Ra Health Dictionary

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

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

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

See “death rate”.... mortality rate

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

See URTICARIA.... nettle-rash

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

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

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

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

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

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

See X-RAYS.... radiology

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

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

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

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

See ERUPTION.... rash

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

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

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

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

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

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

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

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

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

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

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

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

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

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

See ESR.... erythrocyte sedimentation rate

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

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

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

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

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

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

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

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

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

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

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

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

Inflammation of spinal nerve roots... radiculitis

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

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

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

A cancer that responds to radiotherapy.... radiosensitive

Senecio jacobaea. N.O. Compositae.

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

Nanny.

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

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

Part used ? Herb.

Action: Diaphoretic, detergent, antiseptic.

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

See CREPITATIONS.... râle

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

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

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

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

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

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

Rubus idaeus. N.O. Rosaceae.

Synonym: Rubus strigosus, American Raspberry.

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

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

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

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

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

Part used ? Leaves.

Action: Astringent, stimulant.

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

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

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

See ESR.... sedimentation rate

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

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

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

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

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

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

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

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

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

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

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

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

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

willd.

Family: Asparagaceae.

Habitat: Native to Europe and West Asia.

English: Asparagus, Sparrow grass.

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

Unani: Haliyun.

Family: Asparagaceae.

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

English: Indian asparagus.

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

Unani: Sataavar.

Siddha/Tamil: Thanneervittan kizhangu, Sataavari Kizhangu.

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

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

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

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

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

The root extracts exhibited antiallergic activity in animal studies.

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

Lamk

Family: Caesalpiniaceae.

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

Ayurvedic: Ashmantaka, Kanchini.

Unani: Kachnaar.

Folk: Aapataa (Maharashtra), Kachnaala.

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

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

Rubus species

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

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

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

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

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

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

See DRUG ASSISTED RAPE.... date rape

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

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

(Linn.) Nutt.

Family: Ranunculaceae.

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

English: Black Cohosh Root, Black Snake Root.

Folk: Cohosh, Jiuenti (Punjab).

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

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

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

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

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

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

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

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

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

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

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

Linn.

Synonym: F. glomerata Roxb.

Family: Moraceae.

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

English: Cluster Fig, Country Fig.

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

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

Siddha/Tamil: Atthi.

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

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

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

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

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

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

The ethanolic extract of seeds also showed hypoglycaemic activity.

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

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

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

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

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

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

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

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

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

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

... lyssa is another term for rabies.

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

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

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

Hook. f.

Synonym: I. royleana auct. non-DC.

Family: Compositae; Asteraceae.

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

English: Elecampane.

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

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

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

Roots are used in Kashmir as adulterant of Saussurea lappa.

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

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

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

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

The roots also exhibit sedative and blood pressure lowering activity.

The European species is equated with Inula helenium Linn.

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

Linn. non-Roxb. & auct.

Vigna radiata (Linn.)

Family: Papilionaceae; Fabaceae.

Habitat: Extensively cultivated all over India.

English: Greengram, Golden Gram.

Ayurvedic: Mudga, Mungalya.

Unani: Moong.

Siddha/Tamil: Pattishai-payaru.

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

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

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

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

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

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

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

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

(German) Resembling a raven Rabeah... rabea

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

(Hebrew) A vain or empty woman Racah, Racca, Raccah... raca

(Hindi) Born of the creation Rachanna, Rashana, Rashanda, Rachna... rachana

(Hebrew) The innocent lamb; in the Bible, Jacob’s wife

Rachael, Racheal, Rachelanne, Rachelce, Rachele, Racheli, Rachell, Rachelle, Rachil, Raechel, Raechell, Raychel, Raychelle, Rashell, Rashelle, Raychel, Rechell, Rakel... rachel

Pain in the vertebral column... rachialgia

(English) Of the red cliffs Radcleff, Radclef, Radclif, Radclife, Radclyffe, Radclyf, Radcliphe, Radclyphe... radcliffe

(English) An elfin counselor Radell, Radel, Radele, Radella, Radela, Raedself, Radself, Raidself... radella

(Roxb.) K. Schum.

Synonym: Bignonia xylocarpa Roxb. Stereospermum xylocarpum (Roxb.) Wt.

Family: Bignoniaceae.

Habitat: Gujarat, Karnataka, Tamil Nadu.

English: Padri tree.

Siddha/Tamil: Vedanguruni, Pathiri.

Folk: Paadiri. Kharsing, Kadashing, Bairsinge (Maharashtra).

Action: Plant—antiseptic. Resin— used for the treatment of skin diseases. Rootbark—bitter, astringent; used as substitute for Stereospermumpersonatum (Hassk.) D. Chatterjee and S. suaveolens DC. (Trumpet-Flower, Yellow Snake tree, also known as Padri).

The leaves gave flavonoids, dinatin and its glycoside. Roots yielded O- acetyl oleanolic acid, stigmasterol and a red pigment, radermachol.... radermachera xylocarpa

(Arabic) One who is content; satisfied

Radeya, Radhiya, Radhiyah, Radhia, Radhiah, Radhea, Radheah... radeyah

(Hindi) A successful woman; in Hinduism, one of Krishna’s consorts Radhah, Radhika, Radhikah, Radheeka, Radhyka, Radheaka... radha

Neuralgia of the nerve roots... radiculalgia

Substances which absorb X-RAYS, rather than transmitting them, appear white on X-ray ?lm and are described as radio-opaque. This is true of bones, teeth, certain types of gall-stones, renal stones and contrast media used to enhance the accuracy of radiographic imaging.... radio-opaque

See ISOTOPE.... radioactive isotopes

Protection, Lust ... radish

(Slavic) Hardworking for the people

Radilla, Radinka, Radmila, Redmilla, Radilu... radmilla

(Arabic) From the mountain in Medina

Radwah, Radhwa, Radhwah... radwa

... raegan, ragan, raygan, reganne, regann, regane, reghan, reagan, reaghan, reegan

(Spanish) A beautiful and unique woman

Raekah, Rayka, Raika, Raykah, Raikah... raeka

(Arabic) One who is happy and prosperous

Rafah, Raafa, Raffa, Raffah... rafa

(Hebrew) Form of Raphaela, meaning “the divine healer” Rafelah, Rafellah, Rafella, Rafele, Rafelle... rafela

(Gaelic) A prosperous lady; wealthy Raffertey, Rafferti, Raffertie, Raffertee, Raffertea... rafferty

(Arabic) An exalted woman Rafia, Rafi’ah, Rafee’a, Rafeea, Rafeeah, Rafiya, Rafiyah... rafi’a

(Arabic) A pleasant companion; a sweetheart

Rafigah, Rafeega, Rafeegah, Rafyga, Rafygah... rafiga

(African) A beloved friend Rafikie, Rafiky, Rafikey, Rafikee, Rafikea, Raficki, Rafickie, Raficci... rafiki

(Arabic) A pleasant young woman... raghd

(English) In Arthurian legend, Gawain’s wife

Ragnal, Ragnalle, Ragnalla, Ragnale, Ragnala, Ragnallia, Ragnallea... ragnall

(Swedish) Feminine form of Ragnar; one who provides counsel to the army

Ragnarah, Ragnarra, Ragnaria, Ragnarea, Ragnari, Ragnarie, Ragnary, Ragnarey, Ragnaree... ragnara

(Norse) One who gives beautiful advice

Ragnfride, Ragnfrida, Ragna, Ragnfryd, Ragnfryde, Ragnfryda, Ragni, Ragnie, Ragny, Ragney, Ragnee, Ragnea... ragnfrid

(Norse / Teutonic) One who provides counsel in battle / an all-knowing being

Ragnild, Ragnhilda, Ragnhilde, Ragnilda, Ranillda, Renild, Renilda, Renilde, Reynilda, Reynilde, Ragnilde... ragnhild

Courage ... ragweed

(Hebrew) A trustworthy and helpful woman

Rahabe, Rahabb, Rahaba, Rahabah... rahab

(Arabic) Born during the springtime Rahii, Rahy, Rahey, Rahee, Rahea, Rahie... rahi

(Hebrew) Form of Rachel, meaning “the innocent lamb” Rahill, Raaheel, Rahille, Rahila, Rahilla, Raheela, Rahel, Rahelle... rahil

(Arabic) A compassionate woman; one who is merciful Rahima, Raheema, Raheemah, Raheima, Rahiema, Rahyma, Rahymah, Raheama, Raheamah... rahimah

(Arabic) Filled with grace Rahimate, Rahimata, Rahimatia, Rahymateh, Rahymata... rahimateh

(Polish) Form of Regina, meaning “a queenly woman”

Raenah, Raene, Rainah, Raine, Rainee, Rainey, Rainelle, Rainy, Reina, Reinella, Reinelle, Reinette, Reyna, Reynalda, Reynelle, Reyney, Reine, Ranee, Reia... raina

(American) As colorful as the rainbow; symbolizing promise Rainbowe, Raynbow, Raynebow, Raynebowe, Reinbow, Reinbowe... rainbow

(Hebrew / Greek) As beautiful as the rose / one who is carefree Raisabel, Raisse, Raiza, Raizel, Rayzel, Ra’isa, Raisie, Raizie, Raisi, Raizi, Rayzi, Rayzie, Ra’eesa... raisa

(French) A great thinker Raisa, Raissah, Rayssa, Raysa, Raison, Rayson, Raeson, Raessa... raissa

Means “root of (plant name)”; look up the plant name following this description of the plant part used.... raíz de

(Arabic) One who is filled with hope Rajah... raja

(Hindi) Born at night; in Hinduism, another name for the goddess Kali Rajanie, Rajany, Rajaney, Rajanee, Rajanae, Rajni, Rajnie, Rajny, Rajney, Rajnee, Rajnea, Rajanea... rajani

(Arabic) A lustrous woman Rakshanda, Rakhshonda, Rakshonda, Rakshona, Rakhsha, Raksha... rakhshanda

(Hebrew) From the shore town Rakkathe, Rakkatha, Rakath, Rakathe, Rakatha, Rakkon, Rakon, Rakkona, Rakona... rakkath

(English) From the clearing of roe deer

Raileigh, Railey, Raley, Rawleigh, Rawley, Raly, Rali, Ralie, Ralee, Rawli, Rawlie, Rawlee, Rawly... raleigh

Abnormal sounds in the lungs, either from excess secretions or the narrowing of the bore by inflammation or congestion.... rales

(English) Feminine form of Ralph; wolf counsel Raphine, Ralpheene, Ralpheyne, Ralfina, Ralfeene, Ralfine... ralphina

(Hebrew) One who is exalted Ramah, Ramath, Ramatha, Ramathe... rama

Means “branch of (plant name)”; this would include the leaves and stem of the plant; look up the plant name which follows this description of the plant part used.... rama de

(Spanish) A sensible and thoughtful woman

Ramirah, Rameera, Rameerah, Rameira, Ramiera, Ramyrah, Ramyra, Rameirah, Ramierah, Rameara, Ramearah... ramira

Means “small branch or sprig of (plant name)”; look up the plant name which follows this description of the plant part used.... ramita de

Inflammation of a nerve root... ramitis

(African) A prophetess Ramlah, Ramli, Ramlie, Ramly, Ramley, Ramleigh, Ramlee, Ramlea... ramla

(Spanish) Feminine form of Ramon; one who offers wise protection Ramee, Ramie, Ramoena, Ramohna, Ramonda, Ramonde, Ramonita, Ramonna, Ramowna, Remona, Remonna, Romona, Romonda, Romonde, Romonia, Raimunda, Raimonda, Raimona... ramona

(English) From the raven island; from the island of wild garlic Ramsay, Ramsie, Ramsi, Ramsee, Ramsy, Ramsea... ramsey

(Hindi) An elegant and beautiful woman

Ramyah, Ramiya, Ramiyah, Ramia, Ramiah... ramya

(Arabic) An eye-catching woman; to gaze upon

Ranah, Ra’naa, Rand, Raniyah, Ranarauna, Ranaraunaa, Raunaa... rana

(Irish) A charming woman; one who is prosperous

Ranalt, Rathnait, Ranaite, Rathnaite, Ranalta... ranait

(English) Feminine form of Randall; shielded by wolves; form of Miranda, meaning “one who is worthy of admiration”

Randa, Randee, Randelle, Randene, Randie, Randy, Randey, Randilyn, Randilynn, Randilynne... randi

A sample that is arrived at by selecting sample units such that each possible unit has a fixed and determined probability of selection.... random / random sample

Poir.

Synonym: R. spinosa Poir. R. brandisii Gamble. R. longispina W. & A. R. tomentosa W. & A. non Blume. Xeromphis spinosa Keay.

Habitat: Assam, Naga and Khasi Hills, Travancore and the Andamans.

English: Common Emetic Nut.

Ayurvedic: Madana, Chhardana, Pindi, Shalayaka, Vishapushpaka.

Unani: Mainphal, Jauz-ul-Qai.

Siddha/Tamil: Marukkaaraikai, Madkarai.

Folk: Mainphal.

Action: Fruit—nervine, calmative, antispasmodic, emetic, anthelmintic, abortifacient. Used as a substitute for ipecacuanha.

The Ayurvedic Pharmacopoeia ofIn- dia recommends the dried fruit in chlorosis, common cold, rhinitis and obstinate skin diseases.

The activity of the drug is attributed to the presence of saponins which occur to the extent of 2-3% in fresh fruits and about 10% in dried whole fruit. The saponins are concentrated mostly in the pulp. A mixture of two saponins, viz. randialic or neutral saponin and randialic acid or acid saponin has been isolated from the pulp. On complete hydrolysis both the saponins yield oleanolic acid as sapogenin. Ursosaponin, isolated from the ethanolic extract of the dried whole fruit, gave ursolic acid and glucose. Randianin, isolated from the fruit, gave a haemolytic triterpe- noid saponin.

In experimental animals, the drug caused haemolysis both in vitro and in vivo. Crude saponin fraction showed haemolytic, molluscidal and immuno- stimulating activities.

Oleanolic acid 3-glucoside, isolated from the seed, exhibited anti-arthritic activity in exudative and proliferative phases of inflammation in rats.

Dosage: Fruit—0.5-1.0 g powder for decoction, 3-6 g for induction vomiting. (API, Vol. I.)... randia dumetorum

DC.

Synonym: Catunaregam uliginosa (Retz.) Sivarajan.

Family: Rubiaceae.

Habitat: Southern, Central and Eastern India, including Assam and Sikkim.

Ayurvedic: Pindaalu, Pinditaka.

Siddha/Tamil: Wagatta, Perunkarai.

Folk: Mainphal, Pindaar, Pendraa, Pendhar.

Action: Unripe fruit—astringent. Root—diuretic; used for biliousness, diarrhoea and dysentery

Unripe fruits are roasted and used as a remedy for dysentery and diarrhoea. The root, boiled in purified butter, is also prescribed for dysentery and diarrhoea.

The fruits, like those of Randia spinosa, contain a toxic saponin of oleanolic acid. They also contain leu- cocyanidin and mannitol. The flowers yield an essential oil similar to Gardenia oil.... randia uliginosa

The sampling process whereby each unit in the population has an equal chance of being selected.... random sampling

The tendency for the estimated magnitude of a parameter (e.g. based upon the average of a sample of observations of a treatment or intervention effect) to deviate randomly from the true magnitude of that parameter. Random variation is independent of the effects of systematic biases. In general, the larger the sample size, the lower the random variation of the estimate of a parameter. As random variation decreases, precision increases.... random variation / random error

A method of comparing the results between two or more groups of patients intentionally subjected to di?erent methods of treatment – or sometimes of prevention. Those subjects entering the trial have to give their informed permission. They are allocated to their respective groups using random numbers, with one group (controls) receiving no active treatment, instead receiving either PLACEBO or a traditional treatment. Preferably, neither the subject nor the assessor should know which ‘regimen’ is allocated to which subject: this is known as a double-blind trial.... randomised controlled trial

A technique of assigning subjects to intervention and control groups that is based only on chance distribution. It is used to diminish selection bias.... randomization

In statistics, the difference between the largest and smallest values in a distribution. In common use, the span of values from smallest to biggest.... range

(Hebrew) A lovely singer; a queenly woman

Rania, Ranice, Ranique, Ranit, Ranica, Ranita, Ranite, Ranith, Ranitta, Raanee, Rane, Ranie... rani

(American) Form of Danielle, meaning “God is my judge” Ranele, Ranelle, Raniele, Raniela, Raniella, Raniel... ranielle

(Indian) Feminine form of Ranjit; a charming and delightful woman Ranjitah, Ranjyta, Ranjytah, Ranjeeta, Ranjeetah... ranjita

(Norse) A house woman Rannveig, Ranveiga, Ranveige, Ronnaug, Ronaug... ranveig

Linn.

Family: Ranunculaceae.

Habitat: The Western Himalayas from Kashmir to Kumaon.

English: Corn Buttercup.

Folk: Chambul (Punjab). Gager- kanda (Kashmir).

Action: Used in intermittent fevers, asthma and gout.

The active principle of the herb is protoanemonin (0.54%) and its glyco- sidic precursor, ranunculin. The herb yields hydrocyanic acid in very small amounts.

The leaves contain the antifungal lactone protoanemonin which inhibited growth of Epidermophyton floccosum and the yeast Rhodotorula glutinis.... ranunculus arvensis

Linn.

Family: Ranunculaceae.

Habitat: The plains of northern India, and the warm valleys of the Himalayas from Kashmir to Assam.

English: Blister Buttercup, Celery- leaved Crowfoot.

Ayurvedic: Kaandira, Kaandakatu- ka, Naasaa-samvedana, Toyavalli, Sukaandaka.

Folk: Jal-dhaniyaa.

Action: Fresh Plant—highly acrid, rubefacient, vesicant and toxic; causes inflammation of the digestive tract. Used after drying or as a homoeopathic medicine for skin diseases.

The plant contains anemonin, pro- toanemonin, ranunculine, serotonin and other tryptamine derivatives.

Serotonin (5-hydroxytryptamine) is a potent vaso-constrictor. Pro- toanemonin possesses strong antibacterial, antiviral, cytopathogenic and vermicidal properties, and is effective against both Gram-positive and Gramnegative bacteria, similar to penicillic acid. It inhibits the growth of E. coli, Staphylococcus aureus and Candida al- bicans. It inactivates in vitro diptheria toxin.

Dosage: Whole plant—1-3 g powder. (CCRAS.)... ranunculus sceleratus

Chaix.

Synonym: R. aquatilis Linn. var. capillaceus DC.

Family: Ranunculaceae.

Habitat: Kashmir to Sikkim.

English: Water Crowfoot, Water Fennel.

Ayurvedic: Kaandira (var.).

Folk: Tohlab (Kashmir).

Action: Herb—used in intermittent fevers, rheumatism and asthma.

Ranunculus muricatus Linn. (Punjab and Kashmir) is used in intermittent fevers, gout and asthma in Europe. The herb is rubefacient, vesicant and narcotic.... ranunculus trichophyllus

(Gaelic) Form of Rachel, meaning “the innocent lamb” Raonaide, Raonaida, Raonayd, Raonayde, Raonaild, Raonailde, Raonailda, Raoghnailt... raonaid

(French) Feminine form of Raoul; wolf counsel Raoula, Raula... raoule

(Hebrew) Feminine form of Raphael; the divine healer Rafaela, Rafaelia, Raffaella, Raffaela, Raffaele, Raffaella, Rafella, Rafelle, Raphaella, Raphaelle, Raphayella, Raphella, Refaella, Refella, Rephaela, Rephayelle... raphaela

(Hebrew) A tall, looming woman Rapha, Raphae, Raphia, Raphiah, Raphea, Rapheah... raphah

(Hebrew) One who has been healed by God

Raphoo, Raphou... raphu

(Spanish) Form of Rachel, meaning “the innocent lamb”

Racquel, Racquell, Raquela, Raquelle, Roquel, Roquela, Rakel, Rakell... raquel

(Arabic) Resembling a young gazelle Rashah, Raisha, Raysha, Rashia, Raesha... rasha

(Arabic) Feminine form of Rashid; a righteous woman; one who is guided in the right direction

Rasheda, Rasheeda, Rasheedah, Rasheida, Rashidah, Rashyda, Rachida, Raashida, Raashidah... rashida

Linn.

Family: Cruciferae; Brassicaceae.

Habitat: Cultivated in Uttar Pradesh, Punjab, Maharashtra and Gujarat.

English: Radish.

Ayurvedic: Muulaka, Laghu- muulaka, Muulakapotikaa, Visra, Shaaleya, Marusambhava. Pods— Sungraa, Singri, Mungraa.

Unani: Muuli, Turb Fajal.

Siddha/Tamil: Mullangi.

Action: Radish—preparations are used in liver, gallbladder and urinary complaints. Green leaves— diuretic and carminative. Seeds— diuretic, purgative, expectorant.

A decoction of dry radish is given orally in piles. Extract of the dry root is given for hiccough, influenza, dysentery, colic and urinary troubles.

Key application: In peptic disorders, especially those related to dyskinesia of the bile ducts; and in catarrhs of the upper respiratory tract. (German Commission E.)

The Ayurvedic Pharmacopoeia of India recommends the juice of the whole plant in sinusitis; juice of the root in diseases of the throat and sinusitis; and the seed in amenorrhoea, cough and dyspnoea.

The fleshy root and seeds contain trans-4-methyl-thiobutenyl isothio- cyanate glucoside (the pungent principle), cyanidin-5-glucoside-3-sophoro- side, pelargonidin diglycoside, cyani- din diglycoside, 5-methyl-L-cysteine- sulphoxide (methiin), steroidal sa- pogenins and sulphorophene.

The enzymes present in the radish are phosphatase, catalase, sucrase, amylase, alcohol dehydrogenase and pyruvic carboxylase.

Radish contains caffeic acid and fer- ulic acid which exhibit hepatoprotec- tive and choleretic properties. It contains choline which prevents deposition of fat in liver. Amino acids, or- nithine, citrulline, arginine, glutamic acid and asparatic acid remove toxins from the body and urea acumulation.

Radish is a good source of ascorbic acid (15-40 mg/100 g), trace elements include aluminium, barium, lithium, manganese, silicon, titanium, also iodine (upto 18 mcg/100 g) and ascor- bigen.

Roots, leaves, flowers and pods are active against Gram-positive bacteria.

The seeds are reported to contain a broad spectrum antibiotic, machro- lysin, specific against Mycobacterium tuberculosis. Raphanin, extracted from the seeds, is active against Grampositive and Gram-negative bacteria.

A purified basic protein, homologous to nonspecific lipid transfer proteins, from seeds showed antifungal activity.

Raphanus caudatus Linn., synonym R. sativus var. caudatus, is known as Rat-Tail Radish.

A native to Java, it is cultivated in northern and western India. The root is not used; pods, purple or violet in colour, are consumed for properties attributed to Raphanus sp. These are known as Mungraa or Sungraa.

Dosage: Whole plant-20-40 ml juice; root—15-30 ml juice. (API, Vol. II.) Seed—1-3 g powder. (API, Vol. III.)... raphanus sativus

This is characterised by the presence of rapid eye movements and a reduction in muscle tone. Cerebral cortical activity is prominent and its blood ?ow increased. This activity is, however, di?erent from wakefulness and may cause irregular movements of the body as well as of the eyes. Most dreams occur in REM sleep: these may represent a process of reorganising mental associations after the period of wakefulness. The analysis of the content of dreams has been subject to a variety of interpretations, but no consensus view has evolved.

Physiological changes, such as a fall in temperature and blood pressure, take place just before sleep and continue during the early stages of NREM sleep. There is an intrinsic rhythm of sleep which in most subjects has a periodicity of around 25 hours. This can be modi?ed by external factors to bring it into line with the 24-hour day. Two peaks of a tendency to sleep have been identi?ed, and these usually occur between around 14.00–18.00 hours, and 02.00–06.00 hours. There are, however, di?erences according to age, in that, for instance, infants sleep for most of the 24 hours; during adolescence there is also an increase in the duration of sleep. Sleep requirements fall later in life, but there are wide genetic di?erences in the amount of sleep that people require and also the time at which they fall asleep most readily.

The internal clock can be disturbed by a variety of external factors which include irregular sleeping habits due, for instance, to shift work or jet lag. Sleep is also more likely to occur after physical exertion, reading and social activity. The duration and intensity of exposure to light can also modify sleep profoundly. Light promotes wakefulness and is the main factor that adjusts the 25-hour internal rhythm to the 24hour daily cycle. Neural connections from the retina of the EYE act on an area in the brain called the supra-chiasmatic nucleus which stimulates the pineal gland which produces MELATONIN. This is thought to trigger the range of neurological and metabolic processes that characterise sleep.... rapid-eye-movement (rem) sleep

(Indian) A sweet woman Rashmikah, Rashmyka, Rashmeeka, Rashmeika... rashmika

(Thai) Resembling a crystal Ratanah, Ratanna, Ratannah, Rathana, Rathanna... ratana

Review by a government or private agency of a hospital’s or health service’s budget and financial data, performed for the purpose of determining if the rates are reasonable of the rates and evaluating proposed rate increases.... rate review

A method of paying health care providers in which the government establishes payment rates for all payers for various categories of health service.... rate setting

(Hindi) In Hinduism, goddess of passion and lust

Ratie, Ratea, Ratee, Raty, Ratey... rati

The value obtained by dividing one quantity by another: a general term of which rate, proportion, percentage, etc. are subsets. A ratio is an expression of the relationship between a numerator and a denominator where the two usually are separate and distinct quantities, neither being included in the other.... ratio

See “measurement scale”.... ratio scale

(Indian) As precious as a jewel Ratnah, Ratnia, Ratnea... ratna

(Indian) Born in the evening Ratrie, Ratry, Ratrey, Ratree, Ratrea... ratri

Calamus species

Description: The rattan palm is a stout, robust climber. It has hooks on the midrib of its leaves that it uses to remain attached to trees on which it grows. Sometimes, mature stems grow to 90 meters. It has alternate, compound leaves and a whitish flower.

Habitat and Distribution: The rattan palm is found from tropical Africa through Asia to the East Indies and Australia. It grows mainly in rain forests.

Edible Parts: Rattan palms hold a considerable amount of starch in their young stem tips. You can eat them roasted or raw. In other kinds, a gelatinous pulp, either sweet or sour, surrounds the seeds. You can suck out this pulp. The palm heart is also edible raw or cooked.

Other Uses: You can obtain large amounts of potable water by cutting the ends of the long stems (see Chapter 6). The stems can be used to make baskets and fish traps.... rattan palm

Protection, Money ... rattlesnake root

Linn.

Synonym: R. canescens L.

Family: Apocynaceae.

Habitat: Abundant in moist and warm regions of West Bengal, particularly in 24 Parganas and Howrah, and Kerala (as a weed).

Folk: Badaa Chaand.

Action: Root—sedative, hypotensive. Plant juice, mixed with castor oil, is applied to skin diseases and to destroy parasites.

The plant contains a number of alkaloids, including rauvolscine, aj- malicine, canescine, reserpine, pseu- doyohimbine; yohimbine, corynan- thene, raunescine, iso-raunescine and recanescine.

The major alkaloid is rauwolscine (alpha-yohimbine), present in the root bark (0.1%), stem bark (0.2%) and leaves (0.5%).

The roots are often used as a substitute or adulterant of those of R. serpentina, though the reserpine content of the dried root was found to be comparatively low (0.03-0.05%).

Family: Linaceae.

Habitat: The Himalayas from Kashmir to Sikkim; commonly grown in gardens.

English: Winter-Flax, Yellow Flax.

Ayurvedic: Baasanti.

Folk: Abai (Maharashtra).

Action: Plant—used for the treatment of paralysis in Bihar. The crushed leaves and stems are applied to wounds infested with maggots.... rauvolfia tetraphylla

(English) Resembling the black bird; a dark and mysterious beauty Ravina, Rayvenne, Rayven, Rayvinn, Ravyn, Raevin, Raeven, Ravenne... raven

(Arabic) One who works the earth; a gardener

Rawda, Rawdha, Rawdhah... rawdah

(Arabic) One who recites ancient poetry

Rawiya, Rawiyya, Rawiyyah... rawiyah

(English) An elegant lady Rawni, Rawny, Rawney, Rawnee, Rawnea... rawnie

(Israeli) A beloved friend Rayah... raya

(English) An innocent woman full of grace

Raeann, Raeanna, Raeanne, Rayana, Rayanna, Rayanne, Rayane, Raeane, Raeana, Raiann, Raiane, Raianne, Raianna, Raiana... rayann

(German) Feminine form of Raymond; one who offers wise protection Raymondi, Raymondie, Raymondee, Raymondea, Raymonda, Raymunde, Raymunda... raymonde

(Hebrew / Scandinavian) One who is pure / one who provides wise counsel Raynah, Raynee, Rayni, Rayne, Raynea, Raynie... rayna

The first is less severe, characterized by blanching spasms of blood vessels leading to the hands and feet, initiated by cold, moisture, even emotional stress and low blood sugar. Sort of a finger migraine. After the spasm relaxes, the tissue distal becomes red, hot, even painful. R. Disease is more serious and perhaps deriving from different causes as well. The spasms may not subside, the effected tissues can become purplish, and in extreme cases, gangrenous.... raynauds either syndrome or disease

Benth. ex Kurz.

Family: Apocynaceae.

Habitat: The sub-Himalayas tract from Punjab to Nepal, Sikkim, Bhutan, Assam, Western Ghats and the Andamans.

English: Rauvolfia root, Serpentina Root, Indian Snakeroot.

Ayurvedic: Sarpagandhaa of Ayurvedic texts was not the Sarpagandhaa of modern medicine. (Sarpagandhaa was equated with Naakuli, Sarpach- hatrikaa and Varshaasu Chha- trikaaraa. Sarpagandhaa and Sarpasugandhaa were synonyms of Naakuli.)

Folk: Chhotaa Chaand.

Action: Root—decoction is employed to increase uterine contractions and for expulsion of foetus in difficult cases. The total alkaloidal extract of the root induces bradycardia, hypotension, sedation. It finds application in hypochondria, neuropsychi- atric disorders, psychosis and schizophrenia.

Key application: In mild, essential hypertension (borderline hypertension, especially with elevated tension of the sympathetic nervous system, for example, sinus tachycardia, anxiety, tension and psychomotor irritation, when dietetic measures alone are not sufficient. (German Commission E.)

(Average daily dose: 600 mg drug corresponding to 6 mg total alkaloid.) Treatment is usually administered with a diuretic to prevent fluid retention which may develop if Rauvolfia root is given alone. (WHO.) Contraindicated in depression, bleeding disorders, gastric and duodenal ulcers. (Sharon M. Herr.) Also contraindicated in pregnancy, since it has both teratogenic and abortifacient potential. (Francis Brinker.)

The root and root bark are rich in alkaloids, the most important being reserpine, others, around 30, which include ajmaline, ajmalicine (raubasine), ajmalicine, yohimbine, coryanthine, iso-ajmaline, neo-ajmaline, papaver- ine, raubasine, rauwolscine, rescin- namine, reserpine, sarpagine, serpentine, serpentinine, serpinine and de- serpidine.

Reserpine is hypotensive and tranquilizer, used for certain forms of mental disorders. Ajmalicine (raubasine) and rescinnamine are also hypoten- sive and tranquilizer. Deserpidine is sedative, as well as hypotensive. Aj- maline exhibits antiarrhythmic activity.

A number of Rauvolfia species are found in India: R. beddomei Hook. f.; R. densiflora Benth ex Hook. f. (Himalayas, Khasi and Aka Hills; Western and Eastern Ghats); R. micrantha Hook. f; known as Malabar Rauvolfia, (Kerala, up to an altitude of 300 m)

The roots of R. beddomei contain ajmalicine, sarpagine and serpentine, but no reserpine. R. densiflora yielded 0.51% of total alkaloids (reserpine 0.01%). R. micrantha gave ajmalicine, raunamine, reserpiline, sarpagine, neosarpagine, in addition to reserpine.

(In classical Ayurvedic texts, Nakuli and Gandha-naakuli were included in compound formulations for mental diseases.)... rauvolfia serpentina

So called after Maurice Raynaud (1834–81), the Paris physician who published a thesis on the subject in 1862. This is a condition in which the circulation (see CIRCULATORY SYSTEM OF THE BLOOD) becomes suddenly obstructed in outlying parts of the body. It is supposed to be due to spasm of the smaller arteries in the affected part, as the result of them responding abnormally to impuilses from the SYMPATHETIC NERVOUS SYSTEM. Its effects are increased both by cold and by various diseases involving the blood vessels.

Symptoms The condition is most commonly con?ned to the occurrence of ‘dead ?ngers’ – the ?ngers (or the toes, ears, or nose) becoming white, numb, and waxy-looking. This condition may last for some minutes, or may not pass o? for several hours, or even for a day or two.

Treatment People who are subject to these attacks should be careful in winter to protect the feet and hands from cold, and should always use warm water when washing the hands. In addition, the whole body should be kept warm, as spasm of the arterioles in the feet and hands may be induced by chilling of the body. Su?erers should not smoke. VASODILATORS are helpful, especially the calcium antagonists. In all patients who do not respond to such medical treatment, surgery should be considered in the form of sympathectomy: i.e. cutting of the sympathetic nerves to the affected part. This results in dilatation of the arterioles and hence an improved blood supply. This operation is more successful in the case of the feet than in the case of the hands.... raynaud’s disease

(Arabic) One who’s thirst has been quenched Rayyah... rayya

(Hebrew) God’s secret; a mysterious woman

Razia, Razi, Raziela, Raziella, Razili, Raziella, Raziel, Raziele, Razie, Razee... raziah

(Swahili) A good-natured woman; one who is agreeable Raziyah... raziya

The proportion of a hospital’s patients (or a subset, such as those with asthma) who are readmitted to the hospital following discharge with the same diagnosis. It is used as a performance measure where a higher rate indicates lower quality of care.... readmission rate

The number of completed or returned survey instruments (questionnaires, interviews, etc) divided by the total number of persons who would have been surveyed if all had participated. Usually expressed as a percentage.... response rate

Risk rating means that high-risk individuals will pay more than the average premium price.... risk rating

Health status is usually obtained from survey data by asking the respondent if his/her health is excellent, very good, good, fair or poor (or similar questions).... self-rated health status / perceived health status

The proportion of female mosquitoes that have sporozoites in the salivary gland.... sporozoite rate

Roxb.

Synonym: S. beddomei C. B. Clarke S. candolleana Brand.

Family: Symplocaceae.

Habitat: Throughout North and eastern India, extending southwards to Peninsular India.

English: Lodh tree, Sapphire Berry

Ayurvedic: Lodhra, Rodhra, Shaavara., Sthulavalkal, Trita, Pattikaa Lodhra, Shaabara Lodhra.

Unani: Lodh Pathaani.

Siddha/Tamil: Vellilethi, Velli- lothram.

Action: Bark—used as specific remedy for uterine complaints, vaginal diseases and menstrual disorders; menorrhagia, leucorrhoea (The Ayurvedic Pharmacopoeia of India); also used in diarrhoea, dysentery, vaginal ulcers, inflammatory affections and liver disorders.

The bark gave colloturine, harman (loturine) and loturidine. Stem bark gave proanthocyanidin-3-monogluco- furanosides of 7-O-methyl-and 4'-O- methyl-leucopelargonidin. Betulinic, oleanolic, acetyl oleanolic and ellagic acids are reported from the plant.

Glycosides, isolated from the ethanolic extract of the stem bark, are highly astringent and are reported to be responsible for the medicinal properties of the bark.

The bark extracts have been reported to reduce the frequency and intensity of the contractions in vitro of both pregnant and non-pregnant uteri of animals. A fraction from the bark, besides showing action on uteri, was spasmogenic on various parts of the gastrointestinal tract and could be antagonized by atropine.

The bark extracts were found to inhibit the growth of E. coli, Micrococcus pyogenes var. aureus, and enteric and dysenteric groups of organisms.

Dosage: Stem bark—3-5 g powder; 20-30 g for decoction. (API, Vol. I.)

S. laurina Wall., synonym S. spica- ta Roxb. (North and East Idia, Western and Eastern Ghats); S. ramosis- sima Wall. (the temperate Himalayas from Garhwal to Bhutan); S. sumuntia Buch.-Ham. (Nepal to Bhutan) are also equated with Lodhra.

The powdered bark is used in folk medicine for biliousness, haemorrhages, diarrhoea, dysentery and genitourinary diseases.

Symplocos theaefolia Buch-Ham. ex D. Don (the Eastern Himalayas from Nepal to Bhutan and in the Khasi Hills at altitudes between 1,200 and 2,500 m) is known as Kharanl in Nepal and Dieng-pei or Dieng-twe-pe in khasi.

The ethanolic extract of leaves showed hypoglycaemic activity in rats and anticancer activity against Friend- virus-leukaemia (solid) in mice. The extract of the leaves and of stems showed activity against human epider- moid carcinoma of the nasopharynx in tissue-culture.

The Wealth of India equated S. laurina with Lodh Bholica (Bengal) and S. sumuntia with Pathaani Lodh.

The wood of Symplocos phyllocalyx C. B. Clarke is known as Chandan and Laal-chandan. It should not be confused with Santalum album or Ptero- carpus santalinus.... symplocos racemosa

Invisible light rays of very short wavelength beyond the violet end of the sun’s spectrum. Ultraviolet-C (UVC) (wavelength <290 nm [nanometre – see APPENDIX 6: MEASUREMENTS IN MEDICINE]) is entirely absorbed by the earth’s atmosphere and would otherwise be lethally damaging. Ultraviolet-B (UVB – 290– 320 nm) intensity increases with altitude: it is greatest in midsummer and at midday and penetrates cirrhus cloud. UVB causes sunburn and also tanning. Ultraviolet-A (UVA – 320– 400 nm) penetrates deeper into our skins but does not cause sunburn; it is implicated in many photochemical reactions and PHOTODERMATOSES and in CARCINOGENESIS. UVR helps the skin to synthesise vitamin D.

Ultraviolet lamps produce UVR and are used to tan skin but, because of the risk of producing skin cancer (see SKIN, DISEASES OF), the lamps must be used with great caution.... ultraviolet rays (uvr)

Roxb.

Synonym: V. divaricata Benth & Hook. f., in part.

Tricholepis procumbens Wight. Amberboa divaricata Kuntge.

Family: Compositae.

Habitat: All over India, except West Bengal and eastwards.

Unani: Baadaavard, Al-baavard, Shukaayi.

Folk: Bhu-dandi, Sukaayi (Maharashtra).

Action: Plant—deobstruent, aperient, febrifugal, styptic. Used for disorders of the liver. The mucilage is used in coughs.

The plant yielded a glucoside pro- cumbenin A which yields an aglycone procumbenidine and glucose on hydrolysis. Fructose, surcose, lactose and maltose are also present in the plant.

Shukaayi of Unani medicine is also known as Al-shukaayaa, Al-shaukat- ul-arabia and Arabian Thorn. The fruit and root are used in Unani medicine in chronic fevers and diseases of liver and intestines.

Baadaavard has also been equated with Tricholepisprocumbens Wight and Carduus bendictus. Tricholepis sp. are known as Brahmadandi in Ayurvedic medicine. Carduus nutans Linn. is known as Gul-Baadaavard in Kashmir and is used as febrifuge.... volutarella ramosa

Raphanus sativus L., var nigra. Roots.

Action: cholagogue, digestive, hepatic.

Uses: Indigestion. To increase bile production in liver disorders and to increase intestinal peristalsis. Dyskinesias. Gall bladder disorders. Constipation. Dyspepsia.

Preparations: Powder. 230mg capsules; 3 capsules midday and evening 15 minutes before meals. (Arkocaps)

Freshly pressed Juice: half-1 cup daily. If too pungent mix with a little Slippery Elm powder. ... black radish

See: TACHYCARDIA.... heart, rapid beat

See: PRICKLY HEAT. ... heat rash

Treatment of a cancerous tumour by inserting radioactive material into the growth or into neighbouring tissue. Using this method, also called brachytherapy, radiation can be targeted at the diseased area.

Radioactive material (usually artificial radioisotopes) contained in wires, small tubes, or seeds is then implanted into or near the diseased tissue under general anaesthesia. The material is left in place for variable amounts of time depending on the radioactive substance and the tumour being treated. (See also intracavitary therapy; radiotherapy.)... interstitial radiotherapy

Acid rain air pollution is responsible for increased hospital admissions with respiratory illness when it hangs in a haze over a polluted area. The main components of acid rain are sulphates, salts of sulphur, known to cause breathing difficulties.

Alternatives. Teas: Alfalfa, Angelica leaves, Boneset, Catnep, Chamomile, Coltsfoot, Comfrey leaves, Dandelion leaves, Hyssop, Lemon Balm, Lime flowers, Milk Thistle, Mullein, White Horehound, Red Clover flowers, Sage, Violet leaves, Umeboshi tea.

Tablets/capsules. Chamomile, Echinacea, Iceland Moss, Irish Moss, Liquorice, Lobelia.

Powders. Formula. Equal parts: Echinacea, Barberry bark, Elecampane root. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.

Formula. Tinctures. Echinacea 2; Sarsaparilla 1; Fringe Tree half; Liquorice quarter. Mix. 1-2 teaspoons thrice daily. ... acid rain sickness

Cochlearia armoracia L. Armoracia rusticana, Gaertn. Part used: root.

Constituents: asparagine, B vitamins, Vitamin C, sinigrin and other glucosinolates, resin.

Action: efficient alternative to Cayenne pepper, Diuretic, urinary antispetic, diaphoretic, carminative; liver, spleen and pancreatic stimulant. Bacteriostatic action on Gram-negative bacilli. (Rudat K.D. (1957) Journal Hyg. Epidem. Microbiol. Immunol. Prague 1213)

To raise vital force in the elderly. Antibiotic. Circulatory stimulant with warming effect. Digestive aid. Anti-thyroid.

Uses: Feeble circulation, hypothermia, hyperthyroidism, frostbite, chilblains, absence of stomach acid in the elderly, dropsy following fevers, proteinuria (albuminuria), to arrest vaginal discharge. Hoarseness (1 teaspoon juice in honey). Rheumatic joints (poultice). Common cold, influenza and early stages of fever: cup of Horse Radish tea every 2-3 hours. Combine with Juniper berries (equal parts) for dropsy and kidney stone. Purulent wounds: cold decoction used as a lotion.

Preparations: Average dose: 1-2 grams; thrice daily.

Tea: 1 teaspoon grated fresh root in each cup boiling water; infuse 20 minutes. Half-1 cup in sips, freely. Horse Radish vinegar. 1oz scraped fresh root to 1 pint cider vinegar. 1-2 teaspoons in water for catarrh, sinusitis, poor circulation or as a male tonic.

Steeping slices of the fresh root in cider produces a copious discharge of urine in dropsy.

Tablets, Blackmore’s Labs: Horse Radish powder 350mg; Dolomite 140mg; Gum Acacia 20mg; Magnesium stearate 10mg.

Diet: Mayonnaise: whip double cream until stiff and fold in fresh grated root, flaked almonds, lemon juice and seasoning, with a little Paprika.

Note: One of the five bitter herbs eaten by the Jews during the Passover Festival. ... horse radish

Harmful ultraviolet radiation from depletion of the ozone layer may affect general health and cause skin cancers, cataracts and immune deficiency. The protection offered by antioxidant nutrients can play a part in reducing the incidence of lens cataract. Until scientific medicine discovers effective treatment it would appear that Vitamins A, E, and Evening Primrose oil have a role to play in protection of the eyes and skin. Horsetail, rich in silica, is believed to delay progression of cataract when taken internally.

Topical. Creams to prevent burning: Vitamin E, Evening Primrose, Houseleek, Aloe Vera. Honey. Most creams contain Vitamin E which acts as a filter and moisturiser.

Diet. Foods rich in beta-carotene, Vitamins C and E.

Supplements. Vitamins A and E.

Note: Use of sunglasses and sun screens on sunny days to avoid burning. Wearing of a hat. ... ozone radiation

A now uncommon procedure in which radiating incisions are made in the cornea (up to, but not through, its innermost layer) to reduce myopia.

Radial keratotomy has been largely replaced by laser procedures, such as LASIK, which carry less risk of permanent damage to the eye.... keratotomy, radial

A surgical procedure for the removal of cancerous lymph nodes in the neck.

The operation is commonly part of the treatment of cancer of the tongue, tonsils, or other structures in the mouth and throat.... neck dissection, radical

See radionuclide scanning.... radioisotope scanning

Shallow of carcinoma ulcer the skin pigment melanin. The risk is reduced by avoiding overexposure to strong sunlight, using sunscreens, and wearing protective clothing and sun hats. Without treatment, the carcinoma gradually invades and destroys surrounding tissues but virtually never spreads to other parts of the body. Treatment is usually with surgery (or in some cases radiotherapy) and is often completely successful. Plastic surgery may also be needed, however, depending on the size and site of the tumour. People who have had a basal cell carcinoma may develop new tumours and should be alert to any changes in their skin. (See also melanoma, malignant; squamous cell carcinoma; sunlight, adverse effects of.)... raised edge

Hazards from radiation may arise from external sources of radiation or from radioactive materials taken into the body. The effects depend on the dose, the duration of exposure, and the organs exposed.

With some forms of radiation, damage occurs when the radiation dose exceeds a certain limit, usually 1 sievert (Sv) (see radiation unit). This damage may include radiation dermatitis, cataracts, organ failure (which may occur many years later), or radiation sickness.

For other types of radiation damage, the risk that damage will occur increases with increasing doses of radiation. Cancer caused by radiation-induced mutation is the major example of this type of damage. Radioactive leaks from nuclear reactors can cause a rise in mutation rates, which may lead to an increase in cancers, such as leukaemias; to birth defects; and to hereditary diseases. Cancer usually develops years after exposure. Radiation damage can be controlled by limiting exposure. People exposed to radiation at work have their exposure closely monitored to ensure that it does not exceed safe limits. People of reproductive age or younger should have their reproductive organs shielded when having X-rays or radiotherapy.There is no evidence of radiation hazards with visual display units (VDUs).... radiation hazards

Several different internationally agreed units (called units) are used to measure ionizing radiation. For example, the roentgen (R) measures the amount of radiation in the air, and the becquerel is the unit of spontaneous activity of a radioactive source such as uranium. For medical purposes, the most commonly used units are the gray (Gy) and the sievert (Sv).

The gray is the unit of radiation that is actually absorbed by any tissue or substance as a result of exposure to radiation. 1 Gy is the absorption of 1 joule of energy (from gamma radiation or X-rays) per kilogram of irradiated matter. The gray supersedes an older unit called the rad (1 Gy = 100 rads).

Because some types of radiation affect biological organisms more than others, the sievert is used as a measure of the impact of an absorbed dose. It uses additional factors, such as the kind of radiation and its energy, to quantify the effects on the body of equivalent amounts of different types of absorbed energy. The sievert replaces an older unit, the rem (1 Sv=100 rems).... radiation unit

A diagnostic technique based on detection of radiation emitted by radioactive substances introduced into the body. Substances are taken up to different degrees by different tissues, allowing specific organs to be studied. For example, iodine is taken up mainly by the thyroid gland, so by “tagging” a sample of iodine with a radioactive marker (radionuclide), the uptake of iodine can be monitored to investigate the functioning of the gland. A radionuclide is swallowed or injected into the blood and accumulates in the target organ. It emits radiation in the form of gamma radiation, which is detected by a gamma camera to produce an image. Cross-sectional images (“slices”) can be obtained using a computer-controlled gamma camera that rotates around the patient. This specialized form of radionuclide scanning is known as (single photon emission computed tomography). Moving mation on blood flow, the movement of the heart walls, the flow of urine through the kidneys, and bile flow through the liver.

Radionuclide scanning is a safe procedure, requiring only minute doses of radiation that are excreted within hours. The radionuclides carry virtually no risk of toxicity or hypersensitivity.... radionuclide scanning

A form of controlled trial that evaluates the effectiveness of a drug, or other treatment, in which subjects are randomly allocated to one of the study groups.

This random allocation means individuals are equally likely to be selected for the particular treatment being investigated or for the control group of the trial.... randomized controlled trials

An abbreviation for radioallergosorbent test. is a type of radioimmunoassay used to detect antibodies to specific antigens.... rast

A circulatory disorder affecting the fingers and toes that shares the mechanism, symptoms, and signs of Raynaud’s disease but results from a known underlying disorder.

Possible causes include arterial diseases, such as atherosclerosis; connective tissue diseases, such as rheumatoid arthritis; and various drugs, such as beta-blocker drugs.

The disorder is an occupational disorder of people who use pneumatic drills, chain saws, or vibrating machinery; it is sometimes seen in typists, pianists, and others whose fingers suffer repeated trauma.

Treatment is the same as for Raynaud’s disease, along with treatment of the underlying disorder.... raynaud’s phenomenon

See dental X-rays.... x-rays, dental

the number of people from a specified population with a specified disease or condition admitted to hospitals in a given geographical area over a specified time period.... admission rate

n. an appliance to prevent normal closure of the teeth in orthodontic treatment and in the treatment of *temporomandibular joint syndrome.... bite-raiser

Rats are rodents that live close to human habitation. They damage and contaminate crops and food stores and can spread disease. The organisms responsible for plague and a type of typhus are transmitted to humans by the bites of rat fleas. Leptospirosis is caused by contact with anything contaminated by rat’s urine.

Rat-bite fever is a rare infection transmitted directly by a rat bite. There are 2 types of this infection, caused by different bacteria. The symptoms include inflammation at the site of the bite and in nearby lymph nodes and vessels, bouts of fever, a rash, and, in one type, painful joint inflammation. Treatment for both types is with antibiotic drugs.

Rabies virus can be transmitted by the bites of infected rats. Lassa fever, also a viral disease, may be contracted from the urine of rats in West Africa. Rats also carry the viral infection lymphocytic chorio-meningitis, as well as the bacterial infection tularaemia.... rats, diseases from

see lupus erythematosus.... butterfly rash

(CR) a system for replacing photographic film with a charged plate. Exposure to X-rays knocks charge off the plate. The resultant image can be read by a laser beam and stored digitally or printed out as required. This system is widely used in conjunction with *PACS systems.... computerized radiography

1. a series of radiating fibres between the cerebral cortex and the internal capsule of the brain. 2. a layer of follicle cells that surrounds a freshly ovulated ovum. The cells are elongated radially to the ovum when seen in section.... corona radiata

the total number of events (e.g. cases of lung cancer) expressed as a rate per 1000 population. When factors such as age structure or sex of populations can significantly affect the rates (as in *mortality or *morbidity rates) it is more meaningful to compare age/sex specific rates using one or more age groups of a designated sex (e.g. lung cancer in males aged 55–64 years). More complex calculations, which take account of the age and sex structure of a population as a whole, can produce *standardized rates and *standardized mortality ratios (SMR).... crude rate

(DR) an alternative to film radiography, by acquiring X-ray images from a large number of individual X-ray detectors on a matrix in a digital format directly. This contrasts with *computerized radiography, in which an *analogue image is taken and then put into a reader to be converted into a *digital image. The technique allows the storage of images and their subsequent retrieval, manipulation, and interpretation using computers (see PACS).... digital radiography

see teletherapy.... external beam radiotherapy

see Schneiderian first- and second-rank symptoms.... first-rank symptom

(GFR) the rate at which substances are filtered from the blood of the glomeruli into the Bowman’s capsules of the *nephrons. It is calculated by measuring the *clearance of specific substances (e.g. creatinine) and is an index of renal function. See eGFR.... glomerular filtration rate

see pulse.... heart rate

an eruption of violet-coloured macules with variable scale and oedema that predominantly affects the eyelids but may be more widespread. It is usually asymptomatic and is a cutaneous sign of *dermatomyositis.... heliotrope rash

see case fatality rate.... hospital fatality rate

(IGRT) the process of imaging during a course of radiation treatment to verify the internal position of the target in comparison to the initial planning scan. This enables adjustment of *treatment fields to improve coverage and allows the use of smaller treatment volumes. The possible methods for IGRT include cone beam CT, *tomotherapy, *cyberknife, and ultrasound and kilovoltage X-rays of implanted fiducial markers.... image-guided radiotherapy

(IMRT) radiotherapy using multiple beams with variable intensity across each field, resulting in dose distributions that can fit to concave shapes and thus reduce dose to surrounding healthy tissues and organs. It can be used to treat a wide range of cancers and can enable safe delivery of higher doses to tumours.... intensity-modulated radiotherapy

(IMR) the number of deaths of children under one year of age per 1000 live births in a given year. Included in the IMR are the neonatal mortality rate (calculated from deaths occurring in the first four weeks of life) and postneonatal mortality rate (from deaths occurring from four weeks). Neonatal deaths are further subdivided into early (first week) and late (second, third, and fourth weeks). In prosperous countries neonatal deaths account for about two-thirds of infant mortalities, the majority being in the first week (in the UK the major cause is prematurity and related problems). The IMR is usually regarded more as a measure of social affluence than a measure of the quality of antenatal and/or obstetric care; the latter is more truly reflected in the *perinatal mortality rate.... infant mortality rate

see INR.... international normalized ratio

a branch of radiology in which complex procedures are performed using imaging guidance, which avoids patients having to undergo invasive surgery to achieve the same results. This is often termed ‘pinhole surgery’. Guidance is commonly by X-ray fluoroscopy, ultrasound, or computerized tomography, and recently also by magnetic resonance imaging. Procedures commonly performed include angioplasty and stenting of vascular structures, drainage of fluid collections or abscesses, stenting of obstructions to the gastrointestinal tract, embolization, cryotherapy, and radiofrequency ablation.... interventional radiology

the degree to which a test result will change the odds that a patient has a disease. The likelihood ratio for a positive test expresses the degree to which the odds that a patient has a disease increase following a positive test. The likelihood ratio for a negative test expresses the degree to which the odds that a patient has a disease decrease following a negative test. Likelihood ratios depend on the *sensitivity and specificity of the test.... likelihood ratio

Liver Imaging Reporting and Data System: see BI-RADS.... li-rads

the number of deaths due to complications of pregnancy, childbirth, and the puerperium per 100,000 live births (see also stillbirth). In 1952 concern about maternal mortality resulted in Britain in the setting up of a triennial *confidential enquiry into every such death to identify any shortfall in resources or care. The first triennial report was published in 1985. Since 2014 reports have been produced annually by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries Across the UK). Levels of *maternal deaths are currently low: a report published in 2017 (covering 2013–15) counted 202 obstetric-related deaths (8.76 per 100,000 live births). Thromboembolism was the commonest direct cause of death (30 deaths, 1.13 per 100,000 live births), while heart disease was the commonest indirect cause of death (54 deaths, 2.34 per 100,000 live births).... maternal mortality rate

a ridge of skin extending from the anus through the perineum. In males it extends further up the scrotum and penis. It represents a fusion line from embryological development and may be the site of cysts and other harmless structures.... median raphe

a laboratory measurement used as a screening test for the first signs of kidney damage in *diabetes mellitus. It detects an increase in the very small levels of the protein albumin present in urine, relative to the concentration of creatinine. It is best measured in an early morning urine sample. See microalbuminuria.... microalbumin:creatinine ratio

a spotty red facial rash that is common during the first few months of life; it disappears without treatment.... milk rash

(nappy rash) a red skin rash within the napkin area, usually caused by chemical irritation (ammoniacal *dermatitis) or infection with *Candida. Ammoniacal dermatitis is caused by skin contact with wet soiled nappies, the stool bacteria reacting with urine to form irritant ammonia. Treatment involves exposure to air, application of barrier creams, and frequent nappy changes. Candidal nappy rash is treated with antifungal creams. Other causes of napkin rash include eczema and psoriasis.... napkin rash

see infant mortality rate.... neonatal mortality rate

one of the gaps that occur at regular intervals in the *myelin sheath of medullated nerve fibres, between adjacent *Schwann cells.... node of ranvier

(PEFR) the maximum rate at which a person can forcibly expel air from the lungs at any time, expressed usually in litres per minute (occasionally in litres per second). A low value can help diagnose asthma in the correct clinical context, and differences between the morning and evening values can also be a feature of poor control of asthma. There is a place for PEFR in the monitoring of acute exacerbations of chronic pulmonary obstructive disease (COPD) but not in the diagnosis of COPD.... peak expiratory flow rate

(PNM) the total number of babies born dead after 24 weeks gestation (*stillbirths) and of live-born babies that die in the first week of life, regardless of gestational age at birth (early neonatal deaths), per 1000 live births and stillbirths. See infant mortality rate. See also confidential enquiries.... perinatal mortality rate

(PRRT) a type of radiotherapy used to treat neuroendocrine tumours (NETs; see neuroendocrine system). A *radionuclide is combined with a relevant *peptide to create a so-called radiopeptide, which is injected into the patient’s bloodstream. Because NETs have an overexpression of peptide receptors, the radiopeptide binds to the tumour, delivering a high dose of radiation directly to the cancer cells. The chief merit of PRRT is this ability to target delivery of radionuclides for highly localized treatment. A similar technique, using a gamma emitter as the radionuclide, can be used for locating and imaging NETs.... peptide receptor radionuclide therapy

Prostate Imaging Reporting and Data System: see BI-RADS.... pi-rads

see tularaemia.... rabbit fever

adj. resembling a bunch of grapes. The term is applied particularly to a compound gland the secretory part of which consists of a number of small sacs.... racemose

(rachio-) combining form denoting the spine.... rachi

n. see backbone.... rachis

n. see spina bifida.... rachischisis

adj. relating to or associated with the radius (a bone in the forearm).... radial

an operation for short-sightedness (myopia). Deep cuts into the tissue of the cornea are placed radially around the outer two-thirds of the cornea; this flattens the curvature of the central part of the cornea and reduces the myopia. This procedure is now rarely performed, having been superseded by *excimer laser treatment.... radial keratotomy

flexion of the forearm (and sometimes also of the fingers) that occurs when the lower end of the radius is tapped. It is due to contraction of the brachioradialis muscle, which is stimulated by tapping its point of insertion in the radius.... radial reflex

measures designed to limit the dose of harmful radiation to patients and workers. Medical exposure to radiation is governed in the UK by the Department of Health and Social Care under the Ionising Radiation (Medical Exposures) Regulations 2000 (IRMER). A guiding theme of protection is the ALARA principle (“as low as reasonably achievable”).... radiation protection

vigorous treatment that aims at the complete cure of a disease rather than the mere relief of symptoms. Compare conservative treatment.... radical treatment

n. (in anatomy) 1. a small *root. 2. the initial fibre of a nerve or the origin of a vein. —radicular adj.... radicle

combining form denoting 1. radiation. 2. radioactive substances.... radio

the administration of an estimated amount of the radioactive isotope iodine-131 as a drink in order to treat an overactive thyroid gland (see thyrotoxicosis). The iodine concentrates in the thyroid and thus delivers its beta radiation locally, with little effect on other tissues. The gland will shrink and become euthyroid over the succeeding 8–12 weeks but there is a high incidence of subsequent hypothyroidism (up to 80%), which requires lifetime treatment with thyroxine. The treatment cannot be used if there is any suspicion of pregnancy, and the patient must stay away from young children and pregnant women for around 10 days after administration. Despite these drawbacks, radioactive iodine remains a popular form of treatment for any cause of hyperthyroidism.... radioactive iodine therapy

n. see autoradiography.... radioautography

n. the study of the effects of radiation on living cells and organisms. Studies of the behaviour of cancer cells exposed to radiation have important applications in *radiotherapy, revealing why some tumours fail to respond to the treatment; this has led to the development of new radiotherapy techniques that make tumours more susceptible to treatment by radiation.... radiobiology

n. inflammation of the skin after exposure to ionizing radiation. This may occur after a short dose of heavy radiation (radiotherapy or atomic explosions) or prolonged exposure to small doses, as may happen accidentally to X-ray workers. The skin becomes dry, hairless, and atrophied, losing its colouring.... radiodermatitis

(RPM) see palatoplasty.... radiofrequency palatal myoplasty

n. a method of identifying the site of a tumour (e.g. colorectal cancer) that relies on its uptake of radioactive isotopes attached to an appropriate anticancer immune cell. As yet this technique is little used in clinical practice.... radioimmunolocalization

(selective internal radiation therapy; SIRT) n. an *interventional radiology technique used in liver cancers. It is similar to *transarterial chemoembolization, but instead of a chemotherapeutic agent yttrium-90 particles are injected into the liver. These emit beta radiation, which kills the cells within 2 mm of their radius. SIRT is a palliative technique.

radiofrequency ablation (RFA) the selective destruction of abnormal conducting tissue in the heart by the targeted delivery of radiofrequency energy via a catheter under X-ray and electrocardiographic guidance. It is usually curative in patients with supraventricular re-entrant tachycardia and is the treatment of choice for this condition (see supraventricular tachycardia; Wolff–Parkinson–White syndrome). It can be used for a variety of other arrhythmias with varying degrees of success. *Cryoablation is an alternative approach that uses freezing to destroy the abnormal tissue.... radioembolization

n. treatment in which a radioactive substance is linked to an antibody that attaches to a specific type of tumour cell, thus delivering the radiation to the tumour and limiting damage to healthy cells. See monoclonal antibody.... radioimmunotherapy

the use of radioactive iodine (iodine-131) to destroy any residual thyroid tissue after thyroidectomy for cancer. Subsequent radioiodine treatment may be necessary to treat suspected or known residual thyroid cancer cells. Following ablation, thyroglobulin levels can be used as a *tumour marker.... radioiodine ablation

n. an *isotope of an element that emits alpha, beta, or gamma radiation during its decay into another element. Artificial radioisotopes, produced by bombarding elements with beams of neutrons, are widely used in medicine as *tracers and as sources of radiation for the different techniques of *radiotherapy.... radioisotope

n. a physician specializing in the interpretation of X-rays and other imaging techniques for the diagnosis of disease. An interventional radiologist specializes in the use of imaging to guide *interventional radiology techniques.... radiologist

(RIS) a computer database used to keep details of all the patients attending a clinical radiology department. It records patient demographics, imaging procedures done, medications given and dosage, person performing the imaging, and time and place of examination. Radiologist reports interpreting the images will also feature here. The RIS is vital to the functioning of a picture archiving and communications system (see PACS) and the electronic medical record system.... radiology information system

n. death (*necrosis) of tissue, commonly bone or skin, caused by exposure to ionizing radiation, as in *radiotherapy. It can be induced by subsequent injury or surgery. See ionization.... radionecrosis

n. see peptide receptor radionuclide therapy.... radiopeptide

n. a substance that increases the sensitivity of cells to radiation. The presence of oxygen and other compounds with a high affinity for electrons will increase radiosensitivity. Chemotherapy drugs such as fluorouracil and cisplatin can be used concurrently with radiotherapy as radiosensitizers (see chemoradiotherapy).... radiosensitizer

n. a doctor who specializes in treatment with radiotherapy.... radiotherapist

n. see root.... radix

n. an *antiretroviral drug (ARV) used, in combination with other ARVs, for treating refractory HIV infection. It acts by inhibiting integrase, an enzyme required by the virus to replicate and infect other cells. Side-effects include abdominal pain, constipation, and *lipodystrophy.... raltegravir

a form of *herpes zoster affecting the facial nerve, associated with facial paralysis and loss of taste. It also produces pain in the ear and other parts supplied by the nerve. [J. R. Hunt (1872–1937), US neurologist]... ramsay hunt syndrome

see pyloromyotomy. [W. C. Ramstedt (1867–1963), German surgeon]... ramstedt’s operation

n. (pl. rami) 1. a branch, especially of a nerve fibre or blood vessel. 2. a thin process projecting from a bone, e.g. the rami of the *mandible.... ramus

the initial deposit of calcium-loaded material on a renal *pyramid that develops into a kidney stone. [A. Randall (1883–1951), US urologist]... randall’s plaque

see intervention study.... randomized controlled trial

a subgroup of a total population selected by a random process ensuring that each member of the population has an equal chance of being included in the sample. It is sometimes stratified so that separate samples are drawn from each of several layers of the population, usually on the basis of age, sex, and socio-economic group. Selection is sometimes facilitated by identifying, in advance, certain units (e.g. towns or neighbourhoods) that will together represent the whole (a so-called sampling frame).... random sample

n. a recombinant *monoclonal antibody fragment used for the treatment of wet age-related *macular degeneration. It inhibits *vascular endothelial growth factor and therefore choroidal *neovascularization. Common side-effects are conjunctival haemorrhage, eye pain, *floaters, increased intraocular pressure, and intraocular inflammation. *Aflibercept and pegaptanib have similar uses and effects.... ranibizumab

receptor activator of nuclear factor kappa B ligand inhibitor: an agent that works by inhibiting the development of *osteoclasts and bone resorption, thus minimizing bone loss and the potential for fractures in those with postmenopausal osteoporosis and bone metastases.... rankl inhibitor

n. see sirolimus.... rapamycin

a focal encephalitis, found most commonly in children, that results in continual focal seizures (see epilepsy). The underlying cause is unknown but it may be due to a viral infection or an autoimmune process. Patients who are unresponsive to medical (antiepileptic) therapy may undergo surgery of the abnormal brain to try and control the seizures. [G. L. Rasmussen (20th century), US anatomist]... rasmussen’s encephalitis

n. a filelike surgical instrument used for scraping the surface of bone (see illustration).... raspatory

an *adenoma of the umbilicus.... raspberry tumour

see craniopharyngioma.... rathke’s pouch

n. (in psychology) the explanation of events or behaviour in terms that avoid giving the true reasons. For example, someone may claim to have been too tired to go to a party whereas in fact he or she was afraid of meeting new people.... rationalization

n. the dried root of the shrub Rauwolfia serpentina, which contains several alkaloids, including reserpine. Rauwolfia and its alkaloids lower blood pressure and depress activity of the central nervous system. They were formerly used as tranquillizers and to treat hypertension, but have been replaced by more effective and reliable drugs.... rauwolfia

see fertility rate.... reproduction rate

(RR) breathing rate: the number of breaths per minute. Normally between 6 and 12, it increases after exercise and in cases of *respiratory distress and decreases after head injury and opioid overdosage.... respiratory rate

symptoms of *schizophrenia first classified by German psychiatrist Kurt Schneider (1887–1967) in 1938. First-rank symptoms were considered by Schneider to be particularly indicative of schizophrenia; they include all forms of *thought alienation, *delusional perception, *passivity, and third-person auditory *hallucinations in the form of either a running commentary or voices talking about the patient among themselves. Some schizophrenic patients never exhibit first-rank symptoms or only experience them in some psychotic episodes. They may also occur in *mania. Second-rank symptoms are common symptoms of schizophrenia but also often occur in other forms of mental illness. They include *delusions of reference, paranoid and persecutory *delusions, and second-person auditory hallucinations.... schneiderian first- and second-rank symptoms

see Schneiderian first- and second-rank symptoms.... second-rank symptom

see radioembolization.... selective internal radiation therapy

(SMR) the ratio of observed mortality rate to expected mortality rate (calculated using indirect standardization), expressed as an integer where 100 represents agreement between observed and expected rates. See standardized rates.... standardized mortality ratio

Thyroid Imaging Reporting and Data System: see BI-RADS.... ti-rads

invisible short-wavelength radiation beyond the violet end of the visible spectrum. Sunlight contains ultraviolet rays, which are responsible for the production of both suntan and – on overexposure – *sunburn. The dust and gases of the earth’s atmosphere absorb most of the ultraviolet radiation in sunlight (see ozone). If this did not happen, the intense ultraviolet radiation from the sun would be lethal to living organisms.... ultraviolet rays

(WHR) the ratio of the circumference of the waist to that of the hips. It is used as a measure of obesity and is a more reliable predictor of obesity-related mortality than *body mass index alone.... waist to hip ratio

rates used to summarize the *morbidity or *mortality experience of a population. Age-specific rates and population structures from a study population and a reference or *standard population are used to produce a weighted average. Standardized rates can be used to compare the health experience of populations with different structures. Direct standardization requires application of age-specific rates from a study population to a reference population structure (e.g. the European standard population) to produce a (directly) standardized rate. Indirect standardization requires application of age-specific rates from a standard population (e.g. England and Wales) to a study population structure to produce an expected morbidity or mortality rate. Compare crude rate.... standardized rates

Ravensara aromatica

FAMILY: Lauraceae

SYNONYMS: Madagascar clove-nutmeg, aromatic ravensare, Ravensara anisata, Agatophyllum aromaticum.

GENERAL DESCRIPTION: The genus Ravensara includes many species of evergreen trees or shrubs native to Madagascar and the Comoro Islands. These evergreen trees can grow up to 30 metres tall in rainforests, usually on all type of soils. The best-known species of this genus is R. aromatica used for its essential oil. It grows to a height of about 20 metres with several buttress roots at the base, with reddish bark, dark green shiny leaves and small yellow-green flowers. The fruit, a fleshy berry, are an important food source for birds. All parts of the tree are aromatic.

DISTRIBUTION: R. aromatica is native to Madagascar and once thrived in the rainforests, but is now an endangered species due to de-forestation and over-exploitation. By the early part of this century, this species required protection as the production of the essential oil from the bark, used by the pharmaceutical industry, was particularly destructive as it required felling the trees. Only the leaves can now be used for oil production, to prevent cutting down the whole tree. There is now a conservation programme in place to protect these trees: it is therefore important to obtain the essential oil of the leaf from sustainable sources.

OTHER SPECIES: There are over 30 species of Ravensara that grow in Madagascar. The common name of the genus Ravensara is actually a latinization of the Malagasy term ravintsara which means ‘good leaves’, a term originally used by the natives to describe another species of tree. European botanists in the nineteenth century made several attempts to classify the various indigenous aromatic trees of Madagascar, but due to the similarity of the two names ‘ravintsara’ and ‘ravensara’ they came to be used almost interchangeably. The botanical confusion between these two species has continued to cause a great deal of uncertainty as to their precise origins. In fact, the essential oils derived from these two species are very different aromatically as well as in their chemical composition. However, most of so-called ‘ravensara’ oil from Madagascar, is actually produced from the Cinnamomum camphora species (even if it is said to derive from R. aromatica) so great care needs to be taken in identifying the correct source of each oil. See also entry for Ravintsara.

HERBAL/FOLK TRADITION: In Madagascar, this genus of trees is commonly called hazomanitra, meaning ‘tree that smells’, as the whole part of the plant is aromatic. Traditionally, the Malagasy people used the bark and stem as a tonic and as an antibacterial medicine. The leaves were also burnt in homes after a death to prevent the spread of disease while the anise-flavoured bark was used in the production of local rum. The oil from the Ravensara genus is referred to locally as ‘the oil that heals’ because it is used for so many different conditions. The essential oil from the bark, R. anisata (a synonym for R. aromatica) is known as ‘havozo’ and has a strong anise-like odour.

ACTIONS: Antiviral, antibacterial, antifungal, anti-infectious, antiseptic, antispasmodic, expectorant, immune-stimulant.

EXTRACTION: 1. Ravensara oil is steam distilled from the leaves of the plant. 2. The essential oil distilled from the bark is called havozo. 3. An essential oil is also extracted occasionally from the fleshy fruits or berries.

CHARACTERISTICS: 1. Ravensara oil (from the leaf) has a sweet, fresh, slightly lemony, licorice-like scent with an earthy undertone. 2. Havozo (from the bark) has a fresh, strong aniseed-like odour.

PRINCIPAL CONSTITUENTS: 1. The oil from the leaf contains relatively small amounts of methyl chavicol (estragole), myrcene, a-pinene and linalool with the main constituents being limonene (approx. 13–22 per cent) and sabinene (approx. 10–16 per cent) with very little 1,8-cineole (1.8–3.3 per cent). 2. Havozo (bark oil) has a high methyl chavicol content (up to 90 per cent).

SAFETY DATA: 1. Ravensara (R. aromatica) is generally considered a safe oil (non-toxic and non-irritant) although it is best avoided during pregnancy. 2. Havozo oil is not recommended for use in aromatherapy due to its high methyl chavicol content, as it is a suspected carcinogen. Research has shown, nevertheless this oil has potent anti-microbial properties, being active against E. coli.

AROMATHERAPY/HOME: USE

Skin care: Chickenpox, cold sores, herpes (all types), shingles.

Circulation muscles and joints: Aching limbs, arthritis, cramp, gout, muscle fatigue, rheumatism.

Respiratory system: Bronchitis, colds, congestion, influenza, sinusitis, throat and lung infections, whooping cough.

Immune system: Viral infections especially herpes, hepatitis, chicken pox.

Nervous system: Anxiety, insomnia, nervous tension, stress.

OTHER USES: Ravensara species have been used for a long time to produce essential oils for the pharmaceuticals industry. In perfumery usage, it is employed as a middle note.... ravensara

Cinnamomum camphora

FAMILY: Lauraceae

SYNONYMS: Cinnamomum camphora ct. 1,8-cineole.

GENERAL DESCRIPTION: Cinnamomum camphora is a tall evergreen tropical tree characteristic of the Laurel family that grows up to 20–30 metres tall. The foliage is bright green and the leaves have a glossy, waxy appearance bearing masses of small white flowers in spring. It produces clusters of shiny black berries and has a pale bark that is very rough and fissured vertically.

DISTRIBUTION: C. camphora is native to China, Japan, and Taiwan but has been introduced to many countries throughout the world including India, Australia and the USA, where in places such as Florida it is becoming increasingly invasive and a danger to the native flora. This species is not indigenous to Madagascar and was introduced onto the island during the middle of the nineteenth century. As the plant became accustomed to the Malagasy climate it became a distinct subspecies, which in time adapted so well to the new environment, naturalizing in the central-eastern regions, that it became a very sustainable species for producing an essential oil, now called ravintsara oil. However, since it is clear there are many different sub-varieties of C. camphora in various parts of the world, it is possible that there also existed another native aromatic tree already growing in Madagascar originally known as ravintsara by the local people. According to Georges M. Halpern in The Healing Trail: Essential Oils of Madagascar, an indigenous tree of this name had been part of the Malagasy culture for many centuries and its leaves were used as a traditional folk medicine.

OTHER SPECIES: The genus Cinnamomum has approximately 250 different species, many of which yield an essential oil on distillation. Amongst the most important are C. zeylanicum (cinnamon bark and leaf oils) and C. cassia (cassia oil). The single species C. camphora itself produces a wide range of essential oils including: camphor, ho wood and leaf oil, sassafras and ravintsara. All these essential oils, although derived from the same tropical tree or botanical species, differ in their chemical profile enormously depending on the country of origin as well as the part of the plant used to extract the oil: e.g. leaf or bark.

There are at least 6 different chemotypes of C. camphora essential oil due to this factor, including the camphor, linalool, 1,8-cineole, nerolidol, safrole and borneol types. For example, C. camphora, grown in Taiwan and Japan, is known as Ho oil, and has linalool as its major constituent, whereas in India and Sri Lanka the camphor type of C. camphora remains the most important. The variety of C. camphora cultivated in Madagascar contains high levels of 1,8-cineole and no camphor. In order to avoid any confusion, it has been suggested that Ravintsara should be labelled: ‘Cinnamomum camphora ct. 1,8-cineole.’

HERBAL/FOLK TRADITION: The term Cinnamomum is derived from the Greek root kinnamon or kinnamomon meaning ‘sweet wood’. The word ravint means leaf and sara means ‘good for you’ according to the Malagasy tradition, as the local people have long appreciated the therapeutic value of its leaves which were used in folk medicine to treat digestive complaints, headaches, colds and chest infections. It has also been used for culinary applications and employed as a herbal tea. The Malagasy people themselves believe that the original Ravintsara tree is an indigenous species: a ‘cousin’ of the well-known C. camphora species, which has since been introduced.

ACTIONS: Antibacterial, anticatarrhal, antifungal, anti-infectious, antimicrobial, antirheumatic, antiviral, decongestant, cicatrisant (wound healer), expectorant, immune and neurotonic.

EXTRACTION: Steam distilled from the leaves of the plant.

CHARACTERISTICS: Fresh, woody, slightly floral, balsamic, eucalyptus-like scent. It blends well with eucalyptus, rosemary, bay, frankincense, cardamon, pine, cypress, juniper and citrus oils.

PRINCIPAL CONSTITUENTS: Ravintsara is akin to Eucalyptus globulus oil (as both are particularly effective for respiratory infections) due to its high 1,8-cineole content ranging from 45–55 per cent. Other major constituents include monoterpenes (sabinene 15 per cent, alpha-pinene and beta-pinene), sesquiterpenes (beta-carophyllene), monoterpenic alcohols (alpha-terpineol 7 per cent and terpineol) and esters (terpenyl acetate).

NOTE: Ravintsara essential oil contain at least 45 per cent 1,8-cineole compared to approximately 5 per cent found in Ravensara aromatica oil.

SAFETY DATA: Ravintsara oil is generally very well tolerated by the majority of the population, although like eucalyptus, it can cause sensitization in some individuals and should be used in moderation.

AROMATHERAPY/HOME: USE

Skin care: Shingles, herpes, verrucas, warts and athletes foot.

Circulation muscles and joints: Aching muscles and joints.

Respiratory system: Coughs, colds, influenza and other respiratory ailments such as asthma, bronchitis, sinusitis, laryngitis, otitis, tonsillitis and whooping cough.

Immune system: Viral infections especially air-borne infections.

Nervous system: Nervous debility

OTHER USES: Ravintsara oil is produced in a ‘pharmaceutical grade’ for the chemical and perfumery industry.... ravintsara