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There are several reasons why over 60% of breast cancer patients present with advanced disease medication for arthritis in elderly order diclofenac paypal. Aim: this study aims to arthritis relief hands purchase 50 mg diclofenac visa assess the knowledge of breast cancer risk factors and practice of screening modalities among a cross-section of women in 5 different local government areas in Lagos arthritis knee support buy genuine diclofenac on line. Methods: this is a descriptive and cross-sectional study conducted among women during a breast cancer awareness and screening program in 5 local government areas of Lagos arthritis in back at younger age generic diclofenac 50mg amex. A self-administered questionnaire was administered to arthritis knee exam effective 50mg diclofenac assess the knowledge of breast cancer risk factors and Fig 2. Conclusion: this study shows that there is a low uptake of breast cancer screening practices and the high knowledge of screening methods did not translate to higher screening practices among the studied population. There is a need to create more awareness on the risk factors identification and emphasize the importance of regular screening for breast cancer as essentials for early diagnosis and survival. The target Fundraising, Abuja, Nigeria audience of the program was set for women between the ages of 30 and 49 and remains today. Here, we describe the implementation status of the program at the Background: Early detection and improvements/advancements in medicine have primary health care level; health centers and district hospitals in Rwanda. This is an important observation given the impact cancer has on the abilities of according to the lesions’ size. Nurses, midwives and medical officers from health individuals to function physically, psychologically, and socially within the context of centers and district hospitals are trained through a 10-day curriculum (5 days for their environment. It is important therefore to identify and target specific groups that theoryand5daysforpractice)beforeinitiatingtheprovisionofservicestoclientsin may be less willing to present for early cancer screening. Training has been an integral inventory, early cancer detection behavior scale and a demography profile. Overthisprogram’simplementationthree-and-a-half-yearcourse,38,000 differences in current cancer detection behavior between males (M 5 0. Data further show differences benumber of health facilities implementing cervical cancer screening program. WhatsAppisasocialmediaapplicationwhichhaswidepenetrationinMalaysia, with more than halfthe population relying on WhatsApp for news. Individuals from the National Cancer Background: Collection of data concerning men’s health generally and urological health Society of Malaysia database were randomized into 1 of 3 arms receiving a WhatsApp particularly has always had its challenges, especially in the African setting. Some of the message; difficulties stem from cultural factors that consider sensitive topics pertaining to men’s i) a poster of a free mammography service for underprivileged women; ii) a poster of the free mammography service for underprivileged women with health as taboo. Aim: To determine how to overcome barriers in conducting a transatlantic a personal message from the Director of the National Cancer Society of prostate cancer familial study in Africans. Results: Presently, 625peopleare enrolled for thestudy andmore arewaiting to be recruited the outcomes of the trial were in the next phase. About 73% of the participants requested a home or office visit rather than i) number of women who returned a call or WhatsApp message to the designated visit a data collection center. On the average, the questionnaire required an average of two numbers; hours of personal interview rather than the one hour that had been envisaged. However the ii) numberofwomenwhobookedanappointmentforthemammographyservice;and participants declared that participant incentives were well worth it. Therewerestatisticallysignificantdifferences explanation of the importance of the study and assurance of privacy, the answers were obbetween the three delivery arms; with the highest percentages of women booking and tained. About 46% of theparticipants requestedthat their results betypedandgiventothem attending their mammographyappointmentscomingfrom the armwhichhad adesignated personally, 21% requested results be sent as to them as text messages while 26% requested screening date with limited availability. Conclusion: WhatsApp was highly effective general results of the study be made available to them in form of booklets, flyers and orally in at increasing community penetration and marketing a free mammography service for town hall meetings. The best practice for engaging the community for research include themselves of the service. Munisamy1,2 Danish Cancer Society, the Screening Group at Department of Prevention and Information, Copenhagen, Denmark 1National Cancer Society of Malaysia, Kuala Lumpur, Malaysia; 2Chulalongkorn University, College of Public Health Sciences, Bangkok, Thailand Background: In Denmark, the coverage rate for cervical cancer screening is about 75% for women aged 23 to 64 years whereas the participation rate is Background: Breast cancer is the most common cancer among Malaysian women, with a rising 65%. The participation rate varies with age, and is between 47%-57% among incidence from 16. In 2005, a qualitative study among women between control is early screening; of which mammography is a highly accurate tool, having been shown to reducethenumberofmortalityratesduetobreastcancerupto30%. However,mammographyisoften 23 and 39 years found a range of barriers for nonparticipation. Barriers were not as widely available in Malaysia; and in many local settings, healthcare providers have to limit lack of knowledge about the aim of cervical screening. Methods: this was a crossamong women aged 30 to 50 years found similar barriers. Shetty Memorial Institute of Dental 1Ragas Dental College and Hospital, Department of Public Health Dentistry, Sciences, Public Health Dentistry, Mangalore, India Chennai, India; 2Balaji Dental College and Hospital, Department of Public Health Dentistry, Chennai, India Background: Oral cancer is a public health problem and causing huge economic and a social burden. Early detection of oral potentially malignant Background: Breast cancer in women is a major health burden across the disorders and oral cancers is very important in reducing the morbidity and globe,which accountsfor 12% ofall new cancercases and 25% ofall cancers mortality rates. Though studies have demonstrated a significant reduction in Technique’ asa toolfor oralcancerscreening among South Indianpopulation. Datawerecollectedregarding the sociodemographic which can overcome these disadvantages and enhance screening are advodetails, history of tobacco use and knowledge regarding oral cancer. Human epidermal growth factor receptor-2 (c-erbB-2) is a biomarker participants were then screened for presence of oral premalignant/malignant thatcanbedetectedinsalivaofbreastcancerpatients. Exfoliative cytology was done using traditional method proteinindicatesthepresenceofanaggressivetumorwithpoorprognosis. The data were tabulated and subjected to topathologically diagnosed with breast cancer were divided into three groups statistical analysis. Appropriate statistical tests were used to analyze technique whereas the Oral Rub and Rinse Technique showed 19% Class I thedemographicdetailsandmeansalivaryc-erbB-2levels. Conclusion: this study results throws Technique can be a reliable tool for population screening of oral cancer. Kumar3 Cancer Research Malaysia, Head and Neck Cancer Team, Subang Jaya, Malaysia 1Nayati Medicity, Oncology, Mathura, India; 2Nayati Medicity, Mathura, India; 3Nayati Medicity, Biostatistics, Mathura, India Background: the burden of oral cancer is significant in Asia, accounting for 11%ofcancerdeathsinAsiacomparedwith5%intherestoftheworld. High Background: Oral cavityispronefor myriadofchangeswithadvancingageas andincreasingaccesstomobilephonesinlow-andmiddle-incomecountries well result of environmental and life style related factors like consumption of presents an opportunity to use telemedicine to facilitate early detection of tobacco (smoke or smokeless) and alcohol. Methods: We determined the concordance between evaluation of 11,145 subjects from 106 health screening camps, organized in Uttar Praoral lesions using mobile phone-captured images and clinical oral examidesh and Rajasthan between April 2015 to June 2017 was analyzed to unveil nation using kappa statistics. Results: the primary for the documentation of oral lesions, and the communication between symptoms were mouth ulcer in 5. The overall prodentists and specialists with regards to management of these patients. All of these dentists Conclusion:Resultsofthisstudycanbeusedforcreatingawarenessamongthe wanted to continue using the app as screening tool in the future as they population regarding the hazards of tobacco use. More number of studies believethatitcouldassistthemintheidentificationofhigh-riskoralmucosal needs to be conducted all over India to understand the prevalence and the lesions through direct communication with specialists. Mensah Therapy: An Observational Study Spanning 52 Years University of KwaZulu Natal, Pharmacology, Durban, South Africa R. Most patients regularly visit community pharmacies for health information and also seek Background: Asignificantdecreaseinbreastcancermortalityhasbeendemonstratedin advice from pharmacists with respect to signs and symptoms of cancer. There have been questions regarding readily accessible health care professionals, community pharmacists are the value of mammography in the era of modern therapies, and the relative contribution also in the best position to include cancer-screening initiatives into their of mammography screening and modern therapy on mortality reduction. Aim: We have sought to clarify the extent to which early detection through mammography screening practice. Pharmacists are therefore in a good position to raise awareness contributes to the reduction of breast cancer death in the era of modern adjuvant when they counsel people who buy over-the-counter medication for the therapies. We address this question by studying five decades of continuous data from control of possible cancer-related symptoms. Aim: the aim of this review was a stable population spanning the preand postscreening and adjuvant therapy periods. Crude and incidence-based mortality rates were compared among four successive 13were systematically searched for studies conducted between 2005 to July yearperiods:theprescreeningperiodfrom1964through1976,theSwedishTwo-County 2017. Studies that focused on knowledge of community pharmacist in cancer randomized screening trial period from 1977 through 1989, and two service screening screening, signs and symptoms were included. Furthermore,wemeasuredtheeffectof ticles were identified from the search, of which 4 out of the 28 potentially early detection upon breast cancer mortality in women exposed to mammography relevantabstractswereincludedinthe review. Findingsoftheselectedstudies screening by comparison with breast cancer death in women not exposed to mamrevealed lack of sufficient knowledge on breast cancer screening, signs and mography screening, within these three screening periods. Conclusion: the selected studies focused were 5844 incident cases and 1425 breast cancer deaths during the 52 years of observation. The relative breast cancer mortality rates associated with exposure to largelyonbreastcancer,whichhinderthegeneralizabilityandtransferabilityof screening, adjusted for self-selection bias, were 0. Hence there is a need for more studies to be conducted in this period (1977-1989), 0. Conclusion:Thecombinationof earlydetectionof breast cancer through mammography screening and the resultant earlier treatment has significantlyreducedbreastcancermortalityinDalarnaCountyinthewomenexposedto screening,comparedwiththewomennotparticipatinginscreening,byafactorof 2. Thesemortalitybenefitscan beattributedtothefargreatereffectivenessofmodern therapeutic methods upon cancers detected at screening compared with the poorer effectiveness of the same therapeutic methods in women not participating in screening. Olorode 1University of Calabar, Medical Laboratory Science, Calabar, Nigeria; 2Niger M. It Background: the use of tobacco may affect the human oral microbiome hasbeeninuseforaslongasotherformsoftobaccoconsumptionanditsusehave resulting in numerous diseases including cancer. In developing countries, tobacco is mostly change on the teeth, halitosis, periodontitis and other health implications. Despite the claims by some tobacco companies Aim: the study was aimed at determining the changes caused by tobacco and a few harm reduction proponents that using smokeless tobacco products is smoking on the oral microbiome of cigarette smokers and the shift toward less harmful than smoking or that smokeless tobacco should be used as a tool to help smokers quit smoking (but continue using tobacco in the form of smokeless organisms that may cause oral cancer and lung diseases. Methods: One tobacco), the fact remains that using smokeless tobacco still exposes users to hundredandtwentysubjectsmadeof60tobaccosmokersand60nonsmokers many harmful chemicals and still heightens a user’s risk for many of the same were enrolled for the study. The aim of this study is to assess the awareness of the subjects using sterile swab sticks under standard aseptic methods. The health hazards of tobacco among smokeless tobacco users in Kancheepuram specimens were subjected to microscopy and culture. Methodology: the inhabitants of the villages in Kanidentified using standard microbiological techniques. Results: the mean cheepuram district, who have completed 18 years were included in the study. Ethical clearance from the board, permission from the village panchayat leader and There was a higher rate of bacterial colonization 86. Most members of the oral biofilm habitants of the villages aged 18 to 75 years and present on the day data collection belonged to the Enterobacteriaceae with Klebsiella pneumoniae being the and who were willing to participate in the study were included. Random sampling most prevalent isolate among smokers while Pseudomonas aeruginosa method was used and data were collected from a cross-sectional survey, using 4 (20. Halitosis was mostly associated with Candida consisted oftotal400individuals,male 200and females200. There was a statistically significant association between observed that more than 70% were unaware of the harmful effects of tobacco. Conclusion: Smoking may have altered bacterial acquisition and factor were friends 43. Conclusion: have shown that smoking predisposes to oral cavity diseases which may the dangers from smoking and chewing tobacco are well documented within the predispose to oral cancer or lung diseases.

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Sometimes due to arthritis pain apply heat or cold buy diclofenac on line amex special circumstances arthritis in neck natural remedies order generic diclofenac, grandmother remedies and traditional medicines from neither have access to arthritis relief for back pain order diclofenac with paypal a dentist nor visiting a dentist is my grammas note books which can be referred in possible arthritis treatment kerala purchase cheap diclofenac on line, and one might has been experiencing severe emergency cases of reliving of toothache arthritis pain associates pg county purchase diclofenac online pills. Being familiar Grandma Remedies and Herbal Medicines for Relieving Toothache J Dental Sci 2 Open Access Journal of Dental Sciences Clove oil recommendations: Place a clove of garlic on the teeth and chew on it. After a few minutes of chewing the garlic, Clove is undoubtedly the most common natural toothache would become milder. The smell of clove, reminds us a useless, try the second method: mix mashed garlic with a dental office environment. In fact, in a solution of little salt and small amount of peanut butter, and then Euogenol, clove oil is used. Leave it the mixture at least for 30 reduces tooth sensitivity, and reduces the pain. For immediate effect of clove, drops of clove oil to warm water, and then rinse your soak a cotton pellet in one drop of clove oil and then put it mouth with it. It ts not wise to leave the cotton pellet in the tooth more than two minutes because it Ginger and red pepper dressing causes inflammation and chemical burns of the gum. Because of the Garden Sage analgesic effect, they send relief pain massages to the brain. To get a better result, a mixture of these spices can this herb is a natural and immediate paregoric that is be prepared as follow: Equal amounts of ginger and red useful to reduce toothache. Its antibiotic and antipepper are mixed with water to make a paste, then inflammatory features can help to soothe the pain. It is prepare a small ball of cotton and immerse it into the also effective on reduction of gingivitis, bleeding gum and paste. Its function is such that teaspoon of salt in a glass of water, gargles for 5 minutes ginger stimulates blood stand to the side which leads to and discards it. Mix a few drops of tea tree oil or lavender oil with a few drops Oregano oil of sage oil and dilute this mixture in a few drops of olive this oil has antibacterial and antioxidant properties oil. If oregano oil is mixed with a small amount of Aloe Vera olive oil and is left on a painful tooth, it would help to Pure Aloe Vera juice and mouthwashes have a similar reduce the toothache. This is how Aloe Vera to 5 drops of oregano oil in 1/4 cup of warm water, swish functions. Application of this oil will called Streptococcus and prevents from fermentation of sub side dental pain after a while. Application of Aloe Vera gel not only accelerates the improvement of mouth sores (oral herpes) but also relieves the pain of ulcers. Asafetida Dental problems such as toothache and bleeding gums can be managed at home by using this herbal Garlic medicine until they visit a dentist as soon as possible. Eating garlic not only strengthens the immune system Mix half teaspoon of Asafoetida seeds powder with two but also due to its special properties fights against most tablespoon of fresh lemon juice, and then heat the kinds of the illness. It will have a rapid effect on properties, and it is a normal antibiotic that is likely relieving toothache. It also method is to fry a teaspoon of asafetida powder in the helps to relieve pain and prevents the spread of infection. Put one teaspoon of For more than 1600 years, sesame is used to relieve coriander seeds powder in a glass of boiled water, and let toothache in China [4]. It can be used as a good dental pain in the following way, a good analgesic can be prepared: reliever. Boil 10 grams of coriander seeds in 4 liters of First, heat up a pan water to boil. For each of sesame, doubling the little bit and then taste and swish in the mouth for one amount of water is required. It should be noted analgesic effect, waiting for evaporating of half of the that to a large extent, chewing of coriander seeds, would water is necessary. Grandma recommends those patients, formed to a small pellet and placed into the cavity. Salt water Salt is a strong antiseptic; so if toothache is caused by Black tea infection, salt can soothe the pain faster than any other Black tea also has anti-inflammatory properties which way. Mint herbal tea and peppermint oil drop Tea tree oil Mint has the anti-inflammatory and antiseptic Application of this oil has a significant effect on properties, and for pain relief is another grandma choice. Just Mint herbal tea has a good flavor and also can be used as rub some of this oil with finger tip on the teeth and then an anesthetic. After that,rinse mouth procedure: Put one teaspoon of dried mint in a cup of with warm water. Repeat this twice a day to get ride of boiled water and then wait to brew for 20 minutes. Another method would be dissolving one drop of peppermint oil in 1/4 of glass of water. This homemade Acemella Oleracea mouthwash can be used for 30 seconds, 3 times a day. If At the University of Cambridge, the researchers looking for a fast and reliable solution to get rid of Aphtus claimed they have discovered a new anesthetic jell from a ulcer, use the peppermint. This herb, in addition to plant deep in Amazon Jungle in Peru which may replace healing the ulcer, relieves pain and numbness which is dental injections. There is an excellent prescription patients who have dental phobia and fear from dental from grandma remedies book. Then, take a small cotton ball, soak into this treatment of dental pain, ulcers, abscesses and dental solution and rub gently on the ulcer surface a few times a cleaning. This procedure is not recommended for children, transferred to South Asia by the sailors [6-8]. This herbal remedy can be applied in root canal Coriander therapy, after dental implant surgery, as well as, pain this herb has existed since an ancient time and has reduction after tooth extractions in the children. It also has antiinflammatory and antiseptic properties which may help to reduce pain and inflammations caused by dental Oil gargling abscesses. Turmeric also can help to strengthen oral In ancient medicine, this is a therepeutic method. It causes the reductoin of a group of bacteria Mix a teaspoon of turmeric powder with a little amount known as Streptococcus Cutaneous in the mouth; helps to of water until it forms to a paste mood. After brushing remove toxins from the mouth so that improves the teeth, place this paste directly on the affected area for 20 overall oral health. Another way could be used is to solve 1 spoon of salt and 1/2 teaspoon of turmeric one tablespoon of extract virgin coconut oil in the powder in a glass of lukewarm water and use it as a mouthfor 15 minutes and then discard it. After rinsing mouth, gently mixture of 1/4 teaspoon of turmeric powder, 1 teaspoon brush teeth as usual. Leave it on the result can be reached if this process would be repeated place for 20 minutes and then rinse mouth with warm twice a day for a month. Because of its anti microbial and Whether you are frustrated from toothache or suffer antiseptic properties, onions can eliminate the oral from back pain; ice has always been a good temporary bacteria and decrease pain. If you want to have temporary relief before antioxidant agent called Flavonoids Quercetin which helps you get to the dentist, try the method below: Put some ice to relieve a toothache [9]. If one is not able to chew it, place a small piece of onion on the painful tooth numb your teeth, hold the bag for 15 minutes on that part or gum. They claimed, Guava Leaves when somebody put ice between his thumb and index finger, the nerve ending in his finger sends a cold message Guava fresh leaves also due to its anti-inflammatory, to his brain, therefore, the relief toothache message antimicrobial and pain reduction properties can relieve reaches to his brain and pain fades away. Simply, chew one or two tender leaves of Guava to the extent that water comes out and covers the painful surfaces. Another way is to put 4 to 5 fresh leaves Myrrh of this plant into some water to boil. Then, add some salt to the solution and use as Myrrh gum sap can help to reduce the dental pain. Pour a teaspoon of powdered myrrh in two cups Mountain honey of water and boil for 30 minutes. Greeks, the ancient Egyptians, Hindus and Chinese had Pour one teaspoon of this prepared solution in a cup of used honey for medical purposes in traditional medicine water and gargle 5 to 6 times a day to get the desired [10-12]. For treatment of halitosis, Granma recommends to mix 1 Lavender Spike teaspoon of mountain honey with half a cup of warm water and 1 teaspoon of cinnamon and then gargle three this aromatic plant can be particularlly used to relieve times a day. The solution can be swallowed to help the toothache: allievate the gum problems, and even diinfect Karimi M. Grandma Remedies and Herbal Medicines for Relieving Copyright© Karimi M Toothache. These pain, she suggests combination of one teaspoon of recommendations are merely suggested to reduce the mountain honey with one teaspoon of cinnamon powder pain associated with dental abscesses and dental to form a paste, and then place it in the tooth cavity 3 infections until the patient refers to the dentist as soon as times a day. References Wheat grass juice Wheat prevents the growth of bacteria in the mouth 1. Benzi G, Ceci A (1997) Herbal Medicines in European with its antimicrobial properties. To whiten teeth, gargling of this solution is (2010) Transdermal behavior of the N-alkyl amide recommended in the morning. It can remove teeth stains spilanthol (affinin) from sehtnalipS allemca and oral bacteria from the surface area. J Ethnopharmacol 127(1): 77it can whiten the teeth and has a significant effect in 84. Although vanilla does not eliminate dental Genetic Analysis of Quercetin in Onion (Allium cepa infection, but provides the opportunity to control L. Pecanac M, Janjic Z, Komarcevic A, Pajic M, less side effects, and also do not neglect the old grandma Dobanovacki D, et al. Dental management must be adapted to these patients’ special conditions, as a greater bleeding tendency, hypertension, anemia, drug intolerance, increased susceptibility to infections and the presence of several oral manifestations associated with either the disease or its treatment. Key words: Chronic renal disease, dental considerations, dental management, oral manifestations. The signs and symptoms in padisease”, “tacrolimus”, “uremic stomatitis”, “xerostotients with renal failure are known as “uremic syndromia”; “dyalisis”, combined with “oral manifestations” me” (1-3). In dental practice, the function of views), 4 transversal studies, 2 series of clinical cases, the kidneys can be assessed indirectly through plasma1 randomized clinical assay, 1 letter to the editor and 1 tic creatinine (Cr). For this reason, thout a decrease in glomerular fltration rate uremic individuals have a characteristic halitosis (ureFiltration rate < 60 ml/min/1. This halitosis is related to another In Spain, the exact prevalence of renal pathology remanifestation: the perception of an unpleasant, metallic mains unknown. Treatment of the chronic renal insuffciency of dimethyland trimethylamines, or low zinc levels includes dietary changes, correction of systemic compli(due to the malabsorption derived from gastrointestinal cations, and dyalisis or a renal graft (3). There can also be a burning sensation in the the most common cause of death in patients with end lips and tongue, of a neuropathic origin (9) or even a stage renal failure is cardiac arrest, followed by infecsensation of an enlarged tongue (3). Therefore, the objectives of this paper are, (atrophia of minor salivary glands’ parenchyma), and e113 J Clin Exp Dent. Sometimes these Bleeding tendency in these patients may be due to facindividuals are afficted by anemia due mainly to the detors depending on the disease itself, like alterations in crease in the synthesis of erythropoietin, which can be platelet aggregation and renal anemia (secondary to clinically observed as a skin and mucosa paleness (5). For that in patients with an end stage or untreated renal disease reason, it can be concluded that hemodialysis predispo(1, 10). Clinically, it is characterized by the presence of ses to ecchymosis, petechiae and hemorrhage in the oral erythematous lesions which are localized or generalized. These lesions are covered by a pseudomembranous exuOral hygiene of patients receiving hemodyalisis is usuadate that can be removed, leaving an intact or ulcerated lly poor, so deposits of calculus (3) and plaque may be mucosa (8).

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With the convulsions may come foaming at the mouth arthritis foundation cheap diclofenac 100 mg overnight delivery, twitching of the muscles tylenol arthritis pain label purchase cheapest diclofenac, biting of the tongue arthritis neck pain exercises buy diclofenac 50mg, distorted fixation of limbs arthritis diet wikipedia buy diclofenac overnight, rotation of the head and deviation of the eyes arthritis childers diet that stops it order line diclofenac. Causes Epilepsy denotes electrical malfunctioning within the brain due to damage of brain cells or some inherited abnormality. Digestive disturbances, intestinal toxaemia and a strained nervous condition are very often the main cause of petit mal. Grand mal usually results from hereditary influences, serious shock or injury to the brain or nervous system. Meningitis, typhoid, and other diseases attendant with prolonged high temperature can also lead to grand mal. It may result from allergic reactions to certain food substances, especially some particular form of protein which is the main constituent of meat. Circulatory disorders such as hardening of arteries leading to the brain may also cause epileptic seizures. Chronic alcoholism, lead poisoning, cocaine and other such habits can also lead to this disease. Other causes of epileptic seizure include mental conflict, deficient mineral assimilation, particularly of magnesium and calcium and wrong vitamin metabolism. According to some researchers, hypoglycemia or low blood sugar is also involved in most cases of epilepsy. Treatment In the natural form of treatment, the sufferer from epilepsy has to follow a rigorous regimen consisting of a strict dietary, complete relaxation and optimum exercise in the open air. He must assume a cheerful, optimistic attitude, refrain from mental and physical overwork and worry. To begin with, the patient should be placed on an exclusive fruit diet for first few days. During this period he should have three meals a day of fresh juicy fruits such as oranges, apples, grapes, grapefruit, peaches, pears, pineapple and melon. Thereafter, he may gradually adopt a well balanced diet of three basic food groups viz. The diet should include a moderate amount of raw milk preferably goat’s milk and milk products such as raw butter and homemade cottage cheese. The diet should eliminate completely all animal proteins, except milk, as they not only lack in magnesium,but also rob the body of its own magnesium storage as well as of vitamin B6. The best food sources of magnesium are raw nuts, seeds, soyabeans, green leafy vegetables such as spinach, kale, beet-tops etc. The patient should avoid all refined foods, fried and greasy food, sugar and products made with it, strong tea, coffee, alcoholic beverages, condiments and pickles. The patient should avoid over eating and take frequent small meals rather than a few large ones. Mud packs on the abdomen twice daily help remove toxaemic conditions of the intestines and thereby hasten removal of epileptic conditions. The application of alternate hot and cold compresses to the base of the brain, that is at the back of the head will be beneficial. The procedure is to dip the feet in a bucket of hot water and apply first a hot towel and then a cold one to the base of the brain. The alternate hot and cold towels should be kept for two or three minutes about four times. If the sufferer from epilepsy has taken strong drugs for many years, he should not leave off entirely all at once. The dosage may be cut to half to begin with and then gradually reduced further until it can be left off completely. An epileptic should strictly observe all the natural laws of good health and build and maintain the highest level of general health. It causes a great deal of concern to persons affected by loss of hair, especially Indian women who regard good hair growth with thick long hair as a sign of beauty. An upgrowth at the base of the folic, called the papilla, actually produces hair; when a special group of cells turn amino acids into keratin, a type of protein of which hair is made. Persons lacking vitamin B6 lose their hair and those deficient in folic acid often become completely bald. Another important cause of falling of hair is stress such as worry, anxiety and sudden shock. This adversely affects the supply of essential nutrition required for the healthy growth of the hair. General debility, syphilis, chronic cold, influenza and anaemia, also gives rise to this disorder. Treatment the healthy condition of the hair depends, to a very large extent, on the intake of sufficient amounts of essential nutrients in the daily diet. Women require 60 grams, men 80 to 90, adolescent boys and girls 80 to 100 grams of protein. A deficiency of some of the B vitamins, of iron, copper and iodine may cause hair disorders like falling of hair and premature greying. Any person having trouble with his or her hair should eat foods rich in inositol such as yeast, liver and molasses. Although this vitamin may help to stimulate the growth of a woman’s hair, its lack is probably not a major cause of slow growth. Women are generally deficient in iodine and vitamin B1, either of which can slow down circulation to the scalp to such an extent that hair may fall out and new hair grow in very slowly. Women who keep their diets adequate in iodine, the B vitamins and iron have a better growth of hair. According to Adelle Davis, a world famous nutritionist, "increasing the intake of protein, particularly of liver, wheat germ and yeast, and supplementing the diet with a teaspoon of inositol daily usually stops a man’s hair from falling, and I have seen three or four persons whose hair became thick after these improvements were made. It has been found that a diet which contains liberal quantities of (i) seeds, nuts and grains, (ii) vegetables and (iii) fruits would provide adequate amounts of all the essential nutrients. These foods should, however, be supplemented with certain special foods such as milk, vegetable oils, honey, wheat germ, yeast and liver. The most effective among these remedies is a vigorous rubbing of the scalp with fingers after washing the hair with cold water. It will activate the sebaceous glands and energise the circulation of blood in the affected area, making the hair grow healthy. Amla oil, prepared by boiling dry pieces of amla in coconut oil, is considered a valuable hair tonic for enriching hair growth. A mixture of equal quantity of fresh amla juice and lime juice used as a shampoo stimulates hair growth and prevents hair loss. A mixture of lettuce and spinach juice is said to help the growth of hair if it is drunk to the extent of half a litre a day. The juice of alfalfa (lecerne) in combination with carrot and lettuce juice, taken daily also helps the growth of hair to a remarkable extent. The combination of these juices is rich in elements which are particularly useful for the growth of hair. While preparing alfalfa juice, the leaves of the plant only may be used when it can be obtained fresh. Daily application of refined coconut oil mixed with limewater and lime juice on the hair, prevents loss of hair and lengthens them. Application of the juice of green coriander leaves on the head is also considered beneficial. Application of its fresh leaf-juice helps the growth of the hair and keeps them soft. A little quantity of henna leaves should be gradually put in this oil till about 60 grams of these leaves are thus burnt in the oil. Another effective home remedy for loss of hair is the application of coconut milk all over the scalp and massaging it into the hair loss. The coconut milk is prepared by grinding the coconut shavings and squeezing it well. Washing the hair with a paste of cooked black gram dal, (urad dal) and fenugreek (methi) lengthens the hair. A fine paste made from pigeon pea or red gram (arhar dal) can also be applied regularly with beneficial results on bald patches. The seeds of lime and black pepper seeds, ground to get a fine paste, is one of the valuable remedies. Another useful remedy for patchy loss of hair is the paste of liquorice (mulethi) made by grinding the pieces in milk with a pinch of saffron. This paste should be applied over the bald patches in the night before going to bed. Almost every person has to work overtime on certain occasions, sacrificing rest and sleep, which may cause temporary fatigue. Chronic or continuous fatigue is, however, a serious problem which requires a comprehensive plan of treatment. Many persons constantly feel that they cannot take rest until they finish everything that needs to be done at one time. These persons are usually perfectionists, tense and cannot relax unless they complete the whole job, no matter how tired they may be. Causes the chief cause of fatigue is lowered vitality or lack of energy due to wrong feeding habits. Fatigue is an indication that the cells of the body are not getting sufficient live atoms in the food to furnish them with a constant flow of needed energy. The habitual use of refined foods such as white sugar, refined cereals and white four products as well as processed, tinned and preserved foods have a very bad effect on the system in general. Foods ‘denatured’ in this way are deprived, to a very great extent, of their invaluable vitamins and minerals. Such foods lead to nervousness, tiredness, obesity and a host of other complaints prevalent today. In anaemia, very little oxygen reaches the tissues with the result energy cannot be produced normally. Intestinal parasites can also lead to fatigue as they rob the body of good nourishment and gorge themselves on rich red blood. Other ailments which can cause fatigue are low blood pressure, low blood sugar, any kind of infection in the body, liver damage, a sluggish thyroid and allergy in foods and drugs caused by additives including artificial flavours, colours and preservatives. A person who is tense and cannot relax has all the muscles of his body more or less contracted. Food is continuously burnt, lactic acid accumulates more rapidly than it can be carried to liver for conversion to body starch. Persons who are high-strung, nervous and irritable usually suffer from this type of fatigue. Studies reveal that people who eat small mid-meals suffer less from fatigue and nervousness, think more clearly and are more efficient than those who eat only three meals daily. These mid-meals should consist of fresh or dried fruits, fresh fruit or vegetable juices, raw vegetables or small sandwich of whole grain bread.

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Each of these its low intrinsic activity at the mu receptor arthritis pain gifts generic diclofenac 100mg line, methods has strengths and weaknesses rheumatoid arthritis young living cheap diclofenac 50 mg otc. When however arthritis in neck prognosis purchase generic diclofenac from india, at increasing doses rheumatoid arthritis zig zag buy cheapest diclofenac, unlike a full used properly arthritis pain relief for dogs buy 100 mg diclofenac visa, various pharmacological agents opioid agonist, the agonist effects of buprenorcan produce safe and less uncomfortable phine reach a maximum and do not continue opioid withdrawal. As a result of the to increase linearly with increasing doses of 6 Introduction the drug—the ceiling effect. Until 2002, the only form of the ceiling effect is that an overdose of of buprenorphine approved and marketed in buprenorphine is less likely to cause fatal the United States was the parenteral form for respiratory depression than is an overdose of treatment of pain (Buprenex). Figure 1–1 shows opioids perceive a reinforcing subjective effect the dosage forms of buprenorphine currently from the medication, often described in terms available in the United States. This effect makes the Reckitt Benckiser, buprenorphine were drug particularly appealing to well-motivated the company patients, as it provides an additional disinholding the buprecentive to continued opioid use. The most extensive Buprenorphine can produce euphoria, opioid addiction clinical experience especially if it is injected. Buprenorphine does with buprenorproduce physical dependence, although it phine used for treatment appears to do so to a lesser degree than do treatment of opioid full opioid agonists, and it appears to be addiction is in medications easier to discontinue at the end of medication France, where the treatment. It is injected by individuals addicted to opioids in estimated that close to 70,000 patients are countries where the sublingual tablet is currently receiving maintenance treatment available as an analgesic, its abuse potential with buprenorphine in France. Using the outcome measures of illicit opioid the buprenorphine/naloxone combination use, retention in treatment, and assessment tablet appears to have reduced abuse potenfor adverse events, studies have shown that tial compared with buprenorphine alone when buprenorphine treatment reduces opioid use, studied in opioid-dependent populations. It retains patients in treatment, has few side works on the principle that naloxone is effects, and is acceptable to most patients approximately 10–20 times more potent by (Johnson 1992; Johnson 2000; Ling 1996; injection than by the sublingual route. References (see appendix A) are parenteral route should precipitate an opioid provided so that physicians can consult them withdrawal syndrome. Throughout the remainder of this doccircumstances under which it can be used, ument, use of the term buprenorphine will together provide a new means to treat opioid apply to both sublingual formulations of bupaddiction in the United States. When information is encourages treatment adherence and reduces presented that is specific to either the buprethe possibilities for both abuse and overdose. Care must be taken to assess the consensus panel notes that these guideeach patient fully and to develop a realistic lines represent one approach, but not necestreatment plan for each patient accepted for sarily the only approach, to the treatment of buprenorphine treatment. The Chapter 2 provides additional information on panel considers these guidelines not as inflexible rules that must be applied in every the pharmacological properties of opioids in general and of buprenorphine in particular, instance, but rather as guidance to be conalong with safety considerations (especially sidered in the evaluation and treatment of drug interactions). Because each patient is important screening guidelines and specific unique, and because scientific knowledge and tools for initially assessing patients. Chapter 4 clinical best practices change over time, the provides a step-by-step guide for initiating application of these guidelines to the treatand maintaining treatment and developing a ment of an individual patient must be treatment plan. Chapter 5 provides guidelines informed by the needs of the patient, the on the use of buprenorphine with special popchanging body of scientific and clinical ulations, including, for example, pregnant knowledge, and the clinical judgment of the women, adolescents, individuals leaving physician. Introduction 9 10 2 Pharmacology Overview Five topics related to the general pharmacology of opioids are reviewed In this in the first part of this chapter: (1) opioid receptors; (2) functions of Chapter opioids at receptors; (3) consequences of repeated administration and withdrawal of opioids; (4) the affinity, intrinsic activity, and dissociation of opioids from receptors; and (5) general characteristics of General Opioid abused opioids. These topics are followed by a detailed review of the Pharmacology general and applied pharmacology of buprenorphine. Pharmacology of Buprenorphine General Opioid Pharmacology Buprenorphine Safety, Opioid Receptors Adverse Reactions, and Drug Interactions Opioid receptors are molecules on the surfaces of cells to which opioid compounds attach and through which they exert their effects. The receptor most Buprenorphine relevant to opioid abuse and treatment is the mu receptor. It is through Treatment activation of the mu receptor that opioids exert their analgesic, euphorigenic, and addictive effects. The roles of other types of opioid the Buprenorphine/ receptors in the brain (that is, non-mu opioid receptors) in the Naloxone Combination addictive process are not well defined. Diversion and Misuse of Either Buprenorphine the Functions of Opioids at Receptors Alone or the Opioids can interact with receptors in different ways. For purposes of Buprenorphine/Naloxone this discussion, three types of drug/receptor interactions are Combination Product described: agonists (or full agonists), antagonists, and partial agonists. Summary Full Agonists Drugs that activate receptors in the brain are termed agonists. Agonists bind to receptors and turn them on—they produce an effect 11 in the organism. Increasing doses of full Administration and agonists produce increasing effects until a maximum effect is reached or the receptor is Withdrawal of Opioid Drugs fully activated. Opioids with the greatest the repeated administration of a mu opioid abuse potential are full agonists. In the case of abuse or addicinstead of activating receptors, they effection, the desired effect typically is euphoria. Antagonists do not activate Physical dependence is manifested as a receptors, and they prevent receptors from characteristic set of withdrawal signs and being activated by agonist compounds. An symptoms in response to reduction, cessation, antagonist is like a key that fits in a lock but or loss of the active compound at receptors does not open it and prevents another key (withdrawal syndrome). Examples of opioid antagonists are naltrexone Typical signs and symptoms of the opioid and naloxone. Not all of these signs and symptoms Partial agonists possess some of the properties are necessarily present in any single individual of both antagonists and full agonists. At significant cardiovascular disease), opioid a certain point, however, as illustrated in withdrawal is not life threatening. Patients figure 2–1, the increasing effects of partial with cardiovascular disease or other severe agonists reach maximum levels and do not conditions will need comanagement involving increase further, even if doses continue to the appropriate specialist, as well as conrise—the ceiling effect. As higher doses are reached, partial mu opioid agonists: spontaneous withdrawal agonists can act like antagonists—occupying and precipitated withdrawal. Buprenorphine is an example of a Spontaneous withdrawal can occur when an mu opioid partial agonist, and its properties individual who is physically dependent on as such are discussed in detail below. In an individual who is physically dependent Precipitated Withdrawal on heroin, spontaneous withdrawal usually begins 6–12 hours after the last dose and Precipitated withdrawal also occurs in indipeaks in intensity 36–72 hours after the last viduals who are physically dependent on use. Precipitated withdrawal from heroin lasts approximately 5 days, usually occurs when an individual physically although a milder, protracted withdrawal may dependent on opioids is administered an last longer. In an individual who is not as oxycodone and hydrocodone, have kinetic physically dependent upon opioids, the acute profiles that are similar to heroin, and the administration of an antagonist typically time course of spontaneous withdrawal for produces no effects. In an individual who is these agents should be similar to that docphysically dependent on opioids, however, an umented for heroin. Opioids with longer antagonist produces a syndrome of withdrawal Pharmacology 13 that is qualitatively similar to that seen with agonists, partial agonists, and antagonists can spontaneous withdrawal (although the onset is vary in their affinity. One way to intrinsic activity, drugs also vary in their rate conceptualize precipitated withdrawal is that the antagonist displaces agonists from recepof dissociation from receptors. Dissociation is a measure of the disengagement or uncoupling tors, but because the antagonist does not of the drug from the receptor. Dissociation is activate the receptor, there is a net decrease in agonist effect, resulting in withdrawal. If an individual who is the first drug is present), but it still dissociates physically dependent on opioids receives an or uncouples from the receptor with some acute dose of a partial agonist, the partial regularity. Buprenorphine’s slow dissociation agonist can displace the full agonist from the contributes to its long duration of action. The net effect Characteristics of Abused would be a decrease in agonist effect and a precipitated withdrawal syndrome. PrecipiDrugs tated withdrawal with a partial agonist is more the rate of onset of the pharmacological likely to occur in effects of a drug, and thereby its abuse potenan individual who tial, is determined by a number of factors. In this respect, heroin is highly abusable, relevant to the initiation of buprenorphine as it currently is inexpensive; can be snorted, treatment. Affinity, Intrinsic Activity, and Dissociation Pharmacology of the strength with which a drug binds to its Buprenorphine receptor is termed its affinity. The degree to which a drug activates its receptors is termed Overview its intrinsic activity. Affinity for a receptor and activation of the receptor are two differBuprenorphine is a thebaine derivative that is ent qualities of a drug. It is available affinity for a receptor but not activate the in numerous countries for use as an analgesic. Mu opioid When used as an analgesic, buprenorphine is 14 Pharmacology usually given by injection, via a sublingual sublingual buprenorphine-alone tablet was tablet, or as a transdermal patch, and doses more effective than the 8-mg dose in blocking are relatively low (compared with doses used the reinforcing effects of heroin. Buprenorphine has a slow dissociation rate Buprenorphine is a partial agonist that exerts from the mu opioid receptor, which gives rise significant actions at the mu opioid receptor. Because it is a partial agonist, higher doses of Buprenorphine can be given as infrequently as buprenorphine can be given with fewer three times per week (Amass et al. Past a certain point, dose increases of medication for the treatment of opioid addicbuprenorphine do not further increase the tion on a daily or less-than-daily basis conpharmacological effects of the drug but do trasts with its relatively short duration of increase its duration of withdrawal suppresaction as an analgesic. At low doses, buprenorphine is many times Bioavailability more potent than morphine. Studies of sublingually administered Affinity, Intrinsic Activity, buprenorphine have employed either an alcohol-based solution or a tablet formulation and Dissociation of the drug. Confusion may result when Buprenorphine has high affinity for, but low reviewing the literature on the effectiveness of intrinsic activity at, mu receptors. Buprenorbuprenorphine at various doses because most phine displaces morphine, methadone, and early trials and clinical studies of buprenorother full opioid agonists from receptors. It phine were performed with a sublingually also can block the effects of other opioids administered liquid preparation, whereas the (Bickel et al. Studies have affinity for the mu receptor, full agonists shown that the bioavailability of buprenorcannot displace it and therefore will not exert phine in sublingual tablet form is significantly an opioid effect on receptors already occupied less than via sublingual liquid solution—about by buprenorphine. This effect is dose related, 50–70 percent that of the liquid form (Nath as shown by Comer et al. The abuse potential, Laboratory studies with inpatient subjects however, is lower in comparison with the have examined the effects of buprenorphine abuse potential of full opioid agonists. This is relevant to abuse potential in two populations: consistent with buprenorphine’s partial (1) subjects who have a history of opioid abuse agonist effects and the resultant ceiling in but are not physically dependent on opioids, maximal effects produced. Still, abuse of the and (2) subjects who are physically dependent analgesic form of buprenorphine through on opioids. Similar effects can norphine in opioid-dependent individuals also occur in this population when buprenorphine varies as a function of the time interval is administered via other routes, including the between the dose of agonist and the dose of sublingual route (Jasinski et al. At longer time intervals, it becomes subjects, the addition of naloxone (in the more likely that buprenorphine will exhibit buprenorphine/naloxone combination tablet) either no effects. Finally, the that seen with parenteral administration, dose of buprenorphine administered also can suggesting that the abuse potential by this influence its abuse potential. The relationship between level of physical dependence and buprenorphine-related Potential for Physical precipitated withdrawal has been investigated Dependence primarily in subjects maintained on methaRepeated administration of buprenorphine done. For example, patients maintained on produces or maintains opioid physical 60 mg of methadone daily can experience dependence; however, because buprenorphine precipitated withdrawal from acute doses of is a partial agonist, the level of physical sublingual buprenorphine (Walsh et al. Furthermore, the withdrawal syntained on <30 mg per day of methadone), drome associated with buprenorphine disbuprenorphine could produce opioid agonist continuation may be significantly milder in effects, thus suggesting a potential for abuse. Overdose of likely related to buprenorphine’s slow dissobuprenorphine combined with other medicaciation from the mu receptor. Gradual dose tions, however, may increase morbidity and reduction of buprenorphine results in an even mortality, as described further below.

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They cut off the venous circulation arthritis x ray images 50mg diclofenac for sale, thus raising pressure in the veins and increasing the risk of varicositis arthritis in the knee uk order diclofenac cheap. Elastic girdles should not be worn continuously arthritis treatment vegetables order diclofenac discount, especially when seated for a long time what does arthritis in the knee look like buy 100mg diclofenac otc, such as at a desk arthritis in the knee bone on bone buy generic diclofenac on-line, or during a plane, train or auto trip. Pregnant woman should wear elastic stockings and lie down occasionally during the day. These easy-to-follow flex-exercises are beneficial as they ease the cause of varicose veins and thereby relieve the resultant symptoms. Certain inverted yoga postures such as viparitakarni, sarvagasana, and shirshashana are beneficial in the treatment of varicose veins as they drain the blood from the legs and reduce pressure on the veins. They help to relax the muscles and allow the blood freely in and out of the lower extremities. These diseases are caused by bacteria and germs and canbecome very serious if not treated properly and early. Sexual contact is the commonest way in which this disease is spread through a community. It may also be transmitted from one person to another by kissing or handling infected clothing or other articles. Symptoms and Causes Syphillis usually begins as a small ulcerating type of lesion which may occur anywhere in the body, the most common sites being the penis and vulva or in the vagina. Violent or rough sex behaviour often results in abrasions and thus the virus comes in direct contact with the blood. An acute inflammation of the male urethra or the vagina of the female due to infection through pus by the gonorrhoea germs is known as gonorrhoea. A person having a high degree of toxaemia and a low vitality may develop this condition with the slightest secretion. A clean blood stream and a high vitality on the other hand may protect one from this disease. About two-thirds of women with this disease have no symptoms at all or at most very trivial ones which may be passed off as an apparently harmless vaginal discharge. If the disease is neglected or improperly treated, it may spoil the entire blood stream which may produce gonorrheal rheumatism and cause affection of the eyes. Proper treatment is therfore, highly important soon after the occurrence of the infection. Treatement Syphillis and gonorrhoea are quite amenable to successful treatment by proper dietary and other natural methods, leaving no ill-effects to mar the future life and happiness of their victims. Suppressive drugs employed by the modern medical system in the treatment simply halts the active manifestations of the disease in the victim’s system for the time being. The disease-poisons and the metallic drugs are still left in the patient’s system and these have a most destructive effect upon the tissues and structures of the body, especially upon the nervous tissues. This will not only prevent dreaded aftereffects, but will also greatly enhance the wholegeneral health level of the patient by a thorough cleansing of his system. Each day while fasting, it should be ensured that the bowels are cleansed of the poisonous matter thrown off by the self-cleansing process now set up by the body. After the fast, the patient, may adopt an exclusive fruit diet for further five days. He should thereafter gradually embark upon a balanced diet for three basic food groups as outlined in the treatment for impotence (chapter 75), avoiding all the foods mentioned therein. Austin, a doctor in the Royal Army Medical Corps in Great Britain in his book, ‘ Direct Paths to Health’ mentions a case of a syphilis patient aged 27 years who was cured only by dietetic treatment. The classic drugs has been used, but it had not stopped the ravages of the disease. His face and body were covered with rupial eruptions ulcers covered with a scab-and the odour from his body was most unpleasant. At the end of fourteen days he was allowed two meals a day, one of them consisting of nothing but purely cooked vegetables and some butter, and the other of milk and fresh fruit. Juices which are particularly helpful include those of carrot, cucumber, beet and spinach. The patient may make liberal use of carrot juice either in combination with spinach juice or cucumber or beet. Amaranth (chaulai ka saag) is considered highly beneficial in the treatment of gonorrhoea. Fresh juice of the flowers of the drumstick is very useful in the treatment of gonorrhoea. For better results, this juice should be given twice daily with tender coconut water. A decoction of fresh lady’s fingers has also been found useful in treating gonorrhoea. A cupful of mucilage of lady’s finger is mixed with ripe banana and a glassful of buttermilk. After cooling the pieces are squeezed andthe mucilage is extracted and strained through a muslin cloth. In case of syphilis, a ‘T’ pack should be employed for an hour for the local treatment of the initial sore and it should be repeated twice daily. All clothes, sheets and towels, used by the patient should behandled carefully to avoid new sores and to prevent infection to others. In case of eruptions on the different parts of the body, a wet sheet pack for an hour is beneficial. It will help bring out all the poisonous substances of the skin by producing more eruptions which will gradually dry up. Application of pelvic packs occasionally for an hour is one of the most effective methods of treatment in case of gonorrhoea. As irritation in the prostate gland and urethra is present in this disease, a hot hip bath for eight minutes has a beneficial effect as it tends to relieve irritation. An occasional steam bath for eight minutes is of outstanding value in both syphilis and gonorrhoea. It will help remove the poisonous substances from the body and enable the kidney to perform its work effectively. These hormes are produced in a pair of almond-shaped organs, known as the ovaries. These hormones give the woman strength and stamina and are largely responsible for the peculiarly feminine shape of her body. The ovaries start producing large quantities of estrogen, the dominant female hormone when a girl reaches about 12 years of age. The commencement of menstruation at this time heralds the reproductive phase of her life, when she can have children. The menstrual flow is connected with the female function of ovaluation or the passing of the egg cell or ovum from the ovary to the womb ready for fertilisation. It is a provision of nature to cleanse the inner surface of the womb and enable reproduction to take place normally. The main problem relating to menstrual flow are painful menstruation, stoppage of menstruation and excessive menstruation, besides pre-menstrual tension which is discussed in the next chapter (84). Healthy women, living according to natural laws and eating diets of natural foods do not suffer from the monthly ordeal. Most menstrual disorders are caused by nutritional deficiencies which lead to deficiency and improper metabolism of the female sex hormones. Dysmenorrhoea: Painful menstruation or dysmenorrhoea, as it is called in medical parlance, is a very common occurrence these days. This disorder is traceable to a debilitated and toxic condition of the system in general and of the sex organs in particular due to a wrong diet, wrong style of living and nervous exhaustion. The pain may be felt either two or three days before or immediately before or during the flow. Pain starting two or three days before the flow usually shows that the ovaries are not functioning properly. This is a glandular misfunction and a carefully planned natural diet will usually put matters right. For local treatment, hot sip baths on alternate nights for a week before the period is due will be highly beneficial. Pain immediately before the flow commences is indicative of uterine flexion, which means that the position of the womb is abnormal. A professional examination should be arranged to ascertain the position of the womb and corrective exercises undertaken under professional advice. Uterine flexion often occurs in women who are so thin that they have lost internal fat and the ligament, on which the womb is suspended. General treatment along dietetic lines is essential along with corrective exercises. When the pain occurs during menstruation, it usually means that the womb itself is inflammed. This condition can be relieved by proper attention to diet and hot hip baths just before the period is due and cold hip baths between the periods. The hot hip bath is generally taken for eight to ten minutes at a water temperature of 100 o F which can be gradually increased to 120 o F. The cold hip bath should be taken for 10 to 15 minutes at a water temperature of 50 o F to 65 o F. Amenorrhoea or stoppage of menstrual flow: Stoppage of menstruation is natural during pregnancy and at the menopause, but abnormal at any other time. It is true that some women have very infrequent periods but this seems to be peculiar to their particular type and cannot be termed as stoppage. If, however, the periods have been quite regular for a number of years and then suddenly stop or the cycle becomes frequently interrupted, it denotes a debilitated and devitalised condition of the system, especially of the sex organ. Causes contributing towards this condition are anaemia, worry, grief, fright or other serious emotional disturbances, malformation of the womb, tuberculosis, displacement of womb and debility, especially after a serious illness. The treatment for amenorrhoea should be directed towards the rectification of the. Along with this, a course of general health-building treatment should also be carried out. If serious emotional disturbance has caused the trouble, an initial period of quietness and rest is essential to the treatment. All excitement, excessive mental strain and study should be avoided for a considerable period. Menorrhoea or excessive menstruation: Profuse menstrual flow is common in certain women and usually denotes a blood deficiency, especially blood calcium. A variety of causes may be responsible for this trouble, but toxic condition of the system is at the root of the matter. When the bleeding has stopped, great care should be taken to avoid over exertion or straining the body in any manner. A full nature cure diet should then be adopted using fresh vegetables raw salads twice daily. As a long term measure, what is needed is a scheme of treatment which will thoroughly cleanse the system of toxic material.

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