Feminine form of Raoul; wolf counsel Raoula, Raula... raoule

(Hebrew) Feminine form of Raphael; the divine healer Rafaela, Rafaelia, Raffaella, Raffaela, Raffaele, Raffaella, Rafella, Rafelle, Raphaella, Raphaelle, Raphayella, Raphella, Refaella, Refella, Rephaela, Rephayelle... raphaela

(Hebrew) A tall, looming woman Rapha, Raphae, Raphia, Raphiah, Raphea, Rapheah... raphah

(Hebrew) One who has been healed by God

Raphoo, Raphou... raphu

(Spanish) Form of Rachel, meaning “the innocent lamb”

Racquel, Racquell, Raquela, Raquelle, Roquel, Roquela, Rakel, Rakell... raquel

Linn.

Family: Ranunculaceae.

Habitat: The Western Himalayas from Kashmir to Kumaon.

English: Corn Buttercup.

Folk: Chambul (Punjab). Gager- kanda (Kashmir).

Action: Used in intermittent fevers, asthma and gout.

The active principle of the herb is protoanemonin (0.54%) and its glyco- sidic precursor, ranunculin. The herb yields hydrocyanic acid in very small amounts.

The leaves contain the antifungal lactone protoanemonin which inhibited growth of Epidermophyton floccosum and the yeast Rhodotorula glutinis.... ranunculus arvensis

Linn.

Family: Ranunculaceae.

Habitat: The plains of northern India, and the warm valleys of the Himalayas from Kashmir to Assam.

English: Blister Buttercup, Celery- leaved Crowfoot.

Ayurvedic: Kaandira, Kaandakatu- ka, Naasaa-samvedana, Toyavalli, Sukaandaka.

Folk: Jal-dhaniyaa.

Action: Fresh Plant—highly acrid, rubefacient, vesicant and toxic; causes inflammation of the digestive tract. Used after drying or as a homoeopathic medicine for skin diseases.

The plant contains anemonin, pro- toanemonin, ranunculine, serotonin and other tryptamine derivatives.

Serotonin (5-hydroxytryptamine) is a potent vaso-constrictor. Pro- toanemonin possesses strong antibacterial, antiviral, cytopathogenic and vermicidal properties, and is effective against both Gram-positive and Gramnegative bacteria, similar to penicillic acid. It inhibits the growth of E. coli, Staphylococcus aureus and Candida al- bicans. It inactivates in vitro diptheria toxin.

Dosage: Whole plant—1-3 g powder. (CCRAS.)... ranunculus sceleratus

Chaix.

Synonym: R. aquatilis Linn. var. capillaceus DC.

Family: Ranunculaceae.

Habitat: Kashmir to Sikkim.

English: Water Crowfoot, Water Fennel.

Ayurvedic: Kaandira (var.).

Folk: Tohlab (Kashmir).

Action: Herb—used in intermittent fevers, rheumatism and asthma.

Ranunculus muricatus Linn. (Punjab and Kashmir) is used in intermittent fevers, gout and asthma in Europe. The herb is rubefacient, vesicant and narcotic.... ranunculus trichophyllus

(Arabic) Resembling a young gazelle Rashah, Raisha, Raysha, Rashia, Raesha... rasha

(Arabic) Feminine form of Rashid; a righteous woman; one who is guided in the right direction

Rasheda, Rasheeda, Rasheedah, Rasheida, Rashidah, Rashyda, Rachida, Raashida, Raashidah... rashida

(Indian) A sweet woman Rashmikah, Rashmyka, Rashmeeka, Rashmeika... rashmika

(Thai) Resembling a crystal Ratanah, Ratanna, Ratannah, Rathana, Rathanna... ratana

Review by a government or private agency of a hospital’s or health service’s budget and financial data, performed for the purpose of determining if the rates are reasonable of the rates and evaluating proposed rate increases.... rate review

Linn.

Family: Cruciferae; Brassicaceae.

Habitat: Cultivated in Uttar Pradesh, Punjab, Maharashtra and Gujarat.

English: Radish.

Ayurvedic: Muulaka, Laghu- muulaka, Muulakapotikaa, Visra, Shaaleya, Marusambhava. Pods— Sungraa, Singri, Mungraa.

Unani: Muuli, Turb Fajal.

Siddha/Tamil: Mullangi.

Action: Radish—preparations are used in liver, gallbladder and urinary complaints. Green leaves— diuretic and carminative. Seeds— diuretic, purgative, expectorant.

A decoction of dry radish is given orally in piles. Extract of the dry root is given for hiccough, influenza, dysentery, colic and urinary troubles.

Key application: In peptic disorders, especially those related to dyskinesia of the bile ducts; and in catarrhs of the upper respiratory tract. (German Commission E.)

The Ayurvedic Pharmacopoeia of India recommends the juice of the whole plant in sinusitis; juice of the root in diseases of the throat and sinusitis; and the seed in amenorrhoea, cough and dyspnoea.

The fleshy root and seeds contain trans-4-methyl-thiobutenyl isothio- cyanate glucoside (the pungent principle), cyanidin-5-glucoside-3-sophoro- side, pelargonidin diglycoside, cyani- din diglycoside, 5-methyl-L-cysteine- sulphoxide (methiin), steroidal sa- pogenins and sulphorophene.

The enzymes present in the radish are phosphatase, catalase, sucrase, amylase, alcohol dehydrogenase and pyruvic carboxylase.

Radish contains caffeic acid and fer- ulic acid which exhibit hepatoprotec- tive and choleretic properties. It contains choline which prevents deposition of fat in liver. Amino acids, or- nithine, citrulline, arginine, glutamic acid and asparatic acid remove toxins from the body and urea acumulation.

Radish is a good source of ascorbic acid (15-40 mg/100 g), trace elements include aluminium, barium, lithium, manganese, silicon, titanium, also iodine (upto 18 mcg/100 g) and ascor- bigen.

Roots, leaves, flowers and pods are active against Gram-positive bacteria.

The seeds are reported to contain a broad spectrum antibiotic, machro- lysin, specific against Mycobacterium tuberculosis. Raphanin, extracted from the seeds, is active against Grampositive and Gram-negative bacteria.

A purified basic protein, homologous to nonspecific lipid transfer proteins, from seeds showed antifungal activity.

Raphanus caudatus Linn., synonym R. sativus var. caudatus, is known as Rat-Tail Radish.

A native to Java, it is cultivated in northern and western India. The root is not used; pods, purple or violet in colour, are consumed for properties attributed to Raphanus sp. These are known as Mungraa or Sungraa.

Dosage: Whole plant-20-40 ml juice; root—15-30 ml juice. (API, Vol. II.) Seed—1-3 g powder. (API, Vol. III.)... raphanus sativus

This is characterised by the presence of rapid eye movements and a reduction in muscle tone. Cerebral cortical activity is prominent and its blood ?ow increased. This activity is, however, di?erent from wakefulness and may cause irregular movements of the body as well as of the eyes. Most dreams occur in REM sleep: these may represent a process of reorganising mental associations after the period of wakefulness. The analysis of the content of dreams has been subject to a variety of interpretations, but no consensus view has evolved.

Physiological changes, such as a fall in temperature and blood pressure, take place just before sleep and continue during the early stages of NREM sleep. There is an intrinsic rhythm of sleep which in most subjects has a periodicity of around 25 hours. This can be modi?ed by external factors to bring it into line with the 24-hour day. Two peaks of a tendency to sleep have been identi?ed, and these usually occur between around 14.00–18.00 hours, and 02.00–06.00 hours. There are, however, di?erences according to age, in that, for instance, infants sleep for most of the 24 hours; during adolescence there is also an increase in the duration of sleep. Sleep requirements fall later in life, but there are wide genetic di?erences in the amount of sleep that people require and also the time at which they fall asleep most readily.

The internal clock can be disturbed by a variety of external factors which include irregular sleeping habits due, for instance, to shift work or jet lag. Sleep is also more likely to occur after physical exertion, reading and social activity. The duration and intensity of exposure to light can also modify sleep profoundly. Light promotes wakefulness and is the main factor that adjusts the 25-hour internal rhythm to the 24hour daily cycle. Neural connections from the retina of the EYE act on an area in the brain called the supra-chiasmatic nucleus which stimulates the pineal gland which produces MELATONIN. This is thought to trigger the range of neurological and metabolic processes that characterise sleep.... rapid-eye-movement (rem) sleep

A method of paying health care providers in which the government establishes payment rates for all payers for various categories of health service.... rate setting

(Hindi) In Hinduism, goddess of passion and lust

Ratie, Ratea, Ratee, Raty, Ratey... rati

The value obtained by dividing one quantity by another: a general term of which rate, proportion, percentage, etc. are subsets. A ratio is an expression of the relationship between a numerator and a denominator where the two usually are separate and distinct quantities, neither being included in the other.... ratio

See “measurement scale”.... ratio scale

(Indian) As precious as a jewel Ratnah, Ratnia, Ratnea... ratna

(Indian) Born in the evening Ratrie, Ratry, Ratrey, Ratree, Ratrea... ratri

Protection, Money ... rattlesnake root

(English) Resembling the black bird; a dark and mysterious beauty Ravina, Rayvenne, Rayven, Rayvinn, Ravyn, Raevin, Raeven, Ravenne... raven

Calamus species

Description: The rattan palm is a stout, robust climber. It has hooks on the midrib of its leaves that it uses to remain attached to trees on which it grows. Sometimes, mature stems grow to 90 meters. It has alternate, compound leaves and a whitish flower.

Habitat and Distribution: The rattan palm is found from tropical Africa through Asia to the East Indies and Australia. It grows mainly in rain forests.

Edible Parts: Rattan palms hold a considerable amount of starch in their young stem tips. You can eat them roasted or raw. In other kinds, a gelatinous pulp, either sweet or sour, surrounds the seeds. You can suck out this pulp. The palm heart is also edible raw or cooked.

Other Uses: You can obtain large amounts of potable water by cutting the ends of the long stems (see Chapter 6). The stems can be used to make baskets and fish traps.... rattan palm

Benth. ex Kurz.

Family: Apocynaceae.

Habitat: The sub-Himalayas tract from Punjab to Nepal, Sikkim, Bhutan, Assam, Western Ghats and the Andamans.

English: Rauvolfia root, Serpentina Root, Indian Snakeroot.

Ayurvedic: Sarpagandhaa of Ayurvedic texts was not the Sarpagandhaa of modern medicine. (Sarpagandhaa was equated with Naakuli, Sarpach- hatrikaa and Varshaasu Chha- trikaaraa. Sarpagandhaa and Sarpasugandhaa were synonyms of Naakuli.)

Folk: Chhotaa Chaand.

Action: Root—decoction is employed to increase uterine contractions and for expulsion of foetus in difficult cases. The total alkaloidal extract of the root induces bradycardia, hypotension, sedation. It finds application in hypochondria, neuropsychi- atric disorders, psychosis and schizophrenia.

Key application: In mild, essential hypertension (borderline hypertension, especially with elevated tension of the sympathetic nervous system, for example, sinus tachycardia, anxiety, tension and psychomotor irritation, when dietetic measures alone are not sufficient. (German Commission E.)

(Average daily dose: 600 mg drug corresponding to 6 mg total alkaloid.) Treatment is usually administered with a diuretic to prevent fluid retention which may develop if Rauvolfia root is given alone. (WHO.) Contraindicated in depression, bleeding disorders, gastric and duodenal ulcers. (Sharon M. Herr.) Also contraindicated in pregnancy, since it has both teratogenic and abortifacient potential. (Francis Brinker.)

The root and root bark are rich in alkaloids, the most important being reserpine, others, around 30, which include ajmaline, ajmalicine (raubasine), ajmalicine, yohimbine, coryanthine, iso-ajmaline, neo-ajmaline, papaver- ine, raubasine, rauwolscine, rescin- namine, reserpine, sarpagine, serpentine, serpentinine, serpinine and de- serpidine.

Reserpine is hypotensive and tranquilizer, used for certain forms of mental disorders. Ajmalicine (raubasine) and rescinnamine are also hypoten- sive and tranquilizer. Deserpidine is sedative, as well as hypotensive. Aj- maline exhibits antiarrhythmic activity.

A number of Rauvolfia species are found in India: R. beddomei Hook. f.; R. densiflora Benth ex Hook. f. (Himalayas, Khasi and Aka Hills; Western and Eastern Ghats); R. micrantha Hook. f; known as Malabar Rauvolfia, (Kerala, up to an altitude of 300 m)

The roots of R. beddomei contain ajmalicine, sarpagine and serpentine, but no reserpine. R. densiflora yielded 0.51% of total alkaloids (reserpine 0.01%). R. micrantha gave ajmalicine, raunamine, reserpiline, sarpagine, neosarpagine, in addition to reserpine.

(In classical Ayurvedic texts, Nakuli and Gandha-naakuli were included in compound formulations for mental diseases.)... rauvolfia serpentina

The entire set of information that has been collected, before any cleaning, editing or statistical manipulation begins.... raw data

(Arabic) One who works the earth; a gardener

Rawda, Rawdha, Rawdhah... rawdah

(Arabic) One who recites ancient poetry

Rawiya, Rawiyya, Rawiyyah... rawiyah

(English) An elegant lady Rawni, Rawny, Rawney, Rawnee, Rawnea... rawnie

The margin flowers on a composite head, usually sterile, that resemble single petals. (Example: the white “petals” of a Daisy.)... ray flowers

(Israeli) A beloved friend Rayah... raya

(English) An innocent woman full of grace

Raeann, Raeanna, Raeanne, Rayana, Rayanna, Rayanne, Rayane, Raeane, Raeana, Raiann, Raiane, Raianne, Raianna, Raiana... rayann

(German) Feminine form of Raymond; one who offers wise protection Raymondi, Raymondie, Raymondee, Raymondea, Raymonda, Raymunde, Raymunda... raymonde

(Hebrew / Scandinavian) One who is pure / one who provides wise counsel Raynah, Raynee, Rayni, Rayne, Raynea, Raynie... rayna

Linn.

Synonym: R. canescens L.

Family: Apocynaceae.

Habitat: Abundant in moist and warm regions of West Bengal, particularly in 24 Parganas and Howrah, and Kerala (as a weed).

Folk: Badaa Chaand.

Action: Root—sedative, hypotensive. Plant juice, mixed with castor oil, is applied to skin diseases and to destroy parasites.

The plant contains a number of alkaloids, including rauvolscine, aj- malicine, canescine, reserpine, pseu- doyohimbine; yohimbine, corynan- thene, raunescine, iso-raunescine and recanescine.

The major alkaloid is rauwolscine (alpha-yohimbine), present in the root bark (0.1%), stem bark (0.2%) and leaves (0.5%).

The roots are often used as a substitute or adulterant of those of R. serpentina, though the reserpine content of the dried root was found to be comparatively low (0.03-0.05%).

Family: Linaceae.

Habitat: The Himalayas from Kashmir to Sikkim; commonly grown in gardens.

English: Winter-Flax, Yellow Flax.

Ayurvedic: Baasanti.

Folk: Abai (Maharashtra).

Action: Plant—used for the treatment of paralysis in Bihar. The crushed leaves and stems are applied to wounds infested with maggots.... rauvolfia tetraphylla

So called after Maurice Raynaud (1834–81), the Paris physician who published a thesis on the subject in 1862. This is a condition in which the circulation (see CIRCULATORY SYSTEM OF THE BLOOD) becomes suddenly obstructed in outlying parts of the body. It is supposed to be due to spasm of the smaller arteries in the affected part, as the result of them responding abnormally to impuilses from the SYMPATHETIC NERVOUS SYSTEM. Its effects are increased both by cold and by various diseases involving the blood vessels.

Symptoms The condition is most commonly con?ned to the occurrence of ‘dead ?ngers’ – the ?ngers (or the toes, ears, or nose) becoming white, numb, and waxy-looking. This condition may last for some minutes, or may not pass o? for several hours, or even for a day or two.

Treatment People who are subject to these attacks should be careful in winter to protect the feet and hands from cold, and should always use warm water when washing the hands. In addition, the whole body should be kept warm, as spasm of the arterioles in the feet and hands may be induced by chilling of the body. Su?erers should not smoke. VASODILATORS are helpful, especially the calcium antagonists. In all patients who do not respond to such medical treatment, surgery should be considered in the form of sympathectomy: i.e. cutting of the sympathetic nerves to the affected part. This results in dilatation of the arterioles and hence an improved blood supply. This operation is more successful in the case of the feet than in the case of the hands.... raynaud’s disease

The first is less severe, characterized by blanching spasms of blood vessels leading to the hands and feet, initiated by cold, moisture, even emotional stress and low blood sugar. Sort of a finger migraine. After the spasm relaxes, the tissue distal becomes red, hot, even painful. R. Disease is more serious and perhaps deriving from different causes as well. The spasms may not subside, the effected tissues can become purplish, and in extreme cases, gangrenous.... raynauds either syndrome or disease

(Arabic) One who’s thirst has been quenched Rayyah... rayya

(Hebrew) God’s secret; a mysterious woman

Razia, Razi, Raziela, Raziella, Razili, Raziella, Raziel, Raziele, Razie, Razee... raziah

(Swahili) A good-natured woman; one who is agreeable Raziyah... raziya

Red blood cells or erythrocytes... rbc

Stands for Royal College of Nursing.... rcn

These form an agreed UK thesaurus of health-care terminology named after the general practitioner who devised them initially in the 1970s. The coding system provides a basis for computerised clinical records that can be shared across professional and administrative boundaries. Such records have essential safeguards for security and con?dentiality. The codes accommodate the di?erent views of specialists, but use simple terms without any loss of the ?ne detail necessary in specialist terminology. The Read Codes are being merged with the world’s other leading coding and classi?cation system: the College of American Pathologists’ Systemised Nomenclature of Medicine (SNOMED-RT).... read codes

The re-entry of a person to a hospital or other health facility within a specified interval after discharge with the same diagnosis.... readmission

The proportion of a hospital’s patients (or a subset, such as those with asthma) who are readmitted to the hospital following discharge with the same diagnosis. It is used as a performance measure where a higher rate indicates lower quality of care.... readmission rate

As used by immunologists, this term refers to IgE antibodies. As used by microbiologists, it refers to antibodies produced in syphilis – probably in response to the tissue damage caused by Treponema pallidum. Production of these antibodies in patients with syphilis has been utilised in the development of the non-treponemal serological tests for syphilis such as the VDRL Test, the RPR Test and the now superceded Wasserman Complement Fixation Test. These tests are useful in that they are only positive in active syphilis but they have many biological false positive reactions, including pregnancy.... reaginic antibody

(Irish) Form of Rhiannon, meaning “the great and sacred queen” Reannah, Reanne, Reannon, Reanon, Reann, Reana, Reeanne, Reanan, Reannan... reanna

(Hebrew) Form of Rebecca, meaning “one who is bound to God” Rebah, Reeba, Rheba, Rebba, Ree, Reyba, Reaba... reba

(Hebrew) One who is bound to God; in the Bible, the wife of Isaac Rebakah, Rebbeca, Rebbecca, Rebbecka, Rebbie, Rebeca, Rebeccah, Rebeccea, Rebeccka, Rebecha, Rebecka, Rebeckah, Rebeckia, Rebecky, Rebeha, Rebeka, Rebekah, Rebekha, Rebekka, Rebekkah, Rebekke, Rebeque, Reveka, Revekah, Revekka, Ribecca, Rebi, Rimca... rebecca

See GENETIC ENGINEERING.... recombinant dna technology

Reconstructive surgery on the skin and underlying tissues that have been damaged or lost as a result of disease or injury. Congenital malformations are also remedied using reconstructive surgery. Surgeons graft healthy skin from another part of the body to repair skin damaged or destroyed by burns or injuries. New techniques are under development for growing new skin in the laboratory to be used in reconstructive surgery. Surgeons also repair damage using skin ?aps prepared in another part of the body – for example, a skin ?ap from the arm may be used to repair a badly injured nose or face. Reconstructive surgery is also used to repair the consequences of an operation for cancer of, say, the neck or the jaw. Plastic surgeons undertake cosmetic surgery to improve the appearance of noses, breasts, abdomens and faces.... reconstructive (plastic) surgery

See REPRESSED MEMORY THERAPY.... recovered memory syndrome

Pain in the rectum... rectalgia

Inflammation of the rectum... rectitis

See “cost”.... recurrent cost

A branch of the vagus NERVE which leaves the latter low down in its course, and – hooking around the right subclavian artery on the right side and round the arch of the aorta on the left

– runs up again into the neck, where it enters the larynx and supplies branches to the muscles which control the vocal cords.... recurrent laryngeal nerve

Spider found mostly in Australia and is similar to the Black Widow of America and the Button spider of South Africa. Belongs to the species Latrodectus hasseltii.... red back spider

See FIRST AID.... red cross

See Cebolla.... red onion

The appearance of a reddish-brown scum on the surface of the sea caused by dinoflagelates at certain times of the year when heat and other climatic conditions allow for vast expansion in their numbers. Unlike the dinoflagellates that cause PSP, they seems to cause no medical problem apart from irritation of the eyes (conjunctivitis), foul-tasting sea water, and leaving a rotting, unpleasant smell when they dry out on the beach.... red tide

The following are described under their separate dictionary entries: FAECES; HAEMORRHOIDS; FISTULA; DIARRHOEA; CONSTIPATION.

Imperforate anus, or absence of the anus, may occur in newly born children, and the condition is relieved by operation.

Itching at the anal opening is common and can be troublesome. It may be due to slight abrasions, to piles, to the presence of threadworms (see ENTEROBIASIS), and/or to anal sex. The anal area should be bathed once or twice a day; clothing should be loose and smooth. Local application of soothing preparations containing mild astringents (bismuth subgallate, zinc oxide and hamamelis) and CORTICOSTEROIDS may provide symptomatic relief. Proprietary preparations contain lubricants, VASOCONSTRICTORS and mild ANTISEPTICS.

Pain on defaecation is commonly caused by a small ulcer or ?ssure, or by an engorged haemorrhoid (pile). Haemorrhoids may also cause an aching pain in the rectum. (See also PROCTALGIA.)

Abscess in the cellular tissue at the side of the rectum – known from its position as an ischio-rectal abscess – is fairly common and may produce a ?stula. Treatment is by ANTIBIOTICS and, if necessary, surgery to drain the abscess.

Prolapse or protrusion of the rectum is sometimes found in children, usually between the ages of six months and two years. This is generally a temporary disorder. Straining at defaecation by adults can cause the lining of the rectum to protrude outside the anus, resulting in discomfort, discharge and bleeding. Treatment of the underlying constipation is essential as well as local symptomatic measures (see above). Haemorrhoids sometimes prolapse. If a return to normal bowel habits with the production of soft faeces fails to restore the rectum to normal, surgery to remove the haemorrhoids may be necessary. If prolapse of the rectum recurs, despite a return to normal bowel habits, surgery may be required to rectify it.

Tumours of small size situated on the skin near the opening of the bowel, and consisting of nodules, tags of skin, or cauli?ower-like excrescences, are common, and may give rise to pain, itching and watery discharges. These are easily removed if necessary. Polypi (see POLYPUS) occasionally develop within the rectum, and may give rise to no pain, although they may cause frequent discharges of blood. Like polypi elsewhere, they may often be removed by a minor operation. (See also POLYPOSIS.)

Cancer of the rectum and colon is the commonest malignancy in the gastrointestinal tract: around 17,000 people a year die from these conditions in the United Kingdom. Rectal cancer is more common in men than in women; colonic cancer is more common in women. Rectal cancer is a disease of later life, seldom affecting young people, and its appearance is generally insidious. The tumour begins commonly in the mucous membrane, its structure resembling that of the glands with which the membrane is furnished, and it quickly in?ltrates the other coats of the intestine and then invades neighbouring organs. Secondary growths in most cases occur soon in the lymphatic glands within the abdomen and in the liver. The symptoms appear gradually and consist of diarrhoea, alternating with attacks of constipation, and, later on, discharges of blood or blood-stained ?uid from the bowels, together with weight loss and weakness. A growth can be well advanced before it causes much disturbance. Treatment is surgical and usually this consists of removal of the whole of the rectum and the distal two-thirds of the sigmoid colon, and the establishment of a COLOSTOMY. Depending upon the extent of the tumour, approximately 50 per cent of the patients who have this operation are alive and well after ?ve years. In some cases in which the growth occurs in the upper part of the rectum, it is now possible to remove the growth and preserve the anus so that the patient is saved the discomfort of having a colostomy. RADIOTHERAPY and CHEMOTHERAPY may also be necessary.... rectum, diseases of

(English) From the red meadow Redel, Redelle, Redele, Redella, Redela... redell

(American) Feminine form of Redmond; one who offers wise protection Redmondi, Redmondie, Redmondee, Redmondea, Redmonda, Redmunde, Redmunda... redmonde

Blood sucking hemipterans found in Latin America and which serve as vectors for Trypanosoma cruzi, the cause of Chagas’ Disease. These insects are also known as ‘cone nose bugs’, ‘assassin bugs’ or ‘triatomids’. They belong to the family Reduviidae and the genera Rhodnius and Triatoma, Panstrongylus amongst others.... reduviid bugs

Colloquial term for red tide. Contrary to the popular belief this has nothing to do with the spawning of the reef seen at set times of the year.... reef spawn

The base population from which a sample is drawn at the time of initial sampling. The standard against which a population that is being studied can be compared. See “population”.... reference population

The direction of people to an appropriate facility, institution or specialist in a health system, such as a health centre or a hospital, when health workers at a given level cannot diagnose or treat certain individuals by themselves, or face health or social problems they cannot solve by themselves.... referral

Trifolium pratense. N.O. Leguminosae.

Synonym: Purple Clover, Trefoil.

Habitat: Fields and roadsides.

Features ? This is the common clover of the field, long cultivated by the farmer, and is found growing to a height of one foot or more. The leaves, composed of three leaflets, grow on alternate sides of the stem. The leaflets themselves are broad, oval, pointed, and frequently show a white spot. The stem is hairy and erect, and the red (or, perhaps, purplish-pink) flower-heads (the part of the plant employed in herbal practice) are formed by a large number of separate blossoms at the end of a flower stalk. Both taste and odour are agreeable.

Action: Alterative and sedative.

The infusion (1 ounce to 1 pint of boiling water, which may be drunk freely) makes a reliable medicine for bronchial and spasmodic coughs. The alterative character is best brought out in combination with such agents as Burdock and Blue Flag.

Fernic writes of Red Clover ? "The likelihood is that whatever virtue the Red

Clover can boast for counteracting a scrofulous disposition, and as antidotal to cancer, resides in its highly-elaborated lime, silica, and other earthy salts."... red clover

Red Ginseng Tea is extracted from a human-shaped perennial plant originating from China and Korea, where its root has been used in traditional medicine for thousands of years. The Chinese considered that ginseng tea had the power to prolong life and cure a variety of diseases. Red ginseng teais obtained from the unpeeled dried ginseng root which has undergone a steaming process and thus turned reddish-brown. Red Ginseng Tea brewing The red ginseng tea steeping process requires a minimum of five minutes which allows the extraction of the best ingredients from the plant root with healing properties. The ideal brewing temperature is eighty degrees Celsius. It is best served with honey. Red Ginseng Tea health benefits For centuries, red ginseng tea has been used to raise mental alertness and avert tiredness. The root of the plant is full of beneficial minerals and vitamins, as well as essential oils and natural enzymes. Red ginseng tea has both a stimulating and calming effect on the mind, it reduces stress, it improves blood circulation, digestion and the respiratory function. In addition, the immune system is strenghtened. Red ginseng tea consumption is also related to an increased metabolic rate, which leads to a faster weight loss process. Furthermore, research shows that one of the health benefits of red ginseng tea includes its cancer-preventive properties and its potential ability to treat Lyme disease. Red Ginseng Tea side effects Red Ginseng Tea is generally known to have no or only mild side effects which are usually the result of excessive tea consumption - it is therefore advisable to have a moderate tea intake and to seek advice from a health expert first. Some of these side effects include insomnia, nausea, headaches, anxiety, high or low blood pressure, irregular heartbeat or digestive problems. It is not recommended to consume red ginseng tea along with other medication, because it can interact with it and lead to unpleasant side effects. The consumption of red ginseng tea should mainly be avoided by children, pregnant women, people with diabetes, blood pressure poblems or those affected by prostate, uterine, ovarian or breast cancer. Red Ginseng Tea is sweet, tasty and has a stimulating effect, giving you the boost you need throughout the day. You can now enjoy a delightful cup of tea and benefit from its tremendously positive effects.... red ginseng tea

Salvia officinalis. N.O. Labiateae.

Synonym: Garden Sage.

Habitat: Cultivated in gardens.

Features ? Stem and leaves reddish, grows up to about twelve inches. Stem quadrangular, slightly hairy. Leaves stalked, oblong-lanceolate, rounded at ends, crenulate at margins, reticulated both sides. Flowers labiate, reddish-purple. Taste, powerfully aromatic.

Part used ? Leaves.

Action: Aromatic, astringent, tonic, stomachic.

In the treatment of laryngitis, inflammation of throat and tonsils, and ulceration of mouth and throat. The 1 ounce to 1 pint infusion in frequent wineglass doses is given as an internal medicine, the gargle and mouth wash being made as follows ? Pour 1 pint of hot malt vinegar on to 1 ounce of the Red Sage leaves, adding 1/2 pint of cold water.

Both Red Sage and the green-leaved variety are extensively used in the kitchen as a flavouring and digestive,

Red Sage will also tend to darken grey hair—see "Toilet Recipes."... red sage

Fluid ?owing in the opposite direction to normal (i.e. back ?ow). Often refers to regurgitation of stomach contents into the OESOPHAGUS (see also OESOPHAGUS, DISEASES OF), or of urine from the URINARY BLADDER back into the ureters (see URETER).... reflux

A purposeful, dynamic process that involves systematic policy, structural and process changes and is aimed at achieving desired goals.... reform

(Spanish) Feminine form of Refugio; one who is sheltered; protected Refugiah, Refugiya, Refugiyah, Refugea, Refugeah... refugia

(Gaelic) Born into royalty; the little ruler... regan

One of the simplest forms of activity of the nervous system. (For the mechanism upon which it depends, see NERVOUS SYSTEM; NEURON(E).) Re?ex acts are divided usually into three classes.

Super?cial re?exes comprise the sudden movements which result when the skin is brushed or pricked, such as the movement of the toes that results from stroking the sole of the foot.

Deep re?exes depend upon the state of mild contraction in which muscles are constantly maintained when at rest, and are obtained, as in the case of the knee-jerk (see below), by sharply tapping the tendon of the muscle in question.

Visceral re?exes are those connected with various organs, such as the narrowing of the pupil when a bright light is directed upon the EYE, and the contraction of the URINARY BLADDER when distended by urine.

Faults in these re?exes give valuable evidence as to the presence and site of neurological disorders. Thus, absence of the knee-jerk, when the patellar tendon is tapped, means some interference with the sensory nerve, nerve-cells, or motor nerve upon which the act depends – as, for example, in POLIOMYELITIS, or peripheral NEURITIS; whilst an exaggerated jerk implies that the controlling in?uence exerted by the BRAIN upon this re?ex mechanism has been cut o? – as, for example, by a tumour high up in the SPINAL CORD, or in the disease known as MULTIPLE SCLEROSIS (MS).... reflex action

(Latin) A queenly woman Regeena, Regena, Reggi, Reggie, Régine, Regine, Reginette, Reginia, Reginna, Rejine, Reginy... regina

See ANAESTHESIA – Local anaesthetics.... regional anaesthesia

See ILEITIS.... regional ileitis

See “database”.... register

Granulation is the forming of connective tissue fibroblasts, epithelium and inflammatory cells around the nucleus of new capillaries in tissues that have been burned or scraped. This delicate tissue is often reinjured, and regranulation becomes a slower process, with more formation of scar tissue. Some plant resins will quickly stimulate the process, increase the complexity of healing, and lessen fibroblast scar formation.... regranulation

A tool to estimate the relationships among a dependent variable Y and one (or many) independent variable(s) X. The purpose of regression analysis is to find the “best fit” data points from a straight line drawn on an XY graph.... regression analysis

Backflow of blood from the left ventricle of the heart (pumping arterial blood outwards to the aorta) into the left atrium (receiving oxygenated blood from the lungs) because of faulty closure of the mitral (bicuspid) valve that guards between the two chambers.... regurgitations, mitral

Backflow of blood from the right ventricle (pumping deoxygenated thick venous blood into the lungs) into the right atrium (receiving used blood from the rest of the body) because of faulty closure of the tricuspid valve that guards between the two chambers.... regurgitations, tricuspid

A hospital that specializes in providing restorative services to rehabilitate chronically ill and/or disabled individuals to a maximum level of functioning.... rehabilitation hospital

Professional sta? working in health care are registered with and regulated by several statutory bodies: doctors by the GENERAL MEDICAL COUNCIL (GMC); dentists by the GENERAL DENTAL COUNCIL; nurses and midwives by the Council for Nursing and Midwifery, formerly the UK Central Council for Nursing, Midwifery and Health Visiting (see NURSING); PHARMACISTS by the Royal Pharmaceutical Society; and the professions supplementary to medicine (chiropody, dietetics, medical laboratory sciences, occupational therapy, orthoptics, physiotherapy and radiography) by the Council for Professions Supplementary to Medicine. In 2002, the Council for the Regulation of Health Care Professions was set up as a statutory body that will promote cooperation between and give advice to existing regulatory bodies, provide a quality-control mechanism, and play a part in promoting the interests of patients. The new Council is accountable to a Select Committee of Parliament and is a non-ministerial government department similar in status to the FOOD STANDARDS AGENCY. It has the right to scrutinise the decisions of its constituent bodies and can apply for judicial review if it feels that a judgement by a disciplinary committee has been too lenient.... regulation of health professions

A service designed to improve function and/or prevent deterioration of functioning. Such services may include physical therapy, occupational therapy, and/or speech therapy. They may be provided at home, in a hospital or in a long-term care facility.... rehabilitation service

A process of being assisted to regain a lost capacity, or to return to a previous level of living skills.... rehabilitative

(Armenian) Resembling a flower Rehane, Rehann, Rehanne, Rehana, Rehanna, Rehanan, Rehannan, Rehania, Rehanea, Rehaniya... rehan

(African) A compassionate woman Rehemah, Rehemma, Rehemia, Rehemiya, Rehemea... rehema

(Hebrew) From the city by the river

Rehobothe, Rehobotha, Rehobothia... rehoboth

(Japanese) One who is thankful Rei... reiko

1 The process by which health care providers receive payment for their services. Because of the nature of the health care environment, providers are often reimbursed by third parties who insure and represent patients/clients. 2 The process whereby patients/clients receive payment for services used, most often through health insurance.... reimbursement

Cladonia rangiferina

Description: Reindeer moss is a low-growing plant only a few centimeters tall. It does not flower but does produce bright red reproductive structures.

Habitat and Distribution: Look for this lichen in open, dry areas. It is very common in much of North America.

Edible Parts: The entire plant is edible but has a crunchy, brittle texture. Soak the plant in water with some wood ashes to remove the bitterness, then dry, crush, and add it to milk or to other food.... reindeer moss

(Teutonic) A wise and strong ruler Reinhelde, Reinhelda, Reinhold, Reinholde, Reinholda... reinheld

A mechanism whereby an insurer can cover high-risk losses through insurance from another insurer.... reinsurance

(Wight) Ding Hou.

Synonym: Hippocratea grahamii Wight.

Pristimera grahamii A. C. Smith.

Family: Celastraceae; Hip- pocrateaceae.

Habitat: Konkan, and the South Andamans.

Folk: Danshir, Daushir, Lokhandi, Yesti, Zerwati (Maharashtra).

Action: Root—used for the treatment of respiratory affections, common cold and influenza.

The roots contain about twice the amount of pristimerin as in R. indica and show similar antibiotic properties. Pristimerin is found active against Streptococcus viridans, causative organism for sore throat and tonsilitis, and S. pyogenes.... reissantia grahamii

A condition probably caused by an immunological response to a virus (see IMMUNITY), in which the patient has URETHRITIS, ARTHRITIS and conjunctivitis (see under EYE, DISORDERS OF). The skin may also be affected by horny areas which develop in it. The disorder was ?rst described by a German physician, H. Reiter (1881–1969); it is more common in men than in women, and is the most common cause of arthritis in young men. It usually develops in people who have a genetic predisposition for it: around 80 per cent of sufferers have the HLA B27 tissue type. Treatment is symptomatic with ANALGESICS and NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS). (See also REACTIVE ARTHRITIS.)... reiter’s syndrome

(Indian) One who walks a straight line

Rekhah, Reka, Rekah... rekha

... relating to, containing or resembling serum.

The ratio of the risk of disease or death among the exposed to the risk among the unexposed; this usage is synonymous with risk ratio.... relative risk

Halle.

Synonym: Hippocratea indica Willd. Pristimera indica A. C. Smith.

Family: Celastraceae; Hippo- crateaceae.

Habitat: North-eastern India.

Siddha/Tamil: Odangod.

Folk: Kazurati, Tirruli (Maharashtra), Atari-lataa, Kathapahaariaa, Lokhandi (Bengal).

Action: Root bark—used for the treatment of respiratory troubles. Stem—febrifuge. Leaves—scorched and given to women during confinement. Powdered leaves and roots are applied to sores and wounds.

The roots contain dulcitol. The root bark contains an antibiotic principle, pristimerin (0.1%) which shows considered in vitro activity against several Gram-positive cocci, both haemolyt- ic and non-haemolytic. Pristimerin also inhibits in vitro growth of different strains of Mycobacterium tuberculosis. Clinical trials have shown that pristimerin is effective in the treatment of inflammatory conditions of the naso-pharyngeal mucosa resulting from common cold and influenzal infections. It is found useful as an adjunct to the common antibiotic therapy of respiratory inflammations of both bacterial and viral origin, and is reported to possess antitumour properties, but its high toxicity precludes its use as a cancero-static agent.... reissantia indica

The idea of a marriage-guidance council came from a group of doctors, clergy and social workers who were concerned for the welfare of marriage. It is based upon two major concepts: that marriage provides the best possible way for a man and woman to live together and rear their children; and that the counsellors share a basic respect for the unique personality of the individual and his (or her) right to make his (or her) own decisions. The organisation consists of between 120 and 130 Marriage Guidance Councils throughout the country, comprising about 1,250 counsellors. These Councils are a?liated to Relate National Marriage Guidance, which is responsible for the selection, training and continued supervision of all counsellors. Anyone seeking help can telephone or write for an appointment. No fees are charged, but those receiving help are encouraged to donate what they can.... relate marriage guidance

The degree of stability exhibited when a measurement is repeated under identical conditions. Reliability refers to the degree to which the results obtained by a measurement procedure can be replicated. Lack of reliability may arise from divergences between observers or instruments of measurement, or instability of the attribute being measured.... reliability

(English) Form of Ella, meaning “from a foreign land” Rellah, Rela, Relah... rella

Rapid-eye-movement is a stage during SLEEP in which the eyes are seen to move rapidly beneath the lids and during which dreaming occurs. It occurs for several minutes at a time approximately every 100 minutes.... rem sleep

(Spanish) Feminine form of Remedio; assisted by God Remedy, Remedi, Remedie, Remedee, Remedey, Remedea... remedios

Treatment which aims to stimulate older people’s memories by means of old films, pictures, objects, music etc. It allows an older person to remember his or her life’s achievements and contribution and can enhance self-esteem.... reminiscence therapy

Beets (Beta vulgaris).

Plant Part Used: Root.

Dominican Medicinal Uses: Eaten raw, juiced or boiled for anemia, cysts, tumor, uterine fibroids.

Safety: Common food, generally considered safe.

Laboratory & Preclinical Data: In vivo: anti-inflammatory, anticarcinogenic (plant extract); antidiabetic, antihepatotoxic, anticarcinogenic, antioxidant, estrogenic, hypoglycemic, influenza-preventative (leaf).

Nutritional: carotenes, fiber, iron (root).

* See entry for Remolacha in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... remolacha

Access to a system or to information therein, typically by telephone or a communications network, by a user who is physically remote from the system. See “e-health”.... remote access

(Hebrew) Follower of the false god

Remphana, Remphane, Remphaine, Remphayn, Remphena, Remphaen, Remphaina, Remphayna, Remphaena... remphan

Schott.

Family: Araceae.

Habitat: Maharashtra, Karnataka.

Folk: Rukhaalu, Maanakand (Maharashtra). Lakshmanaa is a doubtful synonym

Action: Root—use for obstinate skin diseases and pruritus; also for disinfecting genitourinary tract and for promoting conception. Alocasia indica and Eulophia nuda are also known as Maanakanda in Indian medicine. Alocasia indica is used in Siddha medicine as an anti-inflammatory and diuretic herb.... remusatia vivipara

(French) Woman from the town of Rheims

Remi, Remie, Remmy, Remmi, Remmie, Remy, Remmey, Remey, Rhemy, Rhemmy, Remee, Remmee... remy

(Japanese) Resembling a water lily... ren

(Hebrew) One who sings a joyous song

Reena, Reene, Rina, Rinah, Rinna, Rinnah, Renna, Rennah... rena

Calculi relating to kidney... renal calculi

See KIDNEYS, DISEASES OF.... renal diseases

Inefficient functioning of the kidney, leading to death unless acute medical attention is available. Envenomation (especially snake bite) is a common cause, as well as a range of medical conditions, including infection..... renal failure (acute)

(French) One who has been reborn Ranae, Ranay, Ranée, Renae, Renata, Renay, Renaye, René, Rene, Reneisha, Renell, Renelle, Renie, Renisha, Renne, Rennie, Renny, Rhianaye, Rrenae, Renee, Rennay, Renate... renée

(Egyptian) In mythology, the personification of fortune... renenet

(Latin) A dignified woman Renetah, Renetta, Renettah... reneta

(Latin) One who stands firm; resistant

Reneeta, Renyta, Reneata, Renieta, Reneita... renita

Any disease of the kidney... renopathy

(Indian) Resembling fine grains of sand

Renukah, Renooka, Renookah, Renouka, Renoukah... renuka

See UPPER LIMB DISORDERS.... repetitive strain injury (rsi)

(Hebrew) One who offers support

Rephidima, Rephydim, Rephydima, Rephidem, Rephydem, Rephedem... rephidim

Cabbage (Brassica oleracea variety capitata).

Plant Part Used: Leaves (cabbage head), juice from leaves.

Dominican Medicinal Uses: Leaves: eaten raw, juiced, cooked, as a soup, taken internally for treating obesity, diabetes, heart disease, gynecological conditions (uterine fibroids), intestinal parasites or for nutrition; fresh leaves used externally for wound-healing.

Safety: Considered safe; widely consumed; shown to be nontoxic in animal studies.

Contraindications: Thyroid conditions (may interfere with thyroid iodine absorption).

Drug Interactions: Prothrombopenic anticoagulants (may be antagonized); hypothyroid drugs (may interfere).

Laboratory & Preclinical Data: In vivo: antitumor, antiulcer (plant extracts).

Nutrition: calcium, vitamins K and U.

* See entry for Repollo in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... repollo

Also called recovered memory syndrome, this treatment was developed in the wake of the widespread exposure in the 1980s and 90s of the frequency of child sexual abuse. A controversial concept emerged in the USA, picked up later by some experts in the UK, that abused children sometimes suppress their unpleasant memories, and that subsequent PSYCHOTHERAPY could help some victims to recover these memories – thus possibly aiding rehabilitation. This recall of ‘repressed’ memories, however, was believed by some psychiatrists to be, in e?ect, a false memory implanted into the victim’s subconscious by the psychotherapy itself – or perhaps invented by the individual for personal motives.

In 1997 the Royal College of Psychiatrists in the UK produced a comprehensive report which was sceptical about the notion that the awareness of recurrent severe sexual abuse in children could be pushed entirely out of consciousness. The authors did not believe that events could remain inaccessible to conscious memory for decades, allegedly provoking vague non-speci?c symptoms to be recovered during psychotherapy with resolution of the symptoms. Supporting evidence pointed to the lack of any empirical proof that unconscious dissociation of unpleasant memories from conscious awareness occurred to protect the individual. Furthermore, experimental and natural events had shown that false memories, created through suggestion or in?uence, could be implanted. Many individuals who had claimed to have recovered memories of abuse subsequently withdrew and, often, non-speci?c symptoms allegedly linked to suppression worsened rather than improved as therapy to unlock memories proceeded. The conclusion is that recovered memory therapy should be viewed with great caution.... repressed memory therapy

In medicine, the collation and assessment of existing facts and knowledge, and the critical systematic investigation of the normal and abnormal functioning of the body, along with the EPIDEMIOLOGY of diseases and disorders affecting it – the aim being to increase the sum of knowledge in respect of the prevention, diagnosis and treatment of disease.

Ethics of research Although Britain has had legislation governing aspects of research on animals since the 19th century, there is no over-arching statute regulating research on humans and human material. Such activity is covered in law by the vaguely de?ned common-law concept of consent, and by piecemeal legislation such as the DATA PROTECTION ACT 1998 and the HUMAN FERTILISATION & EMBRYOLOGY ACT 1990. Nevertheless, extensive and very detailed ethical guidance on aspects of research has been published by a wide range of national and international organisations (see ETHICS COMMITTEES). Several basic principles feature in all statements about research ethics: these include the importance of ensuring that research is independently and rigorously scrutinised by appropriately constituted ethics committees; verifying that any risk to the research subject is reasonable in relation to the anticipated bene?t; and ensuring that all e?orts are made to minimise possible harm. The research subject’s willingness to tolerate some risk does not relieve researchers of the responsibility of making sure that all risks are kept to a minimum. Above all, a key feature of ethical research has involved seeking informed consent from research participants. This rule, initially applied to actual involvement by human subjects in research, has gradually been extended to include seeking informed consent from patients or from their relatives to the use of data and to the use of human organs and tissue in research, including after POST-MORTEM EXAMINATION. (See also EVIDENCE-BASED MEDICINE.)... research

The procedures and methods, including ethical considerations, predetermined by an investigator, to be adhered to in conducting a research project.... research design

(Latin) Resembling the mignonette flower

Resedah, Reselda, Resedia, Reseldia... reseda

(Hebrew) From the head of the stream; refers to a bridle... resen

An animal species which carries a pathogen without detriment to itself and serves as a source of infection. Host which acts as a reservoir of the infection in nature.... reservoir host

Any human beings, animals, arthropods, plants, soil, or inanimate matter in which an infectious agent normally lives and multiplies and on which it depends primarily for survival, reproducing itself in such manner that it can be transmitted to a susceptible host.... reservoir of infectious agent

Research misconduct is de?ned as behaviour by a researcher that falls short of good ethical and scienti?c standards – whether or not this be intentional. For example, the same data may be sent for publication to more than one medical journal, which might have the e?ect of their being counted twice in any META-ANALYSIS or systematic review; or the data may be ‘salami sliced’ to try to make the maximum number of publications, even though the data may overlap. Fraud in the context of research is de?ned as the generation of false data with the intent to deceive. It is much less frequent than carelessness, but its incidence is estimated as between

0.1 and 1 per cent. A ?gure of 1 per cent means that, in the United Kingdom at any one time, maybe 30 studies are being conducted, or their results published, which could contain false information. Examples include forged ethics-committee approval, patient signatures and diary cards; fabricated ?gures and results; invention of non-existent patient subjects; or sharing one electrocardiogram or blood sample amongst many subjects.

Research fraud should be ?rst suspected by a clinical-trial monitor who recognises that data are not genuine, or by a quality-assurance auditor who cannot reconcile data in clinical-trial report forms with original patient records. Unfortunately, it often comes to light by chance. There may be suspicious similarities between data ostensibly coming from more than one source, or visits may have been recorded when it was known that the clinic was shut. Statistical analysis of a likely irregularity will frequently con?rm such suspicion. The motivation for fraud is usually greed, but a desire to publish at all costs, to be the original author of a medical breakthrough, to bolster applications for research grants, or to strengthen a bid for more departmental resources are other recognised reasons for committing fraud.

In the USA, those proved to have committed fraud are debarred from receiving federal funds for research purposes or from undertaking government-funded therapeutic research. The four Nordic countries (Denmark, Finland, Norway and Sweden) have committees on research dishonesty that investigate all cases of suspected research misconduct. In the United Kingdom, an informal system operated by the pharmaceutical industry, using the disciplinary mechanism of the General Medical Council (GMC), has led to more than 16 doctors in the past ten years being disciplined for having committed research fraud. Editors of many of the world’s leading medical journals have united to form the Committee on Publishing Ethics, which advises doctors on proper practice and assists them in retracting or refusing to publish articles found or known to be false. (See ETHICS; ETHICS COMMITTEES.) Where an author does not o?er a satisfactory explanation, the matter is passed to his or her institution to investigate; where an editor or the committee is not satis?ed with the result they may pass the complaint to the appropriate regulatory body, such as the GMC in Britain.... research fraud and misconduct

Linn.

Family: Resedaccae.

Habitat: Indigenous to western Europe; grown in gardens in India.

English: Dyer's Rocket, Weld.

Action: Plant—diuretic, diaphoretic, anthelmintic.

A luteolin glucoside, luteoloside, has been isolated from the fresh blossoms and outer parts of the plant. It has a low toxicity and mild influence on capillary resistance and possesses diuretic properties.

Reseda odorata Linn., known as Mignonette, is indigenous to North Africa and cultivated in gardens in India.

The herb is reported to allay irritation and ease pains. The seeds are applied externally as a resolvent. The... reseda luteola

(Arabic) Having silky skin Reshmah, Reshman, Reshmane, Reshmann, Reshmanne, Reshmana, Reshmanna, Reshmaan, Reshmia, Reshmea... reshma

An instrument which assesses recipient’s care needs. It has a number of classification levels, ranging from high to low care. These classification levels are sometimes used for placement, staffing level and reimbursement purposes.... resident classification instrument

A contribution paid by residents toward the cost of their accommodation and care in a facility.... resident contribution

See “residential care”; “assisted living facility”.... residential aged care facility

Provides accommodation and other care, such as domestic services (laundry, cleaning), help with performing daily tasks (moving around, dressing, personal hygiene, eating) and medical care (various levels of nursing care and therapy services). Residential care is for older people with physical, medical, psychological or social care needs which cannot be met in the community.... residential care

Accommodation and support for people who can no longer live at home.... residential care services

A new hormone (see HORMONES) recently identi?ed by researchers in the United States. It links OBESITY to type 2 diabetes (see DIABETES MELLITUS – Non-insulin dependent diabetes mellitus (NIDDM)) and its name is based on its action – namely, resistance to INSULIN. This resistance is a hallmark of this type of diabetes and is manifested throughout the body. THIAZOLIDINEDIONE DRUGS, a new class of antidiabetic drugs that lower insulin resistance, are mediated by receptors which are abundant in fat cells, and the researchers claim to have identi?ed a fat-cell PROTEIN that may be responsible for this and which they believe to be a hormone; it was also found in high concentrations in diabetic mice.... resistin

The sum total of body mechanisms which interpose barriers to the progress of invasion or multiplication of infectious agents, or to damage by their toxic products. 1. Immunity - That resistance usually associated with possession of antibodies having a specific action on the microorganism concerned with a particular infectious disease or on its toxin. Passive immunity is attained either naturally, by maternal transfer, or artificially, by inoculation of specific protective antibodies (convalescent or immune serum or immune serum (gamma) globulin (human) and is of brief duration (days to months). Active immunity lasting months to years is attained either naturally, by infection, with or without clinical manifestations, or artificially, byinoculation of fractions or products of the infectious agent or of the agent itself, in killed, modified or variant form. 2. Inherent resistance - An ability to resist disease independently of antibodies or of specifically developed tissue response; it commonly rests in anatomic or physiologic characteristics of the host; it may be genetic or acquired, permanent or temporary.... resistance (host)

The lengthening and intensi?cation of sound produced by striking the body over an air-containing structure such as the lung. Decrease of resonance is called dullness and increase of resonance is called hyper-resonance. The process of striking the chest or other part of the body to discover its degree of resonance is called PERCUSSION, and according to the note obtained, an opinion can be formed as to the state of consolidation of air-containing organs, the presence of abnormal cavities, and the dimensions and relations of solid and air-containing organs lying together. (See also AUSCULTATION.)... resonance

A white, crystalline, antiseptic substance soluble in water, alcohol and oils. It can be used in combination with sulphur to treat ACNE.... resorcinol

Aiding reabsorption of blood from bruises... resorptive

The process of trying to attain the most rational use of manpower, knowledge, facilities and funds to achieve the intended purposes with the greatest effect with the least outlay.... resource management

Usually known as RSV, this is one of the MYXOVIRUSES. It is among the major causes of BRONCHIOLITIS and PNEUMONIA among infants aged under 6 months; its incidence has been increasing, possibly due to atmospheric pollution.... respiratory syncytial virus (rsv)

The diagnostic evaluation, management and treatment of the care of older persons with deficiencies and abnormalities of the cardiopulmonary (heart lung) system.... respiratory therapy

Services provided in the home, at a day care centre or by temporary placement in a nursing home or residential home to functionally disabled or frail individuals to provide occasional or systematic relief to informal caregivers.... respite care

The number of completed or returned survey instruments (questionnaires, interviews, etc) divided by the total number of persons who would have been surveyed if all had participated. Usually expressed as a percentage.... response rate

The habits determining the places and times of day or night that mosquitoes rest.... resting habits

Services provided to older people on a short-term basis to restore their physical condition to a level which would allow them to return home with appropriate support. See “rehabilitation”.... restorative care

Any method used to restrict the movement of a resident or part of the resident ‘s body in order to protect the resident or others from injury.... restraint

The act of restoring to life... resuscitative

See URINE RETENTION.... retention of urine

This consists of highly specialised cells scattered throughout the body, but found mainly in the SPLEEN, BONE MARROW, LIVER, and LYMPH nodes or glands. Their main function is the ingestion of red blood cells and the conversion of HAEMOGLOBIN to BILIRUBIN. They are also able to ingest bacteria and foreign colloidal particles.... reticulo-endothelial system

These are newly formed red blood corpuscles, in which a ?ne network can be demonstrated by special staining methods. Where a large number are present, one can infer that the patient is recovering from ANAEMIA – for example, after a previous bleed (HAEMORRHAGE) or as a result of treatment of iron de?ciency.... reticulocytes

See EYE, DISORDERS OF.... retina, disorders of

... retinoic acid

Period or life stage following termination of, and withdrawal from, regular employment.... retirement

A community which provides several levels/types of housing and services for older people, ranging from independent living units to nursing homes, on one site but generally in separate buildings.... retirement village / retirement community

An ABSCESS occurring in the cellular tissue behind the throat (PHARYNX). It is the result in general of disease in the upper part of the SPINAL COLUMN.... retropharyngeal abscess

A mock-humorous term used by doctors to imply that one can always see things more clearly after the event than at the time. One danger of making a judgement on the competence of a doctor treating a patient is that it is easier to know what was the right thing to have done once you know the end of the story.... retrospectoscope

(Hebrew) A feminine form of Reuel; a friend of God

Reuelah, Reuella, Reuellah, Reuelia, Reuelea, Reueliah, Reueleah... reuela

(Hebrew) One who has been exalted Reuma, Reumia, Ruemiah, Ruema, Ruemah... reumah

(Hebrew) A captivating woman Revekah, Revecka, Reveckah... reveka

The gross amount of earnings received by an entity for the operation of a specific activity. It does not include any deductions for such items as expenses, bad debts or contractual allowances.... revenue

An agent that prevents the action of the viral ENZYME, REVERSE TRANSCRIPTASE, so disrupting the virus’s colonisation of its target host. The reverse transcriptase inhibitor ZIDOVUDINE is used (in combination with other agents) to treat HIV infection.... reverse transcriptase inhibitor

(Latin) A queen full of grace Rexalla, Rexana, Rexanna, Rexane, Rexella, Rexetta, Rexina, Rexine... rexanne

(Spanish) A queenly woman Reyah, Reyeh, Reye, Reyia, Reyiah, Reyea, Reyeah... reya

A condition, now rare, which occurs predominantly in young children following a viral infection of the upper respiratory tract or a viral infection such as CHICKENPOX or INFLUENZA.

The cause is not known, but there is evidence that ASPIRIN may also play a part in its causation. Doctors recommend that children should be given PARACETAMOL in place of aspirin. The initial feature is severe, persistent vomiting and fever. This is followed by outbursts of wild behaviour, DELIRIUM and CONVULSIONS terminating in COMA and death, often from liver failure. The MORTALITY rate is around 23 per cent, and 50 per cent of the survivors may have persistent mental or neurological disturbances. The younger the patient, the higher the death rate and the more common the permanent residual effects. Since aspirin has no longer been licensed for use in children and young people the incidence of the condition has fallen dramatcally. Some cases, previously thought to be Reye’s syndrome, have subsequently turned out to have been due to certain inherited metabolic diseases and to be unconnected with aspirin.... reye’s syndrome

(Arabic) One who is favored by God Reyhann, Reyhane, Reyhanne, Reyhana, Reyhanna, Reyhanah, Reyhannah... reyhan

(Hungarian) Form of Theresa, meaning “a harvester”

Rezah, Rezia, Reziah, Rezi, Rezie, Rezy, Rezee, Resi, Resee, Resie, Resea, Resy, Resey, Rezea, Resea... reza

(Hebrew) As solid as a stone Rezepha, Rezephe, Rezephia, Rezephah, Rezephiah... rezeph

A muscular structure of three parts proximal bulb, narrow isthmus and distal body or corpus as in freeliving rhabditoids, parasitic oxyuroids, and free-living and non-infective stages of Strongyloides spp.... rhabditiform

A group of viruses which includes the RABIES virus.... rhabdoviruses

Edgew.

Family: Rhamnaceae.

Habitat: Western Himalayas from Simla to Kumaon at an altitude of 2,300 to 2,600 m.

English: Buckthorn (related species).

Action: Plant—anticonvulsant, anti-inflammatory, anti-ulcer.

The plant contains kaempferol, kaempferol-7-O-methyl ether and kaempferol-4'-O-methyl ether.

The ethyl acetate soluble portion of the alcoholic extract showed anti- nociceptive, anticonvulsant and anti- inflammatory activity. Kaempferol-4'- O-methyl ether was found to exhibit central nervous system depressant, cardiac stimulant, antispasmodic and anti-inflammatory activity

The plant also contain emodin, which exhibited cardiac and intestinal stimulant, central nervous system depressant and analgesic activity in experimental animals.... rhamnus procumbens

(Welsh) One’s destiny Rhane, Rhanne, Rhann, Rhanna, Rhana... rhan

(Burm. F.) Merr.

Family: Araceae.

Habitat: Deccan Peninsula, Coromandel Coast, Malabar and southwards to Sri Lanka.

Folk: Ganesh-kand (Maharashtra); Aaanaiittippili (Tamil Nadu).

Action: Antidote to poisonous inflictions; used against bites of poisonous raptiles.... rhaphidophora laciniata

(Welsh) A woman with long and coarse hair

Rhawne, Rhaun, Rhaune, Rhawna, Rhauna... rhawn

(African) A sweet-tempered woman

Rhaxmah, Rhaxima, Rhaxmia, Rhaxmana, Rhaxmae, Rhaxmai... rhaxma

(Greek) Of the flowing stream; in mythology, the wife of Cronus and mother of gods and goddesses Rea, Rhae, Rhaya, Rhia, Rhiah, Rhiya, Rheya... rhea

DC.

Synonym: Frangulapurshiana (DC) A. Grey.

Family: Rhamnaceae.

Habitat: Native to Europe; introduced in Kashmir, Himachal Pradesh, Bhutan and the Nilgiris.

English: Buckthorn (related species), Cascara Sagrada, Sacred Bark.

Action: Bark—stool-softener, non-habit forming stimulant laxative, pancreatic stimulant. Used for dyspepsia and habitual constipation.

Key application: In occasional constipation. (German Commission E, ESCOP, WHO.) As a stimulant laxative. (The British Herbal Pharmacopoeia.)

The bark contains up to 10% an- thraquinone glycosides, consisting of the cascarosides A, B, C and D, about 70% of the total; other glycosides in minor concentrations include barbaloin, frangulin, chrysanol, glycosides based on emodin, aloe-emodin, emodin- oxanthrone and chrysophanol; dianthrones, and free aglycones.

The cascarosides act on large intestines and stimulate peristalsis. The emodin exhibits antispasmodic activity in isolated rat intestine. Its anti- inflammatory and antiseptic action was also demonstrated.

Rhamnus catharticus Linn., is equated with common Buckthorn, R. purpurea Edgew. with Purple Buckthorn. R. purpurea is found in the Himalayas from Kashmir to Nepal.

Dried bark of Rhamnus frangula L. (Alder Buckthorn) and dried ripe berries of Ramnus catharticus are also used against constipation. (German Commission E, WHO.)

Long term use or excessive amounts may cause albuminuria, haematuria, slowing ofintestinal transit and cardiac irregularities. (Sharon M. Herr.)

Rhamnus triquetra Brandis (known as Gudlei, Fagoraa, Gardhan in Punjab; Gaunt in Garhwal and Kumaon and Katheraa in Jaunsar) is found in the Himalayas from Kashmir to Nepal. The bark is used as a tonic, astringent and deobstruent. Kaempferol, its 7-O- methyl ether and 4'-O-methyl ether, physcion-8 beta-D-glucoside, emodin and its 8 beta-D-glucoside were isolated from the whole plant. Emodin exhibited CNS depressant activity. (Fi- toterapia, 65, 1994.) The plant exhibited significant anti-inflammatory and a nonspecific antispasmodic activity. It induced cardio-stimulation which might be due to the endogenous release of catecholamines.

Rhamnus napalensis Wall. ex M. Laws. (known as Archal in Nepal; Biringa and Birringguli in Assam) is found in eastern Himalayas and the hills and plains ofAssam, Bihar, Orissa, Madhya Pradesh and northern Andhra Pradesh, ascending up to an altitude of 2,000 m. The fruit, pounded and macerated in vinegar, is prescribed for the treatment of herpes.... rhamnus purshiana

Roxb.

Family: Rhamnaceae.

Habitat: Throughout Himalayas, Khasi and Jaintia Hills, hills of Orissa, Madhya Pradesh, and the Nilgiris.

English: Indian Buckthorn.

Folk: Chhaduaa, Tadru (Punjab), Chadolaa (Garhwal).

Action: Ripe fruit—purgative, emetic. Given in the affections of spleen. (Purgative action not found in the bark.)

The bark showed only traces of hy- droxymethyl anthraquinones and did not exhibit purgative action on experimental animals.

The plant contains the enzyme, rhamnodiastase, capable of hydrolyz- ing flavonoid glycosides.... rhamnus virgatus

Wight & Arn.

Family: Rhamnaceae.

Habitat: Hills of Peninsular India, up to an altitude of 2,000 m.

Ayurvedic: Rakta-Rohidaa (a name applied to several other astringent herbs).

Action: Bark—bitter, astringent and deobstruent.

The leaves gave chrysophanol, phys- cion, musizin, lupeol, rhamnazin, rhamnocitrin, emodin, frangulin A and beta-sitosterol. A naphthalene- glucoside lactone—beta-sorigenin-1- O-beta-D-glucoside has been isolated from the stem bark. Cynodontin, chrysophanol, physcion, musizin, lu- peol, emodin, beta-syriogenin, beta- sitosterol and its glucoside were also isolated.... rhamnus wightii

(Latin) In mythology, a Vestal virgin and mother of Remus and Romulus Rhea Silva, Rea Silvia, Rea Silva... rhea silvia

(Anglo-Saxon) A divine woman; a goddess Rhedah... rheda

(Welsh) Resembling a fern Rhedynn, Rhedyne, Rhedynne, Rhedin, Rheden... rhedyn

(Hebrew) An affectionate woman Rhesah, Rhesia, Rhesiah, Rheza, Rhezah, Rhezia, Rheziah... rhesa

(Latin) Feminine form of Rhett; a well-spoken woman Rhetah, Retta, Rhetta... rheta