Means “fruit of (plant name)”; look up the plant name which follows this description of the plant part used.
In most people, deafness is a result of sensorineural hearing impairment, commonly known as nerve deafness. This means that the abnormality is located in the inner ear (the cochlea), in the auditory nerve, or in the brain itself. The prevalence of this type of hearing impairment rises greatly in elderly people, to the extent that more than 50 per cent of the over-70s have a moderate hearing impairment. In most cases no de?nite cause can be found, but contributory factors include excessive exposure to noise, either at work (e.g. shipyards and steelworks) or at leisure (loud music). Anyone who is exposed to gun?re or explosions is also likely to develop some hearing impairment: service personnel, for example.
Conductive hearing impairment is the other main classi?cation. Here there is an abnormality of the external or middle ear, preventing the normal transmission of sound waves to the inner ear. This is most commonly due to chronic otitis media where there is in?ammation of the middle ear, often with a perforation of the ear drum. It is thought that in the majority of cases this is a sequela of childhood middle-ear disease. Many preschool children suffer temporary hearing loss because of otitis media with e?usion (glue ear). Wax does not interfere with hearing unless it totally obstructs the ear canal or is impacted against the tympanic membrane. (See also EAR; EAR, DISEASES OF.)
Treatment Conductive hearing impairment can, in many cases, be treated by an operation on the middle ear or by the use of a hearing aid. Sensorineural hearing impairments can be treated only with a hearing aid. In the UK, hearing aids are available free on the NHS. Most NHS hearing aids are ear-level hearing aids – that is, they ?t behind the ear with the sound transmitted to the ear via a mould in the external ear. Smaller hearing aids are available which ?t within the ear itself, and people can wear such aids in both ears. The use of certain types of hearing aid may be augmented by ?ttings incorporated into the aid which pick up sound directly from television sets or from telephones, and from wire loop systems in halls, lecture theatres and classrooms. More recently, bone-anchored hearing aids have been developed where the hearing aid is attached directly to the bones of the skull using a titanium screw. This type of hearing aid is particularly useful in children with abnormal or absent ear canals who cannot therefore wear conventional hearing aids. People with hearing impairment should seek audiological or medical advice before purchasing any of the many types of hearing aid available commercially. Those people with a hearing impairment which is so profound (‘stone deaf’) that they cannot be helped by a hearing aid can sometimes now be ?tted with an electrical implant in their inner ear (a cochlear implant).
Congenital hearing loss accounts for a very small proportion of the hearing-impaired population. It is important to detect at an early stage as, if undetected and unaided, it may lead to delayed or absent development of speech. Otitis media with e?usion (glue ear) usually resolves spontaneously, although if it persists, surgical intervention has been the traditional treatment involving insertion of a ventilation tube (see GROMMET) into the ear drum, often combined with removal of the adenoids (see NOSE, DISORDERS OF). Recent studies, however, suggest that in many children these operations may provide only transient relief and make no di?erence to long-term outcome.
Advice and information on deafness and hearing aids may be obtained from the Royal National Institute for Deaf People and other organisations.... deafness
The start of ‘dehydration’ is signalled by a person becoming thirsty. In normal circumstances, the drinking of water will relieve thirst and serious dehydration does not develop. In a temperate climate an adult will lose 1.5 litres or more a day from sweating, urine excretion and loss of ?uid through the lungs. In a hot climate the loss is much higher – up to 10 litres if a person is doing hard physical work. Even in a temperate climate, severe dehydration will occur if a person does not drink for two or three days. Large losses of ?uid occur with certain illnesses – for example, profuse diarrhoea; POLYURIA in diabetes or kidney failure (see KIDNEYS, DISEASES OF); and serious blood loss from, say, injury or a badly bleeding ULCER in the gastrointestinal tract. Severe thirst, dry lips and tongue, TACHYCARDIA, fast breathing, lightheadedness and confusion are indicative of serious dehydration; the individual can lapse into COMA and eventually die if untreated. Dehydration also results in a reduction in output of urine, which becomes dark and concentrated.
Prevention is important, especially in hot climates, where it is essential to drink water even if one is not thirsty. Replacement of salts is also vital, and a diet containing half a teaspoon of table salt to every litre of water drunk is advisable. If someone, particularly a child, suffers from persistent vomiting and diarrhoea, rehydration therapy is required and a salt-andglucose rehydration mixture (obtainable from pharmacists) should be taken. For those with severe dehydration, oral ?uids will be insu?cient and the affected person needs intravenous ?uids and, sometimes, admission to hospital, where ?uid intake and output can be monitored and rehydration measures safely controlled.... dehydration
Dengue haemorrhagic fever This is a more severe form of the disease which usually occurs in young children; it is largely con?ned to the indigenous population(s) of south-east Asia. It is accompanied by signi?cant complications and mortality. Immunological status of the host is considered important in pathogenesis.... dengue
Doctors make the diagnosis of depression when they believe a patient to be ill with the latter condition, which may affect physical health and in some instances be life-threatening. This form of depression is common, with up to 15 per cent of the population suffering from it at any one time, while about 20 per cent of adults have ‘medical’ depression at some time during their lives – such that it is one of the most commonly presenting disorders in general practice. Women seem more liable to develop depression than men, with one in six of the former and one in nine of the latter seeking medical help.
Manic depression is a serious form of the disorder that recurs throughout life and is manifested by bouts of abnormal elation – the manic stage. Both the manic and depressive phases are commonly accompanied by psychotic symptoms such as delusions, hallucinations and a loss of sense of reality. This combination is sometimes termed a manic-depressive psychosis or bipolar affective disorder because of the illness’s division into two parts. Another psychiatric description is the catch-all term ‘affective disorder’.
Symptoms These vary with the illness’s severity. Anxiety and variable moods are the main symptoms in mild depression. The sufferer may cry without any reason or be unresponsive to relatives and friends. In its more severe form, depression presents with a loss of appetite, sleeping problems, lack of interest in and enjoyment of social activities, tiredness for no obvious reason, an indi?erence to sexual activity and a lack of concentration. The individual’s physical and mental activities slow down and he or she may contemplate suicide. Symptoms may vary during the 24 hours, being less troublesome during the latter part of the day and worse at night. Some people get depressed during the winter months, probably a consequence of the long hours of darkness: this disorder – SEASONAL AFFECTIVE DISORDER SYNDROME, or SADS – is thought to be more common in populations living in areas with long winters and limited daylight. Untreated, a person with depressive symptoms may steadily worsen, even withdrawing to bed for much of the time, and allowing his or her personal appearance, hygiene and environment to deteriorate. Children and adolescents may also suffer from depression and the disorder is not always recognised.
Causes A real depressive illness rarely has a single obvious cause, although sometimes the death of a close relative, loss of employment or a broken personal relationship may trigger a bout. Depression probably has a genetic background; for instance, manic depression seems to run in some families. Viral infections sometimes cause depression, and hormonal disorders – for example, HYPOTHYROIDISM or postnatal hormonal disturbances (postnatal depression) – will cause it. Di?cult family or social relations can contribute to the development of the disorder. Depression is believed to occur because of chemical changes in the transmission of signals in the nervous system, with a reduction in the neurochemicals that facilitate the passage of messages throughout the system.
Treatment This depends on the type and severity of the depression. These are three main forms. PSYCHOTHERAPY either on a one-to-one basis or as part of a group: this is valuable for those whose depression is the result of lifestyle or personality problems. Various types of psychotherapy are available. DRUG TREATMENT is the most common method and is particularly helpful for those with physical symptoms. ANTIDEPRESSANT DRUGS are divided into three main groups: TRICYCLIC ANTIDEPRESSANT DRUGS (amitriptyline, imipramine and dothiepin are examples); MONOAMINE OXIDASE INHIBITORS (MAOIS) (phenelzine, isocarboxazid and tranylcypromine are examples); and SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS) (?uoxetine – well known as Prozac®, ?uvoxamine and paroxetine are examples). For manic depression, lithium carbonate is the main preventive drug and it is also used for persistent depression that fails to respond to other treatments. Long-term lithium treatment reduces the likelihood of relapse in about 80 per cent of manic depressives, but the margin between control and toxic side-effects is narrow, so the drug must be carefully supervised. Indeed, all drug treatment for depression needs regular monitoring as the substances have powerful chemical properties with consequential side-effects in some people. Furthermore, the nature of the illness means that some sufferers forget or do not want to take the medication. ELECTROCONVULSIVE THERAPY (ECT) If drug treatments fail, severely depressed patients may be considered for ECT. This treatment has been used for many years but is now only rarely recommended. Given under general anaesthetic, in appropriate circumstances, ECT is safe and e?ective and may even be life-saving, though temporary impairment of memory may occur. Because the treatment was often misused in the past, it still carries a reputation that worries patients and relatives; hence careful assessment and counselling are essential before use is recommended.
Some patients with depression – particularly those with manic depression or who are a danger to themselves or to the public, or who are suicidal – may need admission to hospital, or in severe cases to a secure unit, in order to initiate treatment. But as far as possible patients are treated in the community (see MENTAL ILLNESS).... depression
Causes of degeneration are, in many cases, very obscure. In some cases heredity plays a part, with particular organs – for example, the kidneys – tending to show ?broid changes in successive generations. Fatty, ?broid, and calcareous degenerations are part of the natural change in old age; defective nutrition may bring them on prematurely, as may excessive and long-continued strain upon an organ like the heart. Various poisons, such as alcohol, play a special part in producing the changes, and so do the poisons produced by various diseases, particularly SYPHILIS and TUBERCULOSIS.... degeneration
Delirium (confusion) In some old people, acute confusion is a common e?ect of physical illness. Elderly people are often referred to as being ‘confused’; unfortunately this term is often inappropriately applied to a wide range of eccentricities of speech and behaviour as if it were a diagnosis. It can be applied to a patient with the early memory loss of DEMENTIA – forgetful, disorientated and wandering; to the dejected old person with depression, often termed pseudo-dementia; to the patient whose consciousness is clouded in the delirium of acute illness; to the paranoid deluded sufferer of late-onset SCHIZOPHRENIA; or even to the patient presenting with the acute DYSPHASIA and incoherence of a stroke. Drug therapy may be a cause, especially in the elderly.
Delirium tremens is the form of delirium most commonly due to withdrawal from alcohol, if a person is dependent on it (see DEPENDENCE). There is restlessness, fear or even terror accompanied by vivid, usually visual, hallucinations or illusions. The level of consciousness is impaired and the patient may be disorientated as regards time, place and person.
Treatment is, as a rule, the treatment of causes. (See also ALCOHOL.) As the delirium in fevers is due partly to high temperature, this should be lowered by tepid sponging. Careful nursing is one of the keystones of successful treatment, which includes ensuring that ample ?uids are taken and nutrition is maintained.... delirium
Treatment If organic disease is identi?ed, it should, where possible, be treated; otherwise the treatment of dementia is alleviation of its symptoms. The affected person must be kept clean and properly fed. Good nursing care in comfortable surroundings is important and sedation with appropriate drugs may be required. Patients may eventually need institutional care. (See ALZHEIMER’S DISEASE.)... dementia
The dependence that most concerns modern society is one in which individuals become dependent on or addicted to certain substances such as alcohol, drugs, tobacco (nicotine), caffeine and solvents. This is often called substance abuse. Some people become addicted to certain foods or activities: examples of the latter include gambling, computer games and use of the Internet.
The 28th report of the World Health Organisation Expert Committee on Drug Dependence in 1993 de?ned drug dependence as: ‘A cluster of physiological, behavioural and cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs) takes on a high priority. The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behaviour. Psychological dependence occurs when the substance abuser craves the drug’s desirable effects. Physical dependence occurs when the user has to continue taking the drug to avoid distressing withdrawal or abstinence symptoms. Thus, determinants and the problematic consequences of drug dependence may be biological, psychological or social and usually interact.’
Di?erent drugs cause di?erent rates of dependence: TOBACCO is the most common substance of addiction; HEROIN and COCAINE cause high rates of addiction; whereas ALCOHOL is much lower, and CANNABIS lower again. Smoking in the western world reached a peak after World War II with almost 80 per cent of the male population smoking. The reports on the link between smoking and cancer in the early 1960s resulted in a decline that has continued so that only around a quarter of the adult populations of the UK and USA smokes. Globally, tobacco consumption continues to grow, particularly in the developing world with multinational tobacco companies marketing their products aggressively.
Accurate ?gures for illegal drug-taking are hard to obtain, but probably approximately 4 per cent of the population is dependent on alcohol and 2 per cent on other drugs, both legal and illegal, at any one time in western countries.
How does dependence occur? More than 40 distinct theories or models of drug misuse have been put forward. One is that the individual consumes drugs to cope with personal problems or diffculties in relations with others. The other main model emphasises environmental in?uences such as drug availability, environmental pressures to consume drugs, and sociocultural in?uences such as peer pressure.
By contrast to these models of why people misuse drugs, models of compulsive drug use – where individuals have a compulsive addiction
– have been amenable to testing in the laboratory. Studies at cellular and nerve-receptor levels are attempting to identify mechanisms of tolerance and dependence for several substances. Classical behaviour theory is a key model for understanding drug dependence. This and current laboratory studies are being used to explain the reinforcing nature of dependent substances and are helping to provide an explanatory framework for dependence. Drug consumption is a learned form of behaviour. Numerous investigators have used conditioning theories to study why people misuse drugs. Laboratory studies are now locating the ‘reward pathways’ in the brain for opiates and stimulants where positive reinforcing mechanisms involve particular sectors of the brain. There is a consensus among experts in addiction that addictive behaviour is amenable to e?ective treatment, and that the extent to which an addict complies with treatment makes it possible to predict a positive outcome. But there is a long way to go before the mechanisms of drug addiction are properly understood or ways of treating it generally agreed.
Effects of drugs Cannabis, derived from the plant Cannabis sativa, is a widely used recreational drug. Its two main forms are marijuana, which comes from the dried leaves, and hashish which comes from the resin. Cannabis may be used in food and drink but is usually smoked in cigarettes to induce relaxation and a feeling of well-being. Heavy use can cause apathy and vagueness and may even cause psychosis. Whether or not cannabis leads people to using harder drugs is arguable, and a national debate is underway on whether its use should be legalised for medicinal use. Cannabis may alleviate the symptoms of some disorders – for example, MULTIPLE SCLEROSIS (MS) – and there are calls to allow the substance to be classi?ed as a prescribable drug.
About one in ten of Britain’s teenagers misuses volatile substances such as toluene at some time, but only about one in 40 does so regularly. These substances are given o? by certain glues, solvents, varnishes, and liquid fuels, all of which can be bought cheaply in shops, although their sale to children under 16 is illegal. They are often inhaled from plastic bags held over the nose and mouth. Central-nervous-system excitation, with euphoria and disinhibition, is followed by depression and lethargy. Unpleasant effects include facial rash, nausea and vomiting, tremor, dizziness, and clumsiness. Death from COMA and acute cardiac toxicity is a serious risk. Chronic heavy use can cause peripheral neuropathy and irreversible cerebellar damage. (See SOLVENT ABUSE (MISUSE).)
The hallucinogenic or psychedelic drugs include LYSERGIC ACID DIETHYLAMIDE (LSD) or acid, magic mushrooms, ecstasy (MDMA), and phencyclidine (PCP or ‘angel’ dust, mainly used in the USA). These drugs have no medicinal uses. Taken by mouth, they produce vivid ‘trips’, with heightened emotions and perceptions and sometimes with hallucinations. They are not physically addictive but can cause nightmarish bad trips during use and ?ashbacks (vivid reruns of trips) after use, and can probably trigger psychosis and even death, especially if drugs are mixed or taken with alcohol.
Stimulant drugs such as amphetamine and cocaine act like adrenaline and speed up the central nervous system, making the user feel con?dent, energetic, and powerful for several hours. They can also cause severe insomnia, anxiety, paranoia, psychosis, and even sudden death due to convulsions or tachycardia. Depression may occur on withdrawal of these drugs, and in some users this is su?ciently deterrent to cause psychological dependence. Amphetamine (‘speed’) is mainly synthesised illegally and may be eaten, sni?ed, or injected. Related drugs, such as dexamphetamine sulphate (Dexedrine), are prescribed pills that enter the black market. ECSTASY is another amphetamine derivative that has become a popular recreational drug; it may have fatal allergic effects. Cocaine and related drugs are used in medicine as local anaesthetics. Illegal supplies of cocaine (‘snow’ or ‘ice’) and its derivative, ‘crack’, come mainly from South America, where they are made from the plant Erythroxylon coca. Cocaine is usually sni?ed (‘snorted’) or rubbed into the gums; crack is burnt and inhaled.
Opiate drugs are derived from the opium poppy, Papaver somniferum. They are described as narcotic because they induce sleep. Their main medical use is as potent oral or injectable analgesics such as MORPHINE, DIAMORPHINE, PETHIDINE HYDROCHLORIDE, and CODEINE. The commonest illegal opiate is heroin, a powdered form of diamorphine that may be smoked, sni?ed, or injected to induce euphoria and drowsiness. Regular opiate misuse leads to tolerance (the need to take ever larger doses to achieve the same e?ect) and marked dependence. A less addictive oral opiate, METHADONE HYDROCHLORIDE, can be prescribed as a substitute that is easier to withdraw.
Some 75,000–150,000 Britons now misuse opiates and other drugs intravenously, and pose a huge public-health problem because injections with shared dirty needles can carry the blood-borne viruses that cause AIDS/HIV and HEPATITIS B. Many clinics now operate schemes to exchange old needles for clean ones, free of charge. Many addicts are often socially disruptive.
For help and advice see APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELF-HELP – National Dugs Helpline.
(See ALCOHOL and TOBACCO for detailed entries on those subjects.)... dependence
Individuals with dementia suffer a gradual deterioration of memory and of the ability to grasp what is happening around them. They often cover up their early failings and the condition may ?rst become apparent as a result of emotional outbursts or uncharacteristic behaviour in public. Eventually personal habits and speech deteriorate and they become thoroughly confused and di?cult to look after. Treatment is primarily a matter of ameliorating the symptoms, coupled with a sympathetic handling of the sufferer and the relatives. Admission to hospital or nursing home may be necessary if relatives are unable to look after the patient at home. (See also MEDICINE OF THE AGEING.)... senile dementia
Most important of such organs are the heart, which can be sustained by a few grains of Cayenne; the brain (Ginkgo, Skullcap, Kola); stomach (Peppermint); liver (Dandelion); spleen (New Jersey tea). See: LIFE DROPS.
When all desire for food has ceased, sips of honey-water or Balm tea sweetened with honey offer a comforting and sustaining support. ... death
Symptoms. Tremors, restlessness, nausea and sleep disturbance. The greater potency of the drug, the higher the rebound anxiety. Many drugs create stress, weaken resistance to disease, tax the heart and raise blood sugar levels.
Drugs like Cortisone cause bone loss by imperfect absorption of calcium. Taken in the form of milk and dairy products, calcium is not always absorbed. Herbs to make good calcium loss are: Horsetail, Chickweed, Slippery Elm, Spinach, Alfalfa.
Agents to calm nerves and promote withdrawal may augment a doctor’s prescription for reduction of drug dosage, until the latter may be discontinued. Skullcap and Valerian offer a good base for a prescription adjusted to meet individual requirements.
Alternatives. Teas: German Chamomile, Gotu Kola, Hops, Lime flowers, Hyssop, Alfalfa, Passion flower, Valerian, Mistletoe, Oats, Lavender, Vervain, Motherwort. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; half-1 cup thrice daily.
Decoctions: Valerian, Devil’s Claw, Siberian Ginseng, Lady’s Slipper. Jamaica Dogwood, Black Cohosh.
Tablets/capsules. Motherwort, Dogwood, Valerian, Skullcap, Passion flower, Mistletoe, Liquorice. Powders. Formulae. Alternatives. (1) Combine equal parts Valerian, Skullcap, Mistletoe. Or, (2) Combine Valerian 1; Skullcap 2; Asafoetida quarter. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily. Formula No 2 is very effective but offensive to taste and smell.
Practitioner. Tincture Nucis vom. once or twice daily, as advised.
Aloe Vera gel (or juice). Russians tested this plant on rabbits given heavy drug doses and expected to die. Their survival revealed the protective property of this plant: dose, 1 tablespoon morning and evening. Aromatherapy. Sniff Ylang Ylang oil. Lavender oil massage for its relaxing and stress-reducing properties.
Diet. Avoid high blood sugar levels by rejecting alcohol, white flour products, chocolate, sugar, sweets and high cholesterol foods.
Supplements. Daily. Multivitamins, Vitamin B-complex, B6, Vitamin C 2g, Minerals: Magnesium, Manganese, Iron, Zinc. Change of lifestyle. Stop smoking. Yoga.
Notes. “Do not withdraw: insulin, anticoagulants, epileptic drugs, steroids, thyroxin and hormone replacement therapy (the endocrine glands may no longer be active). Long-term tranquillisers e.g., Largactil or any medicament which has been used for a long period. Patients on these drugs are on a finely-tuned medication the balance of which may be easily disturbed.” (Simon Mills, FNIMH)
Counselling and relaxation therapy.
The Committee on Safety of Medicines specifically warns against the abrupt cessation of the Benzodiazepines and similar tranquillisers because of the considerable risk of convulsions. ... drug dependence
See www.rospa.com... accidental death
Sudden death sometimes occurs in infants, usually in the ?rst year of life: this is called SUDDEN INFANT DEATH SYNDROME (SIDS) or, colloquially, cot death, the possible causes of which are an ongoing subject for research and debate.
When a person dies unexpectedly the event must be reported to a CORONER, who has the power to decide whether an AUTOPSY is necessary.... death, sudden
Varieties Volatile oils of plants, such as eucalyptus and turpentine, chlorine water and chlorinated lime, peroxide of hydrogen and charcoal have been used as deodorants. There are now many commercial products available.... deodorants
(2) A surgical instrument for removing very thin slices of skin for grafting.... dermatome
A depot injection is useful for patients who may not take their medication correctly.
It also prevents the necessity of giving a series of injections over a short period.
Hormonal contraceptives (see contraception, hormonal methods of), corticosteroid drugs, and antipsychotic drugs may be given by depot injection.
Side effects may arise due to the uneven release of the drug into the bloodstream.... depot injection
Delays vary in severity and may affect the development of hand–eye coordination, walking, listening, language, speech, or social interaction. Delay may first be noticed by parents or detected during a routine developmental check.
There are many causes of developmental delay. A child who is late in most aspects of development usually has a generalized problem. This may be due to severe visual or hearing impairment, limited intellectual abilities (see learning difficulties), or damage to the brain before, during, or after birth.
Specific areas of delay may occur in movement and walking. Often there is no serious cause. However, specific causes may include muscular dystrophy and spina bifida. Delay in developing manipulative skills is often due to lack of adequate stimulation.
A lack of response to sound may be due to deafness. Autism is a rare cause of unresponsiveness to the human voice although hearing is normal. A hearing problem may cause delayed speech. Twins are often late talkers. Any generalized difficulty with muscle control can affect speech production; this may occur in children with cerebral palsy. Damage to, or structural defects of, the speech muscles, larynx (voice box), or mouth may also cause speech difficulties, as may any disorder affecting the speech area of the brain (see aphasia; dysarthria; dysphonia; speech disorders). Delay in bladder and bowel control have many possible causes (see encopresis; enuresis; soiling).
A child who shows signs of developmental delay should undergo a full assessment by a paediatrician.... developmental delay
(2) The name given to a nerve by whose stimulation motion, secretion, or some other function is restrained or prevented: for example, the depressor nerve of the heart slows the beating of this organ.... depressor
Habitat: Heaths and pastures.
Features ? Stem up to eighteen inches, slender, hairy, well-branched. Leaves opposite, oval-lanceolate, slightly serrate, nearly sessile ; root leaves stalked, ovoid, smooth at margins. Flowers dark purple, on long stalk, florets bunched together.The common name is derived from the root. which appears to have been bitten off at the end, with which vandalism "the devil" is credited.Part used ? Herb.Action: Demulcent, diaphoretic.
Included in formulae for coughs and feverish conditions generally. A 1 ounce to 1 pint infusion may be taken warm in wineglassful doses frequently.... devil's bitThe disease mainly affects tissues in the lungs, resulting in emphysema, and the liver, causing cirrhosis.
The effects of alpha1-antitrypsin deficiency may not become apparent until after the age of 30.
There is no cure, but symptoms can be relieved by drug treatment.
In severe cases, a liver transplant may be a possibility.... alpha-antitrypsin deficiency
The causes of are not fully understood, but the disorder often runs in families, which suggests that genetic factors may be involved. is not, as popularly believed, a result of poor parenting or abuse.
Symptoms develop in early childhood, usually between the ages of 3 and 7, and may include inability to finish tasks; short attention span; inability to concentrate in class; difficulty in following instructions; a tendency to talk excessively, frequently interrupting other people; difficulty in waiting or taking turns; inability to play quietly alone; and physical impulsiveness. Children with may have difficulty in forming friendships. Self-esteem is often low because an affected child is frequently scolded and criticized.
Treatment includes behaviour modification techniques, both at home and at school. In some children, avoidance of certain foods or food additives seems to reduce symptoms. In severe cases, stimulant drugs, usually methylphenidate, may be prescribed. Paradoxically, the use of stimulants in reduces hyperactivity and improves concentration. In general, the condition improves by adolescence but may be followed by antisocial behaviour and drug abuse or substance abuse.... attention deficit hyperactivity disorder
Divers with decompression sickness are immediately placed inside a recompression chamber. Pressure within the chamber is raised, causing the bubbles within the tissues to redissolve. Subsequently, the pressure in the chamber is slowly reduced, allowing the excess gas to escape safely via the lungs. If treated promptly, most divers with the “bends” make a full recovery. In serious, untreated cases, there may be long-term problems, such as paralysis.... decompression sickness
It can also be used as a planned treatment, in which case it is performed under a brief general anaesthesia.
Breathing may be maintained artificially during the procedure.... defibrillation
Dentists in general practice undertake all aspects of dental care. They may refer patients to a consultant in one of the specialized branches of dentistry, such as orthodontics, prosthetics, endodontics, and periodontics. Dental hygienists carry out
scaling (removal of calculi) and advise on oral hygiene methods.... dentistry
Depersonalization is often accompanied by derealization.
It is rarely serious and usually comes on suddenly and may last for moments or for hours.
Depersonalization most often occurs in people with anxiety disorders.
Other causes include drugs and temporal lobe epilepsy.... depersonalization
It usually occurs together with depersonalization and may be caused by fatigue, hallucinogenic drugs, or disordered brain function.... derealization
The tumour is hard, with a well-defined edge.
The tumours occur most frequently in women who have had children.
They may also arise at the sites of old surgical incisions.
Surgical removal is the usual treatment.... desmoid tumour
Desogestrel is reported to have a slightly higher risk of venous thromboembolism than older drugs. Side effects of desogestrel include weight changes and fluid retention. There may also be nausea, vomiting, headache, depression, and breast tenderness.... desogestrel
are separated, one of them almost always quickly loses the symptoms, which have been imposed by the dominant, and genuinely psychotic, partner.... folie à deux
cholesterol in the bloodstream. An excess of LDLs (see hyperlipidaemias) is associated with atherosclerosis. (See also high density lipoprotein.)... low density lipoprotein
Of the 2 types of macular degeneration that may occur, one type is usually remedied by laser treatment.
There is no treatment for the other form, although the affected person may benefit from aids such as magnifying instruments.... macular degeneration
It consists of the encouragement of good oral hygiene, fluoride treatment, and scaling.... preventive dentistry
Most mothers first get the “blues” 4–5 days after childbirth and may feel miserable, irritable, and tearful. The cause is hormonal changes, perhaps coupled with a sense of anticlimax or an overwhelming sense of responsibility for the baby. With reassurance and support, the depression usually passes in 2–3 days. In about 10–15 per cent of women, the depression lasts for weeks and causes a constant feeling of tiredness, difficulty in sleeping, loss of appetite, and restlessness. The condition usually clears up of its own accord or is treated with antidepressant drugs.
Depressive psychosis usually starts 2–3 weeks after childbirth, causing severe mental confusion, feelings of worthlessness, threats of suicide or harm to the baby, and sometimes delusions.
Hospital admission, ideally with the baby, and antidepressant drugs are often needed.... postnatal depression
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
Possible risk factors include: laying the baby face-down to sleep; overheating; parental smoking after the birth; prematurity and low birth weight; and poor socioeconomic background.
Preventive measures include: ensuring that the baby sleeps on its back at the foot of the cot; regulating the baby’s temperature (using the same amount of clothing and blankets that an adult would need); and stopping smoking.... sudden infant death syndrome
Habitat: Alpine regions of Chat- tadhar and Bhalesh ranges of Bhadarwah district in Jammu and Kashmir.
Ayurvedic: Vatsanaabha (related sp.).Folk: Bashahr-Mohra, Dudhiyaa Bish, Safed Bikh.Action: Roots and leaves are used in rheumatism, rheumatic fever and acute headache.
The roots contain 0.9% total alkaloids, of which 0.51% is pseudoaconi- tine.... aconitum deinorrhizumAbsent CORNEAL REFLEX
Absent VESTIBULO-OCULAR REFLEX
No cranial motor response to somatic (physical) stimulation
Absent gag and cough re?exes
No respiratory e?ort in response to APNOEA despite adequate concentrations of CARBON DIOXIDE in the arterial blood.... b nosed. the test for brain-stem death are:
Habitat: Sub-tropical Himalayas, Nepal, Sikkim, Assam and Khasia hills.
English: Ngai Camphor.Ayurvedic: Kukundara (var.).Action: Juice of fresh leaves— insecticidal, mosquito repellant. The plant yields an essential oil which yields camphor.
Aerial part contains sesquiterpene lactones, tagitinin A, tirolundin ethyl ether and iso-alantolactone derivatives.... blumea densifloraAll reversible pharmacological, metabolic, endocrine and physiological causes must be excluded, and there should be no doubt that irreversible brain damage has occurred. Two senior doctors carry out diagnostic tests to con?rm that brain-stem re?exes are absent. These tests must be repeated after a suitable interval before death can be declared. Imaging techniques are not required for death to be diag-... brain-stem death
Habitat: Throughout India, ascending to 1,500 m.
Ayurvedic: Daakuni (used as a substitute for Shankhapushpi in West Bengal)Unani: Sankhaahuli.Folk: Daankuni.Action: Anticonvulsant, CNS depressant, anti-inflammatory, hepatoprotective.
The plant contains calcium 0.38; magnesium 0.16; potassium 1.66 and iron 0.23 g/100 g; copper 18.97, zinc 70.50; manganese 9.60, cobalt 3.15 and chromium 0.60 mcg/g.Roots contain beta-amyrin, friede- lin, genianine and 16 xanthones including mangiferin. Mangiferin is protective activity against induced liver injury in albino rats. Xanthones also showed activity against Mycobacterium tuberculosis.Dried crude powder of the whole plant exhibited anticonvulsant activity in albino rats.Canscora diffusa (Vahl) R. Br. ex Roem. & Schultes (synonym C. lawii Wt.), found throughout India at 1,100 m, is used as a substitute for C. decussata.... canscora decussataHabitat: North-western Himalayas from Kashmir to Garhwal, from 1,000 to 3,500 m.
English: Himalayan Cedar, Deodar.Ayurvedic: Devadaaru, Suradru- ma, Suradaaru, Devakaashtha, Devadruma, Saptapatrika, Daaru, Bhadradaaru, Amarataru, Ama- radaaru, Daaruka, Devaahvaa, Surataru, Surabhuruha.Unani: Deodaar.Siddha/Tamil: Thevathaaram.Action: Bark—decoction is used internally as astringent, antidiarrhoeal and febrifuge. Essential oil—antiseptic (used in skin diseases).
The Ayurvedic Pharmacopoeia of India indicated the use of the heart- wood in puerperal diseases.The wood contains sesquiterpeno- ids; exhibits sapasmolytic activity. Alcoholic extract of the wood showed marked anti-inflammatory activity in mice; alcoholic extract showed antibacterial activity.The wood possesses diaphoretic, diuretic and carminative properties, and is used in fevers and in pulmonary and urinary disorders.Himalayan Cedarwood Oil contains two major sesquiterpenoids—alpha- and beta-himchalenes. Presence ofbu- tyric and caproic acids is also reported. The oil shows in vitro antibacterial and antifungal activity. It increases vascular permeability. Needles, on steam distillation, yield a volatile oil, rich in borneol and its esters. An alcoholic extract of the needles shows significant antibacterial activity against diptheria bacteria. The juice shows antiviral activity against tobacco mosaic virus and potato virus.The bark contains 8-C methyltaxi- foline, dihydroquercetin, 8-C methyl- quercetin, quercetin, sitosterol, and tannins 8.25%, non-tannins 6.95% (varies with the age of the tree). An alcoholic extract of the bark shows significant activity against diptheria bacteria; aqueous extract of the dried bark showed anti-inflammatory activ ity against acute and chronic inflammations. Aqueous extract of the bark is found effective in reducing sugar content of diabetic patient's urine and blood to normal levels.Dosage: Heartwood—3-6 g powder. (API Vol. IV.)... cedrus deodaraHabitat: All over India from temperate to tropics, in ponds and lakes.
English: Coontail, Hornwort.Ayurvedic: Shaivaala (also equated with Vallisneria spiralis Linn., Hydrocharitaceae), Jalnili, Jalaja.Unani: Tuhlub, Pashm Vazg.Siddha/Tamil: Velampasi.Folk: Sevaar.Action: Purgative, antibilious, antibacterial.
The herb is rich in protein, calcium and magnesium; contains ferre- doxin and plastocyanin. EtOH (50%) extract—antimicrobial.Dosage: Whole plant—10- 20 ml juice; 50-100 ml decoction. (CCRAS.)... ceratophyllum demersumBarrel chest is found in long-standing ASTHMA or chronic BRONCHITIS and EMPHYSEMA, when the lungs are chronically enlarged. The anterio-posterior dimension of the chest is increased and the ribs are near horizontal. In this position they can produce little further expansion of the chest, and breathing often relies on accessory muscles in the neck lifting up the whole thoracic cage on inspiration.
Pigeon chest is one in which the cross-section of the chest becomes triangular with the sternum forming a sort of keel in front. It may be related to breathing problems in early life.
Rickety chest is uncommon now and is caused by RICKETS in early life. There is a hollow down each side caused by the pull of muscles on the softer ribs in childhood. The line of knobs produced on each side where the ribs join their costal cartilages is known as the rickety rosary.
Pectus excavatum, or funnel chest, is quite a common abnormality where the central tendon of the diaphragm seems to be too short so that the lower part of the sternum is displaced inwards and the lower ribs are prominent. When severe, it may displace the heart further to the left side.
Local abnormalities in the shape of the chest occur when there is a deformity in the spine such as scoliosis which alters the angles of the ribs. The chest wall may be locally ?attened when the underlying lung is reduced in size locally over a prolonged period. (See SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.) This may be seen over a scarred area of lung such as that observed in pulmonary TUBERCULOSIS.... chest, deformities of
Debonair, Debonaire, Debonnayre, Debonayre, Debonaere, Debonnaere... debonnaire
Special needs The Children Act 1989, Education Acts 1981, 1986 and 1993, and the Chronically Sick and Disabled Persons Legislation 1979 impose various statutory duties to identify and provide assistance for children with special needs. They include the chronically ill as well as those with impaired development or disabilities such as CEREBRAL PALSY, or hearing, vision or intellectual impairment. Many CDTs keep a register of such children so that services can be e?ciently planned and evaluated. Parents of disabled children often feel isolated and neglected by society in general; they are frequently frustrated by the lack of resources available to help them cope with the sheer hard work involved. The CDT, through its key workers, does its best to absorb anger and divert frustration into constructive actions.
There are other groups of children who come to the attention of child health services. Community paediatricians act as advisers to adoption and fostering agencies, vital since many children needing alternative homes have special medical or educational needs or have behavioural or psychiatric problems. Many see a role in acting as advocates, not just for those with impairments but also for socially disadvantaged children, including those ‘looked after’ in children’s homes and those of travellers, asylum seekers, refugees and the homeless.
Child protection Regrettably, some children come to the attention of child health specialists because they have been beaten, neglected, emotionally or nutritionally starved or sexually assaulted by their parents or carers. Responsibility for the investigation of these children is that of local-authority social-services departments. However, child health professionals have a vital role in diagnosis, obtaining forensic evidence, advising courts, supervising the medical aspects of follow-up and teaching doctors, therapists and other professionals in training. (See CHILD ABUSE.)
School health services Once children have reached school age, the emphasis changes. The prime need becomes identifying those with problems that may interfere with learning – including those with special needs as de?ned above, but also those with behavioural problems. Teachers and parents are advised on how to manage these problems, while health promotion and health education are directed at children. Special problems, especially as children reach secondary school (aged 11–18) include accidents, substance abuse, psychosexual adjustment, antisocial behaviour, eating disorders and physical conditions which loom large in the minds of adolescents in particular, such as ACNE, short stature and delayed puberty.
There is no longer, in the UK, a universal school health service as many of its functions have been taken over by general practitioners and hospital and community paediatricians. However, most areas still have school nurses, some have school doctors, while others do not employ speci?c individuals for these tasks but share out aspects of the work between GPs, health visitors, community nurses and consultant paediatricians in child health.
Complementing their work is the community dental service whose role is to monitor the whole child population’s dental health, provide preventive programmes for all, and dental treatment for those who have di?culty using general dental services – for example, children with complex disability. All children in state-funded schools are dentally screened at ages ?ve and 15.
Successes and failures Since the inception of the NHS, hospital services for children have had enormous success: neonatal and infant mortality rates have fallen by two-thirds; deaths from PNEUMONIA have fallen from 600 per million children to a handful; and deaths from MENINGITIS have fallen to one-?fth of the previous level. Much of this has been due to the revolution in the management of pregnancy and labour, the invention of neonatal resuscitation and neonatal intensive care, and the provision of powerful antibiotics.
At the same time, some children acquire HIV infection and AIDS from their affected mothers (see AIDS/HIV); the prevalence of atopic (see ATOPY) diseases (ASTHMA, eczema – see DERMATITIS, HAY FEVER) is rising; more children attend hospital clinics with chronic CONSTIPATION; and little can be done for most viral diseases.
Community child health services can also boast of successes. The routine immunisation programme has wiped out SMALLPOX, DIPHTHERIA and POLIOMYELITIS and almost wiped out haemophilus and meningococcal C meningitis, measles and congenital RUBELLA syndrome. WHOOPING COUGH outbreaks continue but the death and chronic disability rates have been greatly reduced. Despite these huge health gains, continuing public scepticism about the safety of immunisation means that there can be no relaxation in the educational and health-promotion programme.
Services for severely and multiply disabled children have improved beyond all recognition with the closure of long-stay institutions, many of which were distinctly child-unfriendly. Nonetheless, scarce resources mean that families still carry heavy burdens. The incidence of SUDDEN INFANT DEATH SYNDROME (SIDS) has more than halved as a result of an educational programme based on ?rm scienti?c evidence that the risk can be reduced by putting babies to sleep on their backs, avoidance of parental smoking, not overheating, breast feeding and seeking medical attention early for illness.
Children have fewer accidents and better teeth but new problems have arisen: in the 1990s children throughout the developed world became fatter. A UK survey in 2004 found that one in ?ve children are overweight and one in 20 obese. Lack of exercise, the easy availability of food at all times and in all places, together with the rise of ‘snacking’, are likely to provoke signi?cant health problems as these children grow into adult life. Adolescents are at greater risk than ever of ill-health through substance abuse and unplanned pregnancy. Child health services are facing new challenges in the 21st century.... child development teams (cdts)
One example, called ISABEL, can be accessed by paediatricians to check on their diagnosis and management of many childhood disorders.... computerised decision-support systems
When a death occurs at sea, the captain of the ship has authority to permit burial at sea. If, however, there are any doubts about cause of death, the captain may decide to preserve the body and refer the case to the relevant authorities at the next port of call.
Embalming is still used occasionally. The process consists in removing the internal organs through small openings, and ?lling the body cavities with various aromatics of antiseptic power – the skin being swathed in bandages or otherwise protected from the action of the air. Bodies are also preserved by injecting the blood vessels with strong antiseptics such as perchloride of mercury.
Cremation or incineration of the body is now the commonest method of disposal of the dead in the UK, where land for burials is increasingly scarce; today it accounts for around 75 per cent of disposals. The process of incineration takes 1–2 hours. Something in the range of 2·3 to 3·2 kg (5–7 lbs) of ash result from the combustion of the body, and there is no admixture with that from the fuel.
Cremation of a body means that it is almost impossible to conduct any meaningful forensic tests should any subsequent doubts be raised about the cause of death. So, before cremation can take place, two doctors have to sign the cremation forms. The ?rst is usually the doctor who was caring for the patient at the time of death – an important exception being cases of sudden death, when the coroner holds an inquest into the cause and authorises the necessary approval for cremation. In 1999, fewer than 3,500 deaths were certi?ed following a post-mortem, out of a total number of deaths in England and Wales of more than 556,000. When the coroner is not involved, the second doctor must have been quali?ed for ?ve years; he or she must be unconnected with the patient’s care and not linked professionally with the ?rst doctor. (For example, if the ?rst doctor is a general practitioner – as in the majority of cases they are – the second doctor should be from another practice.) Before signing the cremation certi?cate the second doctor must conduct an external examination of the dead person and discuss the circumstances of death with the ?rst doctor.
The two cremation forms are then inspected by crematorium medical referees who must be satis?ed that the cause of death has de?nitely been ascertained. The present death and cremation certi?cation system has been in place in the UK for many years – the legislative framework for cremation was set up in 1902 – and death certi?cation procedures were last reviewed by the government-appointed Brodrick committee in 1971, with no fundamental changes proposed. The case of Harold Shipman, a general practitioner convicted of murdering more than 15 patients, and suspected of murdering many more, has revealed serious weaknesses in the certi?cation system. A comprehensive review of the present procedures was in place at the time of writing (2004).... dead, disposal of the
Decimber, Decymber, Decembar, Decimbar, Decymbar... december
The two most common causes of death in the UK are diseases of the circulatory system (including strokes and heart disease) and cancer.
Overall annual death rates among women in the UK at the start of the 21st century were
7.98 per 1,000 population, and among men,
5.58 per 1,000. Comparable ?gures at the start of the 20th century were 16.3 for women and
18.4 for men. The death rates in 1900 among infants up to the age of four were 47.9 per 1,000 females and 57 per 1,000 males. By 2003 these numbers had fallen to 5.0 and 5.8 respectively. All these ?gures give a crude indication of how the health of Britain’s population has improved in the past century.
Death rates and ?gures on the causes of deaths are essential statistics in the study of EPIDEMIOLOGY which, along with information on the incidence of illnesses and injuries, provides a temporal and geographical map of changing health patterns in communities. Such information is valuable in planning preventive health measures (see PUBLIC HEALTH) and in identifying the natural history of diseases – knowledge that often contributes to the development of preventive measures and treatments for those diseases.... death, causes of
The only certain sign of death, however, is that the heart has stopped beating. To ensure that this is permanent, it is necessary to listen over the heart with a stethoscope, or directly with the ear, for at least ?ve minutes. Permanent stoppage of breathing should also be con?rmed by observing that a mirror held before the mouth shows no haze, or that a feather placed on the upper lip does not ?utter.
In the vast majority of cases there is no dif?culty in ensuring that death has occurred. The introduction of organ transplantation, however, and of more e?ective mechanical means of resuscitation, such as ventilators, whereby an individual’s heart can be kept beating almost inde?nitely, has raised diffculties in a minority of cases. To solve the problem in these cases the concept of ‘brain death’ has been introduced. In this context it has to be borne in mind that there is no legal de?nition of death. Death has traditionally been diagnosed by the irreversible cessation of respiration and heartbeat. In the Code of Practice drawn up in 1983 by a Working Party of the Health Departments of Great Britain and Northern Ireland, however, it is stated that ‘death can also be diagnosed by the irreversible cessation of brain-stem function’. This is described as ‘brain death’. The brain stem consists of the mid-brain, pons and medulla oblongata which contain the centres controlling the vital processes of the body such as consciousness, breathing and the beating of the heart (see BRAIN). This new concept of death, which has been widely accepted in medical and legal circles throughout the world, means that it is now legitimate to equate brain death with death; that the essential component of brain death is death of the brain stem; and that a dead brain stem can be reliably diagnosed at the bedside. (See GLASGOW COMA SCALE.)
Four points are important in determining the time that has elapsed since death. HYPOSTASIS, or congestion, begins to appear as livid spots on the back, often mistaken for bruises, three hours or more after death. This is due to the blood running into the vessels in the lowest parts. Loss of heat begins at once after death, and the body has become as cold as the surrounding air after 12 hours – although this is delayed by hot weather, death from ASPHYXIA, and some other causes. Rigidity, or rigor mortis, begins in six hours, takes another six to become fully established, remains for 12 hours and passes o? during the succeeding 12 hours. It comes on quickly when extreme exertion has been indulged in immediately before death; conversely it is slow in onset and slight in death from wasting diseases, and slight or absent in children. It begins in the small muscles of the eyelid and jaw and then spreads over the body. PUTREFACTION is variable in time of onset, but usually begins in 2–3 days, as a greenish tint over the abdomen.... death, signs of
Habitat: Deccan Peninsula; common in the forest areas of Western Ghats.
Unani: Desi Ushbaa.Siddha/Tamil: Mahali kizhangu.Action: Root—appetizer, blood purifier, bacteriostatic. Used as a substitute for Shveta Saarivaa (Hemidesmus indicus). Sold as Saarivaa in Kerala, Tamil Nadu and Karnataka. The root powder is given to diabetics.
The root contains quercetin, kaempferol, coumarin and rutin. It has a sweet sarsaparilla-like taste; contains 92% fleshy matter and 8% woody core.The root can be stored for longer periods and remains unaffected by microorganisms and insects, apparently due to the presence of the volatile principle which possesses bacteriostat- ic and toxic properties.The root, on steam distillation, gave 4-O-methyl-resorcylaldehyde in a concentration of 0.8%. (The growth of E. coli was arrested by the aldehyde in 0.041% concentration; fish died within 4 min in 0.02% solution.) The sterols consists mainly of stagma and brassica sterols. Alpha-amyrin and lupeol, both free and as esters are also present in the root.The plant contains lupeol, beta- amyrin 2-hydroxy, 4-methoxy benzaldehyde, and ferulic acid.... decalepis hamiltoniiToxins. In conditions such as chronic glomerulonephritis (see KIDNEYS, DISEASES OF) and URAEMIA there is a severe anaemia due to the e?ect of the disease upon blood formation.
Drugs. Certain drugs, such as aspirin and the non-steroidal anti-in?ammatory drugs, may cause occult gastrointestinal bleeding.... defective blood formation
SCALDS; CHEST, DEFORMITIES OF; TALIPES; FLAT-FOOT; JOINTS, DISEASES OF; KNOCK-KNEE; LEPROSY; PALATE, MALFORMATIONS OF; PARALYSIS; RICKETS; SCAR; SKULL; SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.)... deformities
Deianeira, Deianiera, Deianyra, Deianeera, Deianeara... deianira
Deadra, Dede, Dedra, Deedra, Deedre, Deidra, Deirdre, Deidrie, Deirdra, Derdre, Didi, Diedra, Diedre, Diedrey, Dierdre, Deardriu, Dierdra... deidre
Decla, Deckla, Deklah, Decklah, Declah... dekla
Dalaina, Dalainah, Dalaine, Dalanah, Dalanna, Dalannah, Dalayna, Dalaynah, Delanah, Dalinah, Dalinda, Dalinna, Delania, Delanna, Delannah, Delanya, Deleina, Deleinah, Delena, Delenya, Deleyna, Deleynah, Dellaina... delana
Delancie, Delancy, Delanci, Delancea, Delanceah, Delancee... delancey
Delawair, Delaweir, Delwayr, Delawayre, Delawaire, Delawaer, Delawaere... delaware
Habitat: Forests of Bengal, Assam and the Andamans.
Ayurvedic: Paaniya Valli.Action: A decoction of the plant is given in dysentery and coughs. Leaves—used for the treatment of boils. Root—astringent, used as external application for burns.... delima scandens
... della
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 regiaDelphine, Delphinea, Delphinia, Delfa, Delfin, Delfine, Delfyne, Delpha, Delfina, Delphia... delphina
Habitat: Kashmir (Himalayan species).
English: Kashmir Larkspur.Ayurvedic: Used as a substitute for Tagara (valerian).Action: See D. brunonianum.... delphinium cashmirianum
Habitat: Native to China; distributed in West Himalayas.
English: Musk Larkspur.Ayurvedic: Sprikkaa. (Melilotus officinalis, known as Aspurka or Naakhunaa, is also equated with Sprikkaa.) Used as a substitute for Tagara (valerian).Action: Himalayan species act as cardiac and respiratory depressant. All the species of Delphinium are poisonous; find use in indigenous medicine for destroying maggots in wounds, particularly in sheep. The flowers are considered acrid, bitter and astringent; seeds are cathartic, anthelmintic, emetic and insecticidal.... delphinium brunonianum
Habitat: Cultivated in gardens.
English: Forking Larkspur, Larkspur, Lark's Claw, Knight's Spur.Action: Parasiticide. A tincture is used to destroy lice in hair.
The toxicity of the seeds is due to diterpene alkaloids (delcosine, delso- line, consolidine). Delsonine and an- thranoyllycoctonine are amorphous alkaloids.The alkaloids lead to bradycardia, lowering of blood pressure, and cardiac arrest. Also, they have a central paralyzing and curare-like effect on the respiratory system. (German Commission E.)Entire plant, including roots and seeds, is used topically. Not to be used on abraded skin.Seeds contain 1.01-1.06% alkaloids and 28.7% of a fixed oil. A digly- coside pigment, delphonin and kaem- pferol have been isolated from the flowers.... delphinium consolidaHabitat: The temperate Himalayas from Kashmir to Kumaon at altitudes of 2,400-3,600 m.
English: Larkspur. Ayurvedic: Nirvishaa, Nirvishi. (Kyllinga triceps Rottb. is used as a substitute for Nirvishaa.)Unani: Jadwaar Khataai, Maatiryaaq.Folk: Root—astringent, vulnerary, deobstruent, alterative. Used for painful piles, muscular atrophy, gout and as a nervine tonic. Also used as an adulterant for aconite.Oral administration of the aqueous extract of the plant to rats with CCl4- induced hepatotoxicity revealed hepa- toprotective property of the plant.The roots contain campesterol, stig- masterol, sitosterol, cholesterol, delta- avenasterol and alkaloids including de- nudatine, denudatidine, condelphine, talatizidine and iso-talatizidine.... delphinium denudatumHabitat: Native to Mediterranean region.
English: Stavesacre.Unani: Muvizaj.Action: Parasiticide. Used for destroying lice. Contains poisonous alkaloids. Seeds are violently emetic and cathartic; used as an external application in obstinate skin diseases and eruptions under medical supervision.
Seeds contain diterpene alkaloids; delphidine, delphinine, delphirine, del- phisine and neoline.Stavesacre has a similar effect to aco- nitine. Extract from the seeds is used in homoeopathic dilutions.... delphinium staphisagriaHabitat: The temperate Himalaya from Kashmir to Nepal to 2,7004,700 m.
English: Candle Larkspur, Bee Larkspur.Ayurvedic: Nirvisha.Action: Whole plant—cardiac and respiratory depressant, emetic, diuretic, anthelmintic. Seed— insecticidal. Used in skin eruptions. Powdered flowers, mixed with mustard oil, are used for destroying lica.
The plant contains beta-sitosterol and alkaloid delpheline; aerial parts contain an alkaloid, elatine.Seeds are very poisonous; contain several aconitine-like alkaloids. Del- phinidine, isolated from seeds, causes drastic gastro-enteric irritation.... delphinium vestitiumDemetra, Demitra, Demitras, Dimetria, Demetre, Demetria, Dimitra, Dimitre, Dimitria, Dimiter, Detria, Deetra, Deitra... demeter
Habitat: Persia and Afghanistan.
English: Zalil Larkspur.Ayurvedic: Sprikkaa. (Melilotus officinalis, known as Aspurka or Naakhunaa, is also equated with Sprikkaa.)Unani: Zarir, Zalil, Asbarg, Gul-Zalil (flower).Action: Diuretic, anodyne, anti- inflammatory, detergent. Used in jaundice, dropsy and diseases of the spleen. Ash—used externally on wounds and skin diseases.
The seeds contain norditerpenoid alkaloid, zaliline, besides anhweidel- phinine, browniine, desacetylnudi- cauline, lycoctonine, methyllycaconi- tine and nudicauline. The medicinal properties of the plant are attributed to desacetylnudicauline, methyllycaconi- tine and nudicauline.... delphinium zalilDendera, Dendaria, Denderia, Dendarra... dendara
Habitat: The Western Ghats.
Ayurvedic: Jivanti (substitute.)Folk: Nagli (Maharashtra)Action: Juice of fresh plant—stomachic, carminative, antispasmodic, laxative, liver tonic. (excites the bile). A related species, Dendrobium crumenatum Sw., occurs in Andaman Islands. Pounded leaves are used in Malaya for poulticing boils and pimples. Traces of alkaloids have been reported to be present in the pseudobulbs and leaves.
D. macraei Lindl. and D. normale Face. are also known as Jivanti.... dendrobium ovatumHabitat: Throughout India.
Ayurvedic: Bandaaka, Vrkshaadani, Vrkshruuhaa.Siddha: Pulluri, Plavithil (Tamil).Folk: Baandaa.Action: Bark—astringent and narcotic; used in menstrual disorders, consumption, asthma, also for treating wounds.
The plant contains several flavo- noids. Being parasitic, different flavo- noids have been recorded in plants growing on different host plants. Quer- citrin has been found to be the major common constituent. The plant also contains gallic, ellagic and chebulinic acids.Aqueous and alcoholic extracts of the plant were tested in rats for their diuretic and anti-lithiatic activities. Alcoholic extract was found to be more effective than aqueous extract.Dosage: Leaf, flower—10-20 ml juice. (CCRAS.)Essential oil from leaves—antibacterial, antifungal.Dosage: Bark—50-100 ml decoction; leaf—10-20 ml juice. (CCRAS.)... dendrophthoe falcataOver the past four decades the ?nancial outlay on NHS dental services has been around 5 per cent of total NHS funding. This contrasts with 10 per cent during the service’s early years, when the NHS was coping with decades of ‘dental neglect’. The population’s dental health has, however, been steadily improving: in 1968 more than one-third of people had no natural teeth; by the late 1990s the proportion had fallen to 13 per cent.
Dentistry is divided into several groupings.
General dental practitioners Concerned with primary dental care, the prevention, diagnosis and treatment of diseases of the gums and teeth – for example, caries (see TEETH, DISORDERS OF). They also deal with diffculties in biting and the effects of trauma, and are aware that oral disorders may re?ect disease elsewhere in the body. They will refer to the hospital dental services, patients who require treatment that cannot be satisfactorily carried out in a primary-care setting.
Most routine dental prevention and treatment is carried out in general dental practitioners’ surgeries, where the dentists also supervise the work of hygienists and dental auxiliaries. Appliances, such as dentures, crowns, bridges and orthodontic appliances are constructed by dental technicians working in dental laboratories.
There are around 18,800 dentists providing general dental services in the UK. These practitioners are free to accept or reject any potential patient and to practise where they wish. Those dentists treating patients under an NHS contract (a mixture of capitation fees and items of service payments) can also treat patients privately (for an appropriate fee). Some dentists opt for full-time private practice, and their numbers are increasing in the wake of changes in 1990 in the contracts of NHS general dental practitioners.
Community dental practitioner Part of the public-health team and largely concerned with monitoring dental health and treating the young and the handicapped.
In the hospitals and dental schools are those who are involved in only one of the specialities.
Around 2,800 dentists work in NHS hospitals and 1,900 in the NHS’s community services. In some parts of the UK, people wanting NHS treatment are having diffculties ?nding dentists willing to provide such care.
Restorative dentist Concerned with the repair of teeth damaged by trauma and caries, and the replacement of missing teeth.
Orthodontist Correction of jaws and teeth which are misaligned or irregular. This is done with appliances which may be removable or ?xed to the teeth which are then moved with springs or elastics.... dental surgeon
Shaving is the most e?ective way of removing super?uous hairs. Rubbing morning and night with a smooth pumice-stone is said to be helpful. Electrolysis and diathermy are also used.... depilation
Deryne, Derina, Deryna, Deriena, Deriene, Dereina, Dereine, Dereena, Dereene, Dereana, Dereane... derine
(see fetus); during the first 5 years of life (see child development); and during puberty and adolescence.... development
The cause of developmental hip dysplasia is not known, although it is more common in girls, especially babies born by breech delivery or following pregnancies in which the amount of amniotic fluid was abnormally small.
If dislocation is detected in early infancy, splints are applied to the thigh to manoeuvre the ball of the joint into the socket and keep it in position. These are worn for about 3 months and usually correct the problem. Progress may be monitored by ultrasound scanning and X-rays. Corrective surgery may also be required.
If treatment is delayed, there may be lifelong problems with walking. Without treatment, the dislocation often leads to shortening of the leg, limping, and early osteoarthritis in the joint.... developmental hip dysplasia
It relieves pain quickly but has only a short duration of action.
Regular use can produce drug dependence.... dextromoramide
It works rapidly and relieves mild to moderate pain for about 4 hours.
Adverse effects may include drowsiness, dizziness, nausea, and vomiting.... dextropropoxyphene
The 2 main dopa-decarboxylase inhibitors, co-beneldopa and co-careldopa, are a combination of levodopa and benserazide and levodopa and carbidopa respectively.
These drugs prevent levodopa from being activated except within the brain, which reduces the incidence of side effects such as nausea and vomiting.... dopa-decarboxylase inhibitors
Dereka, Dericka, Derrica, Derika, Derecka, Derecca, Deryca, Deryka, Derycca, Derycka... derica
Dericiah, Derisea, Dericea, Derisia, Derycia, Derysia, Dericeah, Dericiyah, Dericiya... dericia
Habitat: Native to the Western Ghats. Found all over India on the banks of rivers and streams.
English: Indian Beech. Pongamia oil tree.Ayurvedic: Naktmaal, Guchpush- pak, Ghritpuur, Udkirya, Karanja.Siddha/Tamil: Pungu.Action: Used for skin diseases— eczema, scabies, leprosy, and for ulcers, tumours, piles, enlargement of spleen, vaginal and urinary discharges. Juice of root—used for closing fistulous sores and cleaning foul ulcers. Flowers— used in diabetes. Powder of seeds— used for whooping and irritating coughs of children. Seed oil—used in cutaneous affections, herpes and scabies.
The tree is rich in flavonoids and related compounds. These include simple flavones, furanoflavonoids, chro- menoflavones, chromenochalcones, coumarones, flavone glucosides, sterols, triterpenes and a modified pheny- lalanine dipeptide.Synonym: D. trifoliate Lour.Family: Fabaceae.Habitat: Costal forests of India and the Andamans.
Folk: Paan-lataa (Bengal), Kitani (Maharashtra).Action: Stimulant, antispasmodic, counter-irritant. Bark—alterative in rheumatism. An oil prepared from the plant is used externally as an embrocation.
The roots contain dehydrorotenone, lupeol and a ketone. Bark contains 9.3% tannic acid. Stems contain tan- nic acid, hexoic, arachidic and stearic acids, ceryl alcohol, isomerides of cholesterol, potassium nitrate, gums and resins.... derris uliginosaDervala, Dervilia, Dervalia, Dervla, Dearbhail... derval
Habitat: Temperate Himalaya from Kashmir to Kumaon at 2,200-4,100, also in eastern Himalaya.
English: Flix Weed, Flax Weed.Action: Leaf and flower—astringent, antiscorbutic. Seed—expectorant, anti-inflammatory, febrifuge, antidysenteric. Aerial parts— antiviral, hypoglycaemic.
The plants has been used externally for ulcers, seeds are used as substitute or adulterant of the seeds of Sisymbrium iro Linn. (The source of Khaakasi, Khubb, Tukhm-e-Shahuh, Khuubkalaan of Unani medicine, known as Hedge Mustard or London Rocket.)... descurainia sophiaDestanee, Destinee, Destiney, Destini, Destinie, Destine, Destina, Destyni, Destany, Destinea, Destanea, Destynea... destiny
Habitat: Ascending to 1,500 m on the Himalaya; common on lower hills and plains throughout India.
Ayurvedic: Shaaliparni, Shaalaparni, Sthiraa, Somyaa, Guhaa, Triparni, Vidaarigandha, Anshumati. Also used as Prshniparni. (Urariapicta Desv., Prshniparni, is used as a substitute for Shaalaparni.)Siddha/Tamil: Pulladi, Sirupulladi Moovilai (root).Folk: Sarivan.Action: Root—antipyretic, diuretic, astringent (used in irritable bowel syndrome, diarrhoea and dysentery), anticatarrhal (used in post-natal care, chronic fever, cough, biliousness, vomiting), diuretic, anthelmintic, laxative and nervine tonic. Desmodium spp.: Roots—carminative, mildly purgative, stomachic, emmenagogue, diuretic. Leaves—galactagogue; a poultice of leaves is used for lumbago. Bark—used in diarrhoea and haemorrhages.
Roots afforded pterocarpanoids— gangetin, gangetinin, desmodin and several alkaloids. The aerial portion gave indole-3-alkylamines and their derivatives.Gangetin showed significant anti- inflammatory activity in 50 and 100 mg/kg p.o. in rats.Dosage: Root—5-10 g powder; 1020 g for decoction. (API Vol. III.)... desmodium gangeticumHabitat: Throughout India, in the plains ascending to 1,200 m in Kumaon and 1,800 m in Kashmir.
Ayurvedic: Tripaadi, Hamsapaadi (Kerala).Siddha/Tamil: Seruppadi.Folk: Jangali Methi, Ran-methi.Action: Fresh leaves—used internally as galactagogue and for diarrhoea; applied externally to wounds and abscesses. Root— diuretic. Also used for cough, asthma.
The leaf contains alkaloids (0.010.15%), major being beta-phenylethyl- amine; also contains tyramine and hy- paphorine. Hypaphorine is present in roots as well. Root contains 0.010.02% alkaloids.... desmodium triflorumHabitat: Throughout the plains of India in dry and hot areas and in sandy deserts.
English: Sacrificial Grass (smaller var.)Ayurvedic: Kusha, Suuchyagra, Yagyabhuushana, Kshurapatra.Siddha/Tamil: Tharubai.Action: Root—cooling, diuretic, galactagogue, astringent. Used for urinary calculi, and other diseases of the bladder. Clums—used in menorrhagia, dysentery, diarrhoea and in skin diseases. The Ayurvedic Pharmacopoeia of India recommended the use of the rootstock in dysuria, vaginal discharges and erysipelas.
Dosage: Rootstock—50-100 g for decoction. (API Vol. III.)... desmostachya bipinnataIn view of their widespread use, such detergents appear to cause relatively little trouble with the skin, but more trouble has been reported with the so-called ‘biological’ detergents – named because they contain an ENZYME which destroys protein. As a result they are claimed to remove proteins (stains such as blood, chocolate, milk or gravy) which are relatively di?cult for ordinary detergents to remove. Unfortunately these ‘biological’ detergents may cause dermatitis. In addition, they have been reported to cause asthma in those using them, and even more so in workers manufacturing them.... detergents
Deverelle, Deverele, Deverel, Deverella, Deverela... deverell
Devan, Deven, Devenne, Devin, Devona, Devondra, Devonna, Devonne, Devvon, Devyn, Devynn, Deheune, Devina, Devyna... devon
Daianira, Dayanira, Dellanira, Diyanira... deyanira
Habitat: Throughout India in the plains, also on the hills.
Action: Aqueous extracts— antibacterial against Staphylococcus aureus.... dryopteris dentata
Habitat: The Himalaya from Kashmir to Arunachal Pradesh and in Assam at 450-3,100 m.
Ayurvedic: Vaaraahikanda (var.), Grishti.Folk: Gun, Kris (Punjab).Action: Tuber—antipthiriac. Leaf— febrifuge. The rhizomes are a rich source of diogenin and its glycoside. Steroidal saponins have also been isolated. Diogenin is used in the preparation of various steroidal drugs.
Synonym: D. hispada Dennst. D. hirsuta Dennst.
Family: Dioscoreaceae.Habitat: Sikkim, the Himalayas, Khasi Hills.... dioscorea deltoidea
Maintaining an up-to-date evidence base of ‘what works’ in public health and health improvements.
Providing useful information to health practitioners.
Commissioning research to remedy the gaps in the evidence base for medical practice.
Improving health promotion and advising on the standards for (and implementation of) public-health activities.
(See APPENDIX 7: STATUTORY ORGANISATIONS.)... health development agency (hda)
– from anaerobic metabolism which is ultimately oxidised after conversion to citrate and metabolism via the citric acid cycle. The increased amount of oxygen above resting concentrations which needs to be consumed to perform this metabolism is known as the oxygen debt or de?cit.... oxygen deficit
About one-third of women have adverse effects as the result of IUCD use: common ones are backache and heavy menstrual bleeding (see MENSTRUATION). The frequency of unwanted pregnancies is about 2 per 100 women-years of use. (See CONTRACEPTION.)... intrauterine contraceptive device (iucd)
Habitat: The Himalayas up to 300 m, and in the plains from Assam to Western and Southern India.
Folk: Jangali Paalak.Action: Plant—astringent; used in cutaneous disorders.
The leaves contain vitamin C 115 mg and vitamin A value 11,700 IU/100 g and are a rich source of calcium and beta-carotene. The dried leaves contained 7.8% of flavonoids and 0.04% of anthraquinone derivatives. Flavonoids include rutin, avicularin, quercitrin, quercetin. Roots contain chrysophan- ic acid and emodin, the total an- thraquinone content being 0.13%.Rumex hastatus D. Don.Folk: Amlora, Chumlora (Kumaon); Khattimal, Katambal (Punjab).Action: Astringent.
The root and bark yield 21-23% tannin.... rumex dentatusHabitat: Western India, as a root parasite.
Folk: Dudhaali (Maharashtra).Action: Root—juice applied to sores on feet, caused by constant exposure to water and moisture.
Alcoholic extract of air-dried powdered stems yielded isoflavonoids, which were found to be estrogenically active in albino rats.... sopubia delphinifoliaCauses These are unknown, with possible multiple aetiology. Prematurity and low birth-weight may play a role. The sleeping position of a baby and an over-warm environment may be major factors, since deaths have fallen sharply since mothers were o?cially advised to place babies on their backs and not to overheat them. Some deaths are probably the result of respiratory infections, usually viral, which may stop breathing in at-risk infants, while others may result from the infant becoming smothered in a soft pillow. Faults in the baby’s central breathing control system (central APNOEA) may be a factor. Other possible factors include poor socioeconomic environment; vitamin E de?ciency; or smoking, drug addiction or anaemia in the mother. Help and advice may be obtained from the Foundation for the Study of Infant Deaths and the Cot Death Society.... sudden infant death syndrome (sids)
Habitat: Assam.
Action: Root—febrifuge.
The roots contain a desmoflavone. A cycloartane triterpenoid desmosinol has been isolated from stem. The root of U. discolor Vahl, synonym Desmos chinensis Lour. (forests of north-east, south and west India) is given for vertigo.The root contains a flavonoid des- mal. Desmal inhibited tyrosine kinase in situ in epidermal growth factor (EGF) receptor overexpressing NIH3T3 (ERIZ) cells. It also inhibited EGF-induced inositol phosphate formation and morphological changes.... unona desmosHabitat: Throughout India in hotter parts, usually climbing on trees.
Siddha/Tamil: Pappili.Folk: Pitti, Raamadhaani, Kevati (var.).Action: Stem bark—powdered and mixed with sesame oil, externally applied to skin diseases and sprains. Root bark—used for atonic dyspepsia, mild fever and debility. Sap—used for the treatment of deafness.
The stem bark gave friedelin and several anthraquinones. The root contains anthraquinones, ventinones A and B. Major constituents of the root bark are emodin, its glucoside and corresponding analogues, ventiloquino- nes. The fruit, leaves and stem gave lupeol, beta-sitosterol and its gluco- side.... ventilago denticulataAetiology: heavy menstrual loss, feeble constitution from hereditary weakness, poor diet, hidden or known blood loss from gastric ulcer, pregnancy, bleeding piles or insufficient food minerals: iron, copper, calcium, etc, chronic liver or kidney disease, worms, anorexia nervosa, rheumatoid arthritis, tuberculosis. Symptoms. Tiredness, dizziness, breathlessness, palpitations, pale face and mucous membranes. White of eyes may be blue. Enlarged flabby tongue often bears impression of teeth marks. Hair lifeless, fingernails brittle and ridged. There may be angina, tinnitus and general reduced efficiency.
Treatment. The object is to achieve absorption of iron to raise normal haemoglobin levels and increase red cells. Echinacea has a reputation for regeneration of red cells. Herbs used with success: Echinacea, Gentian, Motherwort, Mugwort, Barberry, Hops, Nettles, Saw Palmetto, Chaparral, Red Clover, Dandelion.
Bitter herbs stimulate absorption of vital nutrients from the stomach, toning liver and pancreas, increasing the appetite; usually given half hour before meals. See: BITTERS.
Gentian. 1 teaspoon fine-cut chips to 2 cups cold water steeped 8 hours (overnight). Dose: Half-1 cup thrice daily before meals.
Tea. Formula. Combine: Agrimony 1; Barberry bark 1; Nettles 2; White Poplar bark half. Place 1oz (30g) in 1 pint (500ml) cold water and bring to boil. Simmer 10 minutes. Drink cold: Half-1 cup thrice daily, before meals.
Powders. Formula. Echinacea 2; Gentian 1; Kelp 1; pinch Red Pepper. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily, before meals.
Liquid extracts. Formula: Echinacea 1; Queen’s Delight 1; Ginseng 1; Ginger quarter. Dose: 30-60 drops in water, thrice daily, before meals.
Infusion Gentian Co Conc BP (1949). Dose: 30-60 drops.
Diet. Dandelion coffee, as desired. Molasses. Desiccated liver.
Floradix. A pre-digested iron preparation. Readily assimilable by the body. Compounded by Dr Otto Greither (Salus Haus). Iron is fed onto yeast which breaks down the metal and absorbs its cells. Other tonic ingredients include extracts of nettles, carrots, spinach, fennel, Vitamin C plus supplements;
Angelica root, Mallow, Horsetail, Yarrow, Juniper and Rosehips. Not chemically preserved.
Avoid chocolate, egg yolk, tea, coffee, wheat bran.
Supplements. Daily. Vitamin C (1g morning and evening). Vitamin B12, Folic acid 400mcg. Vitamin C is the most potent enhancer of iron absorption. Multivitamin containing iron.
Note: Iron absorption is decreased by antacids, tetracyclines, phosphates, phytates (phytic acid from excessive intake of wholewheat bread), and excessive calcium supplements. Lack of stomach hydrochloric acid impairs iron absorption, especially in the elderly. ... anaemia: iron deficiency
Alternatives. To stimulate flow, Boldo, Horsetail, Dandelion, Blue Flag root, Milk Thistle, Bogbean, Burdock. Teas, capsules, tablets, Liquid extracts, or Tinctures.
A. Vogel recommends: Barberry, Centuary, St John’s Wort, Sarsaparilla.
Combination tea. Equal parts: Peppermint leaves, Milk Thistle, Dandelion root. 1 teaspoon to each cup boiling water; infuse 15 minutes, 1 cup thrice daily for limited period (1 month).
Bile in the urine. (Bilviria)
Arthur Barker: Liquid Extract Black root 1oz (30ml). Liquid Extract Cornsilk 1oz (30ml). Essential Peppermint 30 drops (2ml). Water to 8oz (240ml). 2 teaspoons in water 3 times daily before meals.
Diet. Dandelion coffee. Artichokes.
See: CHOLAGOGUES. CHOLERETICS. ... bile secretion deficiency
Tablets/capsules. Ginseng. Sarsaparilla. Evening Primrose. Agnus Castus, Liquorice.
Powders. Equal parts: Caraway seeds, Saw Palmetto berries. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.
Tinctures. Combine Dong Quai 1; Saw Palmetto 2. Dose: one 5ml teaspoon in water thrice daily.
Topical. Cream for use at bedtime: Lanolin 1oz; Cocoa butter half an ounce; Saw Palmetto berries Tincture or Liquid Extract 30 drops (or 10 grams powder); Oil Cajeput 30 drops. Heat in a pan and pour into jar.
Diet. See: DIET – THIN PEOPLE. Improve nutrition with potassium-rich foods. Two or more bananas daily.
Supplements. Vitamins B6, C, E. Zinc. ... bust developer
Constituents: flavone glycosides, mucilage, tannin.
Action: anti-catarrhal.
Uses: Nasal catarrh, leucorrhoea. Anaemia.
Preparations: Tea. As a medicament or daily ‘health’ tea. 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes. 1 cup as desired.
Vaginal douche: 2oz dried (or handful fresh herb) to 2 pints boiling water; infuse, and inject warm. May also be used as a lotion for skin disorders. ... dead nettle
Symptoms: vomiting, nausea, abdominal pain. Leads to rapid liver degeneration.
Tinctures. Formula. Echinacea 3; Goldenseal 1; Myrrh 1. Dose: 30-60 drops every 2 hours. Practitioner. Stomach irrigation. 50mg ampoules of Silymarin (Madaus) injected by a physician. ... death cap
DERMATOGRAPHIA. A form of nettle rash (hives). Rubbing a sensitive surface produces raised rough patches. ‘Skin writing.’ Treat as for NETTLE RASH. ... dermatitis, seborrhoeic
Every cardiac prescription for this condition should include a gentle diuretic to assist kidney function. The kidneys should be borne in mind, the most appropriate diuretic being Dandelion which would also make good any potassium loss. ... heart – fibrous degeneration
Symptoms. High cholesterol levels, pathological laughing and crying, depression, delusion. Alternatives. Evening Primrose, Oats, Alfalfa, Garlic. German Chamomile, Gotu Kola, Ginkgo, Ginseng. Hawthorn, Rutin.
Powders. Formula: Hawthorn 3; Ginkgo 2; Lily of the Valley 1. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.
Liquid Extracts. Formula as for powders. Dose: one 5ml teaspoon thrice daily.
Tinctures. Formula as above. Dose: two 5ml teaspoons thrice daily.
Guar gum. Lowers serum fat levels, body weight and blood pressure.
Aromatherapy: massage and inhalation: Rosemary.
Arnica. Lotion: 1 part Tincture Arnica to 20 parts distilled extract Witch Hazel. Wipe over forehead and hair-line 1-3 times daily.
Diet. Egg-yolk, Lecithin, Oatmeal porridge.
Supplements. Vitamins A, B-complex, B12, C and E. Choline, Folic acid, Magnesium, Manganese, Zinc. ... dementia, (atherosclerotic)
Symptoms. Disorientation, failure of memory for recent events, failure to comprehend, unable to form elemental judgements, confusion, ataxia (lack of coordination of muscles), emotional instability with outbursts, forgetful.
Alternatives. Remedies known to sustain the brain. Nervines and alteratives believed to leach from the body deposits of toxic minerals: aluminium, sulphur, mercury, etc. Gotu Kola, Ginseng, Ginkgo, Vitamin E conserve oxygen. Pulsatilla – success reported for mental outbursts. Vasodilator of value. Ginkgo favourably reported.
Teas. Basil, Ginseng, Gotu Kola, German Chamomile, Horsetail, Yarrow.
Tea. Formula. Equal parts, Ginkgo, German Chamomile, Yarrow. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup thrice daily.
Tablets/capsules. Prickly Ash, Ginseng, Ginkgo, Kelp, Pulsatilla.
Powders, Liquid Extracts, Tinctures. Combine: Gotu Kola 3; Vervain 2; Rosemary 1. Doses.
Powders: 500mg; two 00 capsules or one-third teaspoon. Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water, honey or fruit juice thrice daily.
Incontinence. A frequent problem for which American Cranesbill is indicated.
Aromatherapy. Inhalation: Feverfew, Thyme.
Contra-indicated: Black Cohosh.
Diet. Low salt. Low fat. High fibre. Egg yolk. Lecithin.
Supplements. Folic acid, Vitamins B-complex, B12, C and E. Selenium, to conserve oxygen. Magnesium, Manganese, Zinc.
General. Home help. Meals on Wheels. Service from local Psychogeriatric unit. ... dementia, (senile)
Essential fatty acids have an important role in the function of the nervous system, being closely related to the fatty (myelin) sheath and cell membranes. Disturbance in their metabolism may result in nerve disorder. Thus, vegetable oils of Soya, corn, safflower and sunflower should replace animal fats and dairy products.
Symptoms. Numb, prickling, tickling sensation on the skin, paralysis, incoordination, physical weakness and visual complaints.
Treatment. Indeterminate diagnosis.
Tablets/capsules. Prickly Ash, Black Cohosh, Ginseng, Ginkgo.
Powders, Liquid Extracts, Tinctures. Formula. Equal parts: Black Cohosh, Prickly Ash, Ginseng. Doses. Powders: two 00 capsules or one-third teaspoon, (500mg). Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water, honey or fruit juice.
Evening Primrose oil capsules or tablets: two 500mg thrice daily.
Aromatherapy. Rosemary spinal rub: 6 drops Oil Rosemary in 2 teaspoons Almond oil.
Diet. High protein, low fat, oily fish or 2 teaspoons Cod Liver oil daily. Gluten-free diet. Cholesterol- free – avoid milk, meat fat and dairy products. Avoid coffee and other caffeine stimulants. Dandelion coffee.
Supplements. B-complex, B3, B6, B12, C, E. Dolomite, Manganese, Zinc. ... demyelinating diseases
Treatment. Conventional medicine advises strong anti-depressants. Alternatives, until “hormones settle down”: Agnus Castus, Helonias, Milk Thistle. Raspberry leaf tea (tablets/capsules/liquid extracts/tinctures). Special attention to the thyroid gland.
Diet. See: GENERAL DIET.
Supplements. Vitamins: B group, E. Minerals: Calcium, Iodine, Magnesium, Zinc. Tyrosine. Supportives: Astute GP, helpful health visitor, thoughtful husband. ... depression – post-natal
In a study of 612 patients attending the Royal Hallamshire Hospital, Sheffield, more than half of the women who had ears pierced reported skin reactions to metallic jewellery, while a third had sensitivity to nickel. (British Journal of Dermatology, Jan 1992)
Treatment. Remove article or cause of irritation. Garlic is claimed to be successful, either in diet or by capsule when the condition is caused by histamines. Other agents: Betony, Burdock leaves, Chickweed, Dandelion, Figwort, Gotu Kola, Plantain, Red Clover.
Internal. Burdock tea. Clivers tea.
Tablets/capsules. Garlic, Devil’s Claw, Blue Flag.
Topical. Avoid use of Calamine, if possible. Creams or salves: Aloe Vera, Comfrey, Evening Primrose, Witch Hazel, Jojoba. All are alternatives to corticosteroids.
Tamus (Black Bryony) tincture. Distilled extract of Witch Hazel. ... dermatitis, contact
Alternatives. Teas. Betony, Burdock leaves, Bogbean, Chickweed, Clivers, Dandelion, Gotu Kola, Ground Ivy, Figwort, Red Clover, Violet, Yarrow.
Cold tea. Barberry bark: one heaped teaspoon to each teacup cold water; stand overnight, drink 1 cup morning and evening next day (most effective).
Tablets/capsules. Blue Flag root, Burdock, Devil’s Claw, Echinacea, Garlic, Poke root, Queen’s Delight, Red Clover, Seaweed and Sarsaparilla.
Formula. Equal parts: Dandelion, Echinacea, Yellow Dock root. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Thrice daily before meals.
Topical. Alternatives to corticosteroids. Tamus tincture or salve – see Black Bryony. Aloe Vera, Witch Hazel, Comfrey, Evening Primrose, Jojoba, Thuja. Bran bath.
Diet. See: DIET – SKIN DISEASES. ... dermatitis, exfoliative
Alternatives. Teas. Betony, Burdock, Elderflowers, German Chamomile, Hops, Gotu Kola, Mullein, Plantain, Red Clover, Valerian.
Tea formula. Equal parts, Mullein, Red Clover, Valerian. Mix. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes; 1 cup thrice daily.
Tablets/capsules. Blue Flag, Dandelion, Devil’s Claw, Echinacea, Poke root, Red Clover, Seaweed and Sarsaparilla, Valerian.
Powders. Formula. Equal parts: Burdock root, Dandelion root, Valerian root. Two 00 capsules or one- third teaspoon thrice daily, (500mg).
Liquid extracts or tinctures. Formula. Chickweed 10ml; Poke root 5ml; Meadowsweet 10ml; Valerian 10ml. Dose: liquid extracts, one 5ml teaspoon; tinctures, two 5ml teaspoons. Thrice daily in water. Topical. Apply dilute Tea Tree oil 3-4 times daily. Witch Hazel, Aloe Vera, Vitamin E cream, Evening Primrose oil, or Marshmallow and Slippery Elm ointment. Bran bath.
Diet. Gluten-free.
DERMATITIS, LIGHT. Photo dermatitis. Reddening and blistering of the skin on exposure to sunlight.
See: SUNBURN. ... dermatitis, herpetiformis
For internal cleansing. Urinary tract – Dandelion, Burdock. Liver – Dandelion, Milk Thistle. Mucous membrane – Goldenseal. Blood – Burdock, Red Clover, Yellow Dock. Intestinal tract – Slippery Elm, Fenugreek, Meadowsweet. Womb – Raspberry leaves. Lymphatic system – Figwort, Poke root. Lungs – Mullein, Angelica root. Skin – Yellow Dock, Chamomile. ... detoxifiers
For minor procedures, a local anaesthetic (see anaesthesia, local) is injected either into the gum at the site being treated or into the nerve a short distance away (called a peripheral nerve block).
In addition, topical anaesthetics are often used on the gums.
For more complicated procedures, such as periodontal (gum) surgery and multiple tooth extractions, general anaesthesia is carried out (see anaesthesia, general).... anaesthesia, dental
The surface of the affected tooth is painted with oxidizing agents and then exposed to ultraviolet light.... bleaching, dental
It is sometimes used as an alternative to crowning (see crown, dental) and may also be used as a preventive technique to protect the teeth.... bonding, dental
Keynote: rheumatism. A versatile remedy.
Constituents: flavonoids, iridoid glycosides.
Action: anti-inflammatory, antirheumatic, analgesic (mild), liver tonic, cholagogue, diuretic, sedative, detoxicant, stomachic, lymphatic, stimulant, cortisone-like action.
Use s. Inflammatory arthritic stiff joints. Gout. Lumbago, sciatica, polymyalgia, neuralgia, liver congestion. Gall bladder disorders. Itching skin conditions. Piles. Inflammatory conditions of the veins. Avoid in pregnancy. Not given in presence of gastric or duodenal ulcer.
Preparations: Thrice daily.
Tablets: dosage as on bottle.
Alternative: a tea is made by dissolving tablets in a cup of boiling water.
Decoction. Quarter to half a teaspoon in each cup water gently simmered 15 minutes. Dose: half a cup. Liquid Extract, BHC Vol 1. (1:1, 25 per cent ethanol). Dose: 1-2ml.
Powder. 250mg capsules; maintenance dose, 2 capsules thrice daily with meals. Or applied to open wounds for healing. ... devil’s claw
A preliminary therapeutic trial in patients with ageing macular degeneration or diabetic retinopathy showed that supplementation with Beta-carotene, Vitamin C, Vitamin E and Selenium halted the progression of degenerative changes and in some cases even brought some improvement. (Age and Ageing 1991, 20(1) 60-9). Bilberries.
Referral to a consultant ophthalmologist. ... eyes - macular degeneration
Services of a qualified optician should be sought after limits of the Bate’s Method of eyesight training have been reached.
Alternatives. Tablets/capsules. Ginseng. Gotu Kola.
Powders. Mix. Parts: Gentian 2; Dandelion 1; pinch Cayenne. Dose: 500mg, (two 00 capsules or one- third teaspoon) thrice daily. (To build-up good general health)
Cider Vinegar. 2 teaspoons to tumbler water; sips during the day.
Topical. Teas. Any one: Eyebright, Fennel, German Chamomile, Plantain, Rue. 1 teaspoon to each cup boiling water; infuse 15 minutes, strain, half fill eyebath and use as a douche.
Diet. Low salt. High fibre. Bilberries.
Supplements. Daily. Vitamin A, 7500iu. Beta-carotene. B-complex. Vitamin C, 100mg. Vitamin E, 100iu. Zinc.
Supportive. Palming. Bate’s exercises. ... eyes – sight deterioration
While cure is not possible, atheroma may be arrested by a cup of herbal tea: Hawthorn blossoms, Motherwort, Horsetail: single or in combination. 1-2 teaspoons to each cup boiling water; infuse 5-15 minutes; 1-2 cups daily.
Formula. Hawthorn 2; Ginkgo 2; Horsetail 1; Ginger quarter. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Twice daily: morning and evening in water or honey.
Diet. See: DIET – HEART AND CIRCULATION. Few grains of Cayenne pepper as seasoning on food once daily.
Stop smoking. ... heart – degeneration, in the elderly
Alternatives. Teas. Alfalfa, Clivers, Yarrow, Motherwort.
Tablets/capsules. Poke root, Kelp, Motherwort.
Formula. Equal parts: Bladderwrack, Motherwort, Aniseed, Dandelion. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons in water thrice daily. Black Cohosh. Introduced into the medical world in 1831 when members of the North American Eclectic School of physicians effectively treated cases of fatty heart.
Diet. Vegetarian protein foods, high-fibre, whole grains, seed sprouts, lecithin, soya products, low-fat yoghurt, plenty of raw fruit and vegetables, unrefined carbohydrates. Oily fish: see entry. Dandelion coffee. Reject: alcohol, coffee, salt, sugar, fried foods, all dairy products except yoghurt.
Supplements. Daily. Broad-spectrum multivitamin including Vitamins A, B-complex, B3, B6, C (with bioflavonoids), E, Selenium. ... heart – fatty degeneration
To strengthen nerves and generate vitality: Ginseng, Bee pollen, Oats, Ginkgo, Saw Palmetto, Damiana. Tea. Formula. Equal parts: Betony, Balm, Skullcap. One heaped teaspoon to each cup boiling water; infuse 5-15 minutes. 1 cup thrice daily.
Gentian. One teaspoon fine-cut root in cup cold water; infuse overnight. Strain; drink cold following morning.
Tablets/capsules: Damiana, Skullcap, Lady’s Slipper, Ginseng, Ginkgo.
Formula. Equal parts: Gentian, Oats. Gotu Kola. Dose: Liquid Extracts: 2 teaspoons. Tinctures: 3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon). Thrice daily.
After surgical operation: St John’s Wort. Hawthorn. ... nervous debility
The affected tooth aches or throbs, and biting or chewing is usually extremely painful. The gum around the tooth is tender and may be red and swollen. An untreated abscess eventually erodes a sinus (channel) through the jawbone to the gum surface, where it forms a swelling known as a gumboil. As the abscess spreads, the glands in the neck and the side of the face may become swollen, and fever may develop. Treatment may consist of draining the abscess, followed by root-canal treatment of the affected tooth, but in some cases extraction of the tooth is necessary. Antibiotics are prescribed if the infection has spread beyond the tooth.
An abscess in a periodontal pocket can usually be treated by the dentist scraping away infected material.... abscess, dental
Cosmetic dentistry procedures include: fitting an orthodontic appliance to correct teeth that are out of alignment or where the bite is incorrect (see malocclusion); fitting a crown; bonding to treat chipped or stained teeth; and bleaching of discoloured teeth.... cosmetic dentistry
Iron deficiency may also be caused or worsened by lack of iron in, or its poor absorption from, the diet.
The symptoms are those of the underlying cause, along with a sore mouth or tongue, and those common to all forms of anaemia, such as fatigue and breathlessness. The diagnosis is made from blood tests and tests to look for an underlying cause. Treatment is given for the cause, along with a course of iron tablets or, very rarely, injections.... anaemia, iron-deficiency
at the tooth’s core. Advanced decay causes toothache and bad breath.
Treatment consists of drilling away the area of decay and filling the cavity (see filling, dental). In advanced decay, it may be necessary to remove the infected pulp (see extraction, dental).
Water fluoridation and the use of fluoride toothpaste helps prevent caries.
The risk of caries is also reduced by cutting sugar consumption, practising good oral hygiene, and visiting the dentist regularly.... caries, dental
Although there is wide variation in individual rates of progress, most children develop certain skills within predictable age ranges.
For example, most infants start to walk at 12–18 months.
Capability for new skills is linked to the maturity of the child’s nervous system.
Individual rates of maturity are determined genetically and modified by environmental factors in the uterus and after birth.
Development is assessed in early childhood by looking at abilities in 4 main areas: locomotion; hearing and speech; vision and fine movement; and social behaviour and play.
(See also developmental delay.)... child development
A crown may be fitted by filing the natural tooth to form a peg and cementing the crown over the top. If the tooth is... crown, dental
Dental curettage is one method used to remove the lining of periodontal pockets and diseased tissue from root surfaces in periodontitis.... curettage, dental
(See also caries, dental.)... decalcification, dental
To treat major disc prolapses and tumours, a laminectomy (removal of the bony arches of 1 or more vertebrae) to expose the affected part of the cord or nerve roots may be performed. Recovery after treatment depends on the severity and duration of the pressure, the success of the surgery in relieving the pressure, and whether any damage is sustained by the nerves during the operation.... decompression, spinal canal
They work by narrowing blood vessels in the membranes lining the nose.
This action reduces swelling, inflammation, and the amount of mucus produced by the lining.
Common drugs include ephedrine, oxymetazoline, and phenylephrine.
Small amounts of these drugs are present in many over-thecounter cold remedies.
Taken by mouth, decongestant drugs may cause tremor and palpitations.
Adverse effects are unlikely with nose drops, but if taken for several days they become ineffective and symptoms may then recur or worsen despite continued treatment.... decongestant drugs
Defoliants are poisonous if swallowed.
Widely used defoliants include sodium chlorate, potassium chlorate, phenoxy herbicides, and paraquat.... defoliant poisoning
Deformities may be congenital (present from birth), or they may be acquired as a result of injury, disorder, or disuse.
Most congenital deformities are relatively rare.
Among the more common are club-foot (talipes) and cleft lip and palate.
Injuries that can cause deformity include burns, torn muscles, and broken bones.
Disorders that may cause deformity include nerve problems, some deficiencies, such as rickets, and Paget’s disease of the bone.
Disuse of a part of the body can lead to deformity through stiffening and contracture of unused muscles or tendons.
Many deformities can be corrected by orthopaedic techniques, plastic surgery, or exercise.... deformity
During a routine dental examination, the dentist uses a metal instrument to
probe for dental cavities, chipped teeth, or fillings. Dental X-rays are sometimes carried out to check for problems that may not be visible. Dentists also check how well the upper and lower teeth come together. Regular examinations in children enable the monitoring of the replacement of primary teeth by permanent, or secondary, teeth. Referral for orthodontic treatment may be made. dental extraction See tooth extraction. dental X-ray An image of the teeth and jaws that provides information for detecting, diagnosing, and treating conditions that can threaten oral and general health. There are 3 types of dental X-ray: periapical X-ray, bite-wing X-ray, and panoramic X-ray.
Periapical X-rays are taken using X-ray film held behind the teeth. They give detailed images of whole teeth and the surrounding tissues. They show unerupted or impacted teeth, root fractures, abscesses, cysts, and tumours, and can help diagnose some skeletal diseases. Bite-wing X-rays show the crowns of the teeth and can detect areas of decay and changes in bone due to periodontal disease. Panoramic X-rays show all the teeth and surrounding structures on one large film. They can show unerupted or impacted teeth, cysts, jaw fractures, or tumours. The amount of radiation received from dental X-rays is extremely small. However, dental X-rays should be avoided during pregnancy.... dental examination
outer surfaces of the front teeth is most frequently caused by excessive intake of fruit juices and carbonated drinks. Erosion of the inner surfaces of the molars may be a result of the regurgitation of stomach acid, as occurs in people suffering from acid reflux or bulimia. (See also caries, dental.)... erosion, dental
There is a widespread rash with severe flaking of the skin, which results in increased loss of water and protein from the surface of the body.
Protein loss may cause oedema and muscle wasting.
Further possible complications include heart failure and infection.
The treatment and outlook depend on the cause.... exfoliative dermatitis
For most extractions, local anaesthesia is used (see anaesthesia, dental). Teeth are usually extracted with dental forceps, which grasp the root of the tooth. In difficult extractions, some gum and bone may also need to be removed from around the tooth.... extraction, dental
using soft nylon or silk thread or tape.
Dental floss may be waxed or unwaxed.
Flossing should be carried out as an adjunct to toothbrushing.... flossing, dental
the mother is unable to push out her baby unaided, or if the baby is showing signs of fetal distress. Forceps are also used to control the head once the body has been delivered in breech delivery to prevent too rapid a birth.An episiotomy (making of a cut in the perineum) is usually needed for a forceps delivery. Recovery and care for mother and child is usually the same as after a vaginal delivery.... forceps delivery
Fractures may involve the crown or the root of a tooth, or both.
Fractures of the enamel can usually be repaired by bonding (see bonding, dental); in some cases, a replacement crown may be fitted (see crown, dental).
Pulpotomy may be performed if the pulp of a tooth is damaged.
Fractures of the root may be treated by splinting (see splinting, dental), root-canal treatment, or removing the tooth (see extraction, dental).... fracture, dental
Impacted wisdom teeth are common, and, if symptomless, may not need to be removed.
In some cases, however, symptoms necessitate their removal.... impaction, dental
A quick-setting material, such as alginate, is placed in a mould over the teeth.
The mould is removed, and plaster of Paris is poured into it to obtain a model of the area.
This model is then used as a base on which to build a denture, bridge, or dental inlay.
Dental impressions are also used in orthodontics to study the position of the teeth and to make orthodontic appliances to correct irregularities.... impression, dental
An inlay may be needed for the back teeth or to protect a weakened tooth.... inlay, dental
Lactase deficiency results in a reduced ability to digest lactose, also known as lactose intolerance.
The condition may be permanent, or may occur temporarily after gastroenteritis, particularly in young children.
Symptoms include abdominal cramps, bloating, flatulence, and diarrhoea, all of which are caused by the laxative effect of the undigested sugar in the intestines.
Treatment is with a lactose-free diet.... lactase deficiency
Limb defects are rare and may be inherited or form part of a syndrome.
In a condition called phocomelia, hands, feet, or tiny finger- or toe-buds are attached to limb stumps or grow directly from the trunk.
The sedative drug thalidomide, when taken by pregnant women, is known to have caused phocomelia in fetuses.... limb defects
Abnormalities in brain biochemistry, or in the structure and/or function of certain nerve pathways within the brain, could underlie manic–depressive illness. An inherited tendency is also an established causative factor.Severe manic–depressive illness often needs hospital treatment. Antidepressant drugs and/or ECT are used to treat depression, and antipsychotic drugs are given to control manic symptoms. Carbamazepine or lithium may be used to prevent relapse.
Group therapy, family therapy, and individual psychotherapy may be useful in treatment. Cognitive–behavioural therapy may also be helpful. With treatment, more than 80 per cent of patients improve or remain stable. Even those with severe illness may be restored to near normal health with lithium.... manic–depressive illness
Typically, a child shows hostile, argumentative behaviour that includes loss of temper, defiance of rules, and swearing.
To some extent such behaviour is common in adolescence, but when law-breaking or violence occur the condition is deemed to be pathological.... oppositional defiant disorder
It is the chief cause of tooth decay (see caries, dental) and gingivitis, and forms the basis of a hard deposit (see calculus, dental).
Some of the microorganisms in plaque, particularly STREPTOCOCCUS MUTANS, break down sugar in the remains of carbohydrate food that sticks to the mucus, creating an acid that can erode tooth enamel.... plaque, dental
protease inhibitors A type of antiviral drug used to delay the progression of HIV infection (see AIDS).... prosthetics, dental
There are different forms of spina bifida. In spina bifida occulta, the only defect is a failure of the fusion of the bony arches behind the spinal cord, which may not cause any problems. When the bone defect is more extensive, there may be a meningocele, a protrusion of the meninges, or a myelomeningocele, a malformation of the spinal cord. Myelomeningocele is likely to cause severe handicap, with paralysis of the legs, loss of sensation in the lower body, hydrocephalus, and paralysis of the anus and bladder, causing incontinence. Associated problems include cerebral palsy, epilepsy, and mental handicap.
Surgery is usually performed a few days after birth. In mild cases, the defect can usually be corrected, but in myelomeningocele, some handicap will remain.
Genetic factors play a part in neural tube defects, which show multifactorial inheritance. Couples who have had an affected child or who have a family history of neural tube defects should seek genetic counselling. The risk of a neural tube defect occurring can be substantially reduced if the mother takes folic acid supplements for a month before conception and during the early part of the pregnancy.
Ultrasound scanning and amniocentesis allow accurate antenatal testing for neural tube defects.... neural tube defect
Overcrowded teeth may lead to malocclusion or may prevent certain teeth from erupting through the gum (see impaction, dental). They can be difficult to clean, increasing the risk of dental decay (see caries, dental) and periodontal disease.
Teeth may need to be extracted to allow room for others. Usually an orthodontic appliance is fitted to the remaining teeth to position them correctly.... overcrowding, dental
Internal resorption is rare, occurring in about 1 percent of adults.... resorption, dental
form. In the absence of these hormones, a female reproductive tract develops. At puberty, another surge of hormones produces secondary sexual characteristics.
Chromosomal abnormalities or hormonal defects can lead to ambiguous sex (see genitalia, ambiguous), although true hermaphroditism is rare.... sex determination
Irritability and a shortened attention span may occur after a short night’s sleep.
Longer periods without sleep leave a person increasingly unable to concentrate or perform normal tasks.
Three or more sleepless nights may lead to hallucinations and, in some cases, to paranoia.... sleep deprivation
A diagnosis is made by doppler ultrasound scanning.
Treatment depends on the site and extent of the clots.
Small clots may not need treatment if they are confined to the calf and the patient is mobile.
Otherwise, anticoagulant drugs or thrombolytic drugs are given.
If there is a high risk of a pulmonary embolism, thrombectomy may be performed.... thrombosis, deep vein
DHSC section of the website: provides information on a wide range of public health issues... department of health and social care
Paediatric reference values... paediatric dentistry
FAMILY: Asteraceae (Compositae)
SYNONYMS: Trilisa odoratissima, Liatris odoratissima, Frasera speciosa, hound’s tongue, deer’s tongue, Carolina vanilla, vanilla leaf, wild vanilla, vanilla trilisa, whart’s tongue, liatrix (oleoresin or absolute).
GENERAL DESCRIPTION: A herbaceous perennial plant distinguished by a naked receptacle and feathery pappus, with large, fleshy, dark green leaves, clasped at the base. When fresh, the leaves have little odour but when dried they acquire a vanilla-like odour, largely due to the coumarin that can be seen in crystals on the upper sides of the leaves.
DISTRIBUTION: Native to eastern USA; gathered on the savannah land between North Carolina and Florida.
OTHER SPECIES: There are several species of deertongue native to America, for example blazing star or prairie pine (Liatris squarrosa), and gayfeather (L. spicata). Not to be confused with the common vanilla (Vanilla planifolia) or with the European hound’s tongue (Cynoglossum officinale), all of which have been used in herbal medicine.
HERBAL/FOLK TRADITION: The roots have been used for their diuretic effects, and applied locally for sore throats and gonorrhoea. It has also been used as a tonic in treating malaria. In folklore the plant is associated with contraception and sterility in women.
ACTIONS: Antiseptic, demulcent, diaphoretic, diuretic, febrifuge, stimulant, tonic.
EXTRACTION: Oleoresin by solvent extraction from the dried leaves.
CHARACTERISTICS: A dark green, heavy, viscous liquid with a rich, herbaceous, new-mown hay scent. It blends well with oakmoss, labdanum, lavandin, frankincense, clove, patchouli and oriental-type fragrances.
PRINCIPAL CONSTITUENTS: Mainly coumarin (1.6 per cent), with dihydrotoumarin and terpenes, aldehydes and ketones.
SAFETY DATA: ‘Coumarin has toxic properties including liver injury and haemorrhages.’. (There is also the possibility of dermal irritation and phototoxicity due to the lactones present.)
AROMATHERAPY/HOME: USE None.
OTHER USES: The oleoresin is used as a fixative and fragrance component in soaps, detergents and perfumery work. Used for flavouring tobacco and; also employed for the isolation of coumarin.... deertongue
Health Encyclopedia