HEADACHES AND MIGRAINE: CEREBRAL BLOOD FLOW

Recent exciting discoveries have revolutionized our ideas of the relationship between thought and blood flow. Previously it was considered that thinking did not use any significant amount of energy and the blood flow to the brain was constant. It is now known, however, that when a group of brain cells is activated it uses up oxygen, produces carbon dioxide, and causes a local increase in blood flow to that area by enlarging the blood vessels.
Using radioactive tracers it is now possible to follow these changes and remarkable pictures have been obtained. For instance, the resting pattern of blood flow shows a marked increase in the frontal areas; talking to the subject causes a decrease of flow to these areas whilst part of the temporal lobe of the brain shows a marked increase of activity – dynamic proof of the long-held hypothesis that this area is one of the speech centers. Similar things happen when other intellectual activities are undertaken so that these techniques confirm localization of various functions in specific areas of the brain. This close relationship between blood vessels and brain cells leads to interesting possibilities. For instance, if the control of blood vessels were to be deranged, subtle changes in brain function could be expected; this has been confirmed in certain forms of mental disease.
Pain has been shown to increase metabolism in the brain and to dilate vessels generally. The increase in vessel diameter makes small local controlling changes more difficult and this could explain why thinking becomes more difficult during severe pain. The paradox is that pain, like stress, produces increased sympathetic activity, yet it increases blood flow to the brain. The resulting vasoconstriction would be expected to decrease it. The answer is probably that the sympathetic controls the larger, so-called resistance vessels, while pain in this context activates local capillaries.
The system which controls blood flow to the brain is highly complex as it is affected by nervous factors, circulating chemicals (amines), and outside factors such as pain, as well as by mental processes. An interesting experiment highlighted the importance of the latter: subjects had to solve problems of mental arithmetic while their brain blood flow was being measured. There was a slight increase to appropriate areas but this became greatly magnified when they were offered money for the successful solution to the problems. This shows that motivation and concentration have a direct effect on the blood flow to the brain and the experiment clearly confirms yet another psychosomatic link.
*24/152/5*

ISD AND THE MIND: SEXUAL TRAUMA AND ISD – CASES OF INCEST

Up to one million cases of incest are reported each year. It is estimated that one out of every four adult women and one out of every eight men were sexually abused in some way during childhood, often by an adult whom they knew and trusted. As you might expect, and as you well know if it happened to you, when an adult has sex with or otherwise sexually abuses a child, the child does not welcome the activity, rarely understands what is happening, and almost always feels powerless to prevent or stop it. Incest, because it also destroys the child’s trust and sense of safety, as well as the normal boundaries of parent-child relationships, inflicts deep psychological wounds that can last a lifetime.
Victims of incest and child molestation often go through life feeling helpless, dirty, damaged, or different from other people. They may blame themselves for what happened, think they have some inherently “evil” or “bad” part that draws unwanted attention to them, believe sex is dangerous or the only thing they are “good for,” feel powerless to control anything about their lives, or attempt to control every aspect of daily living. More often than not, they find it exceedingly difficult to trust or share any details about themselves with other people, making relationships problematic and true intimacy out of the question. They have numbed any feelings, including sexual ones, that may be associated with the abuse. We have yet to meet a childhood sexual-abuse victim whose sexuality had not been negatively affected in some way.
*105\261\8*

HIV: PROBLEMS AFFECTING THE WHOLE BODY-WASTING

Symptoms that affect the whole body, or constitution, are called constitutional symptoms. Constitutional symptoms include fever, night sweats, weight loss, fatigue, lethargy, and malaise. All these symptoms are relatively common both in the general population and in people with HIV infection. People with HIV infection tend to have constitutional symptoms when the CD4 count is low, unless the people are also depressed or have some unrelated medical problem like influenza. Some of these symptoms—fatigue, lethargy, malaise—are subjective and difficult to measure. Others—fever, severe weight loss (wasting)—are more objective.
Wasting is the somewhat unfortunate term given to unintentional weight loss. Wasting that results in the unintentional loss of 10 percent of the body weight, with no explanation other than HIV infection, is now accepted by the Centers for Disease Control as an AIDS-defining diagnosis.
People with HIV infection lose weight for different reasons: difficulty eating, lack of appetite, apathy and depression, prolonged diarrhea, nausea and vomiting, HIV itself, opportunistic infections that affect various organs of the body, and fever. Fever can contribute to wasting because fever increases the rate at which the body metabolizes food by 7 percent for each degree F: a person with a temperature of 103 degrees F through the day will have a metabolic rate that is increased by 30 percent. Wasting is commonly accompanied by protein-calorie malnutrition.
Treatment of wasting depends on the cause. If the cause is difficulty eating, the sores and ulcers that cause the difficulty should be treated with drugs, and the person should eat foods that are soft, easy to swallow, and bland. If the cause is lack of appetite, appetite stimulants like Megace might help, and the person should eat foods he or she likes. If the cause is apathy, the caregiver needs to encourage the person with HIV infection to eat, and a stimulant like Ritalin might help. If the cause is prolonged diarrhea, the infection causing diarrhea should be treated with drugs; the diarrhea itself can also be treated with drugs like Lomotil, loperamide, or paregoric. If the cause is nausea and vomiting, the person should eat small meals frequently, avoid aromatic foods, and eat food that is easily digested; nausea and vomiting can also be treated with drugs. If fever is a factor in wasting, treatment will try to reduce fever with aspirin, acetaminophen, or ibuprofen and will try to eliminate the cause of the fever.
In general, cater to individual tastes, eat small and frequent meals, and eat food that contains a lot of calories and protein. For the short term, anyway, don’t worry too much about a balanced diet and eat snack foods that carry large numbers of calories: peanuts, peanut butter, nuts, raisins, sunflower seeds, M&Ms, Oreo cookies, pizza, milkshakes, potato chips, Fritos, macaroni and cheese, Big Macs, most candy bars, fudge sundaes, marshmallows, and many others. Try asking a licensed dietitian.
When people cannot eat enough to compensate for losses, supplements will help. Supplements like Ensure, Sustacal, Enrich, and Magna-cal (approximately $1 per can) are rich in calories, complex carbohydrates, and fat. The various supplements are similar in nutritional value. They are available in grocery stores and pharmacies. If the supplements are taken in addition to meals, the person will need a few cans a day. If the supplements are the only nutrition the person is getting, the person will need about ten cans a day.
When people have problems that prevent the small intestine from absorbing food, different supplements which are predigested and ready to absorb will help. Supplements like Vivonex T.E.N, cost about $6 to $8 per can. If these supplements are taken in addition to meals, people will use three to six cans a day; if the supplement is the only source of nutrition, the person will need six to nine cans a day.
All nutritional supplements are available without prescription. But if a prescription is written nevertheless, Medicaid and some insurance plans will cover the supplement’s cost.
On the rare occasions when the intestines quit digesting and absorbing food, nutrients might need to be provided by vein—a procedure called parenteral (meaning by vein) hyperalimentation. Most physicians prefer to use parenteral hyperalimentation for only a week or two to get past a temporary problem, though occasionally they use it for longer periods.
*137\191\2*

BACH FLOWER REMEDIES: VINE REMEDY – MR. R. SALMI’S CASE

Mr. R. Salmi at 40 years age was suffering from several ailments, including High Blood Pressure. He was a very capable man with above average intelligence, a very strong will-power, full of self-confidence and an unfailing presence of mind in times of crises. He was very convincing in his talk. Early success in life made him over-ambitious and turned his head. He became proud and over bearing and hypnotized by his rise to power. He convinced himself that his success was proof of his infallible judgements. He would not brook any contradiction, would not enter into argument. His word was final. His word was law.
At home he inspired awe, not love. At office, he inspired fear, not respect. He had no friends. Friendship requires mutual respect and a sense of equality, and he lacked both.
Thus he forced his way to pinnacle of success, often riding roughshod over the feelings of others, without compunction, as if the humane part in him was dead. This lone struggle without any friend, without any sympathy, love or respect from any quarter caused tension in every fibre of his body. Lack of sleep, loss of appetite, stiffness of joints, migraine and H.B.P. was the result.
His family doctor advised him to reduce tension from his mind, but he consistently ignored this advice. At last he warned his wife that if Mr. Sahni did not reduce tension from his mind, there was a genuine risk of some vein in his brain bursting and paralysing him.
In panic she came to us for advice, at the same time fearing that her husband would play hell with her if he came to know that she had dared to come to us without his permission.
So the medicine would have to be given stealthily. VINE Remedy was prescribed to be given 3 to 4 times a day, mixed with his drinking water. After 15 days, Mrs. Sahni reported slight change in her husband’s temperament, as he could now listen to other’s point of view.
After 3 months of this treatment, Mr. Sahni had shed off all tension from his mind and even helped others by his sage advice, and his blood pressure came to normal.
*193\308\8*

BACH FLOWER REMEDIES: ESSENTIAL CHARACTERISTICS OF NEGATIVE ROCK WATER STATE

Here I recollect the case of Mahatma Hans Raj who was a venerated Arya Samaj leader in Lahore. It is said, in his last days, the doctors advised him to take chicken soup to recoup his fast waning strength. But he refused (being a vegetarian) and he died—a peculiar case of negative Rock Water.
A much more venerated Mahatma Gandhi, the world-known apostle of Ahimsa, ordered a sickly calf to be shot dead to terminate his agony when all medical treatment failed to give relief—a case of positive Rock Water.
Essential characteristics of Negative Rock Water State:
(a) Has set a very high ideal of code of conduct for himself and pursues it with dedication.
(b) Is very hard on himself, denies himself the normal pleasures of life, and is prepared to make any sacrifices for his principles.
(c) Is a slave of the dogmatic theories and sometimes exaggerated ideals which are subject to no change under any circumstances.
(d) Holds a wrong concept of spirituality, gives undue importance to forms i.e. special diet, meditation techniques etc., wants to be a saint while on earth.
(e) They have a closed mind, and are not able to put aside their principles and convictions even when confronted with new insights and greater truths.
(f) The constant coercion applied on himself to suppress his important human needs and normal pleasures of life and his inflexible mind often results in inflexibility of his body—his muscles and tenders become stiff and rigid, causing pain.
*172\308\8*

METHODS OF ABORTION

The type of abortion procedure used is determined by how many weeks the woman has been pregnant. Length of pregnancy is calculated from the first day of a woman’s last menstrual period.
If performed during the first trimester of pregnancy, abortion presents a relatively low risk to the mother. The most commonly used method of first-trimester abortion is vacuum aspiration. The procedure is usually performed under a local anesthetic. The cervix is dilated with instruments or by placing laminaria, a sterile seaweed product, in the cervical canal. The laminaria is left in place for a few hours or overnight and slowly dilates the cervix. After it is removed, a long tube is inserted into the uterus through the cervix. Gentle suction is then used to remove the fetal tissue from the uterine walls.
Pregnancies that progress into the second trimester can be terminated through dilation and evacuation (D&E), a procedure that combines vacuum aspiration with a technique called dilation and curettage (D&C). For this procedure, the cervix is dilated with laminaria for one to two days, and a combination of instruments and vacuum aspiration is used to empty the uterus. Second-trimester abortions are frequently done under general anesthetic. Both procedures can be performed on an outpatient basis (usually in the physician’s office), with or without pain medication. Generally, however, the woman is given a mild tranquilizer to help her relax. Both procedures may cause moderate to severe uterine cramping and blood loss.
The hysterotomy, or surgical removal of the fetus from the uterus, may be used during emergencies, when the mother’s life may be in danger, or when other types of abortions are deemed too dangerous.
The risks associated with abortions include infection, incomplete abortion (when parts of the placenta remain in the uterus), missed abortion (when the fetus is not actually removed), excessive bleeding, and cervical and uterine trauma. Follow-up and attention to dangerous signs decrease the chances of developing long-term problems.
The mortality rate for first-trimester abortions averages out to one death for every 530,000 at 8 or fewer weeks. The rate for second-trimester abortions is higher than one per 17,000. This higher rate later in the pregnancy is due to the increased risk of uterine perforation, bleeding, infection, and incomplete abortion due to the fact that the uterine wall becomes thinner as the pregnancy progresses.
Two other methods used in second-trimester abortions, though less common than the D&E method, are prostaglandin or saline induction abortions. In these methods, prostaglandin hormones or a saline solution is injected into the uterus. The injected solution kills the fetus and causes labor contractions to begin. After 24 to 48 hours the fetus and placenta are expelled from the uterus.
One specific surgical method of performing abortion has been the subject of much controversy. Intact dilation and extraction (D &. X), sometimes referred to by the nonmedical term “partial-birth abortion,” is used only in certain cases, such as when injury to the mother may be caused by extracting the fetus through other methods. The procedure generally involves repositioning the fetus to a breech (feet first) position before extracting most of the body except for the head. The contents of the cranium are then aspirated, resulting in “vaginal delivery of a dead but otherwise intact fetus.” Thirty-one states have passed legislation attempting to ban intact dilation and extraction. However, the wording of the legislation in many states has been so general that it could be used to ban all types of abortion. For this reason, such legislation has often been challenged and only ten states currently fully enforce the laws as written. Professional organizations such as the American College of Obstetrics and Gynecology and the American Medical Association state that physicians, acting in the best interests of their patients, should choose the safest and most appropriate method of abortion in each individual case.
*15/277/5*

ORAL HYPOGLYCAEMIC AGENTS (OHA): INDICATION FOR USE OF OHA & CONTRAINDICATIONS INDICATION FOR USE OF OHA

Diabetes type -2 patients in whom diabetes is not optimally controlled even with a fair trial of diet and exercise therapy, mostly in middle aged and elderly group, with diabetics of recent origin or without end organ damage.
Maturity onset diabetes of young (MODY)
CONTRAINDICATIONS
Insulin dependant diabetes mellitus
Ketoacidosis
Severe stress : Infection, trauma, major surgery etc.
Severe diabetic state
Malnourished underweight
Severe debilitating
Known allergic to sulphonylurca
Associated endocrinopathies
Impaired hepatic and renal function
ADVANTAGE OF OHA
Easy administration
Cost effective
Acceptability
Less frequent / less severe Hypoglycaemia when compared to insulin therapy
DISADVANTAGE OF ORAL THERAPY
Patient may not seek proper medical supervision
Limitations of dosage and inflexible dosage
Increased incidence of secondary failure with the passage of time
Toxic reaction and drug interaction
*43\329\8*

WOMEN’S HEALTH: OVULATION

At puberty, each ovary contains approximately 200000 potential eggs. What a thought. Have you ever realized that you have the basic potential to produce nearly a quarter of a million bubs! Frightening, isn’t it. But happily. Nature is kind, and such an event is mechanically impossible (as well as being most undesirable).
Under the influence of F.S.H., each month between 10 and 20 of these primary eggs, called primary follicles, enlarge and mature. About this time, the influence of L.H. takes over and brings the follicles to full maturity. Suddenly one follicle dashes ahead of all the rest, makes its way to the surface of the ovary and bursts through the walls. In this way the tiny egg, or ovum, is released. This happens every menstrual month, and is called ovulation.
Stiff under the influence of L.H., the follicle from which the egg escaped suddenly collapses, devoid of ovum. But it rapidly fills up with fluid, and is converted into a corpus luteum. Within a few days, this starts to produce chemicals itself. They are potent female sex hormones, called oestrogen and progesterone. These two hormones have a direct and profound influence on many parts of the body, but especially on the reproductive organs.
*14\45\4*

HIV: PROBLEMS OF THE DIGESTIVE SYSTEM-PAINFUL SWALLOWING

Some people find eating unpleasant and good nutrition difficult because they have pain when they swallow. Sometimes the pain is in the back of the mouth; usually it is in the chest and is a result of esophagitis, an inflammation of the esophagus. The most common cause by far is infection with Candida albicans, the fungus responsible for thrush. Other causes are infections with viruses; some have no known cause but appear similar to aphthous ulcers of the mouth.
The treatment of esophagitis depends on the cause. The probability of Candida albicans is so great that physicians often treat for Candida without testing for it. If the person with esophagitis does not respond to treatment or if the cause is obscure, an endoscopy—a special procedure in which a specialist (gastroenterologist) puts a tube into the esophagus and takes a sample of tissue—is often advised. If the cause is a viral infection, esophagitis can be treated with antiviral drugs. If the cause is aphthous ulcers, the ulcers in the esophagus, like those in the mouth, often respond to corticosteroids.
Anyone with painful swallowing should see a physician. Despite painful swallowing, it is important to maintain nutrition. Eat foods that are soft or liquid: milkshakes, milk, oatmeal, puddings made with milk or cream, custard, jello, ice cream, cottage cheese, cooked and pureed bland vegetables, popsicles, ground meats, baked fish, melons, bananas, scrambled eggs, omelets, French toast, cream soups, noodles, mashed potatoes. Try drinking through a straw. Such a diet, though easy on your throat, can cause loose stools; liquid supplements, like Enrich, Sustacal with fiber, or Metamucil, are sources of soluble fiber that can help prevent loose stools.
*126\191\2*

SKIN CARE: PROBLEMS ASSOCIATED WITH MOISTURIZERS

Acne production is the biggest problem associated with moisturizers. As a general rule, the heavier the cream the more likely it is to produce blackheads, whiteheads and other blemishes. People under the age of forty should look for ‘non-comedogenic’ creams.
Chemicals which commonly cause major acne include lanolin, mineral oil, paraffin and petrolatum. Other substances which can cause minor acne are butyl stearate, isopropyl isostearate, isopropyl myristate, isopropyl palmitate, myristyl lactate and myristyl myristate. The higher the percentage of these chemicals the more likely it is that blemishes will occur. They tend not to appear immediately but after long-term use.
Moisture creams may contain many irritating chemicals. The reputable American cosmetic companies have minimized this by thoroughly testing their products before they are released on the market.
Allergic reactions to moisturizers are not uncommon and are usually due to the masking perfumes, preservatives or sunscreens. Preservatives which frequently cause allergic reactions include Dowicill (quanterium 15), Kathon (methyl-chloroisothiozalone), Germall (imidazoyl urea), parabens, and other formaldehyde formations.
*78/150/5*
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