Treating asthma herbally!

Introduction

The vital role of plant kingdom makes the sustenance of life of mankind on this planet. Herbs have been the highly esteemed source of medicine throughout human history. They are widely used today and about 25-30 percent of today's prescription drugs contain chemicals derived from plants.

World Health Organization has recognized the potential of traditional and folk medicines in the management and self-reliance of health care system. Herbal therapy provides rational means for the treatment of many diseases such as respiratory problems, gastro-intestinal disorders, cardio-vascular illness, metabolic and degenerative diseases/disorders associated with the aging. 

Prologue

"Asthma" is a chronic lung disease characterized by a diminishing ability to easy breathing due to the obstruction  of the airways affecting the flow of air in and out of the lungs.

Herbs known to be used for asthma

Ayurveda is a long-standing tradition that offers a unique insight into comprehensive approach to asthma management through proper care of the respiratory tract. 

Long pepper (Piper longum)

Traditionally known as Pippali in Sanskrit, has been extensively used in Ayurveda and Unani medicines in the prevention and treatment of bronchial asthma. It is believed that 1-2 teaspoonful three times a day for four weeks of an Ayurvedic formulation  containing P. longum showed relief for the symptoms of asthma.

Malabar nut (Adathoda vasica)

This shrub has a number of traditional medicinal uses. The active compound, vasicinone, showed bronchodilatory activity in vitro  and has been included in traditional preparations for the relief of cough, asthma and bronchitis.

Ginger (Zingiber  Officinale) 

A powerful natural expectorant and used widely in Chinese formulas, for coughs, colds, diarrhea, vomiting, and abdominal pains associated with colds, edema and chronic bronchitis. The dried rhizome of ginger contains approximately 1–4% volatile oils which is considered to be a powerful natural anti allergy agent acting on the respiratory system. 

Black pepper (Piper Nigrum)

Piper Nigrum acts as a powerful anti convulsant and natural anti inflammation agent. Taken over a period of time it builds strong immunity against allergy. 

Indian ipecac (Tylophora asthmatica

A perennial plant native to south and east India and is official in Bengal pharmacopoeia. Traditionally, this has been used in the treatment of asthma, dermatitis and rheumatism. The plant has been described as bronchodilator, emetic, expectorant and diaphoretic.

Cardamon (Elatteria cardamom)This is a powerful natural anti inflammatory agent and an analgesic with significant cardiotonic properties. It heals the inflammation of respiratory tract. 

Chinese cinnamon (Cinnamomum cassia)

This has been used as a diaphoretic, antipyretic and analgesic. Enhances expectoration of fluids in lungs. It has powerful anti edemic properties - prevents stagnation of fluids (mucous) in lungs.

Indian frankincense(Boswellia serrata) 

The active ingredient, boswellic acid blocks the leukotriene biosynthesis by inhibiting enzyme 5-lipoxygenase. There is no clinical documentation available on the effectiveness of boswellic acid in asthma, but the anti-leukotriene mechanism of this compound merits its inclusion in a new generation anti-asthmatic nutraceuticals.

Indian Ginseng (Withania Somnifera)

This is an anti stress herb possesing powerful anti inflammatory properties. It significantly reduces inflammation and blockages in respiratory tract. Taken over a period it builds immunity to allergic triggers. 

Imli (Tamarindus Indica) 

The plant has known to possess powerful anti inflammatory properties. It instantly relieves inflammation in lungs and respiratory tract. It builds strong immunity to allergy.

Cumin(Cuminum Cyminum) 

It acts as a powerful bronchodilator and a relaxant. It makes breathing easy and free of obstruction.  

Vibhitaka (Terminalia Bellerica)

This has proven to be an anti asthmatic, anti-spasmodic, expectorant and anti cough effects. It is commonly used to treat coughs and sore throat. 

Bichuti (Tragia involucrate)

This has powerful wound healing properties particularly in the respiratory tract. It heals the inflammation and polyps in the respiratory tract and acts as a powerful bronchodilator.

Manditti (Rubia Cordifolia)

This is a very powerful anti oxidant and free radical scavenger. It builds strong immunity to allergic triggers. It also has anti-inflammatory effect and prevents stagnation of fluids in lungs (expectorant).

Tulsi (ocimum sanctum)

Tulsi extracts are used in ayurvedic remedies for common colds, headaches, stomach disorders, inflammation, heart disease, various forms of poisoning, and malaria. Traditionally, tulsi is taken in many forms: as herbal tea, dried powder, fresh leaf, or mixed with ghee. Essential oil extracted from Karpoora tulsi is mostly used for medicinal purposes and in herbal cosmetics, and is widely used in skin preparations due to its antibacterial activity. For centuries, the dried leaves have been mixed with stored grains to repel insects.


Conclusion

Asthma is a frightening condition which can seriously impede one’s ability to breathe and suddenly rob the individual of its essential requirement i.e. oxygen. Herbs are considered as a rich source of therapeutic agents for prevention and treatment of asthma and its ailments. Though contribution of allopathic medicine for treating asthma cannot be under estimated, however it is also true that most of the drugs leave harmful/toxic side effects which is the major reason for the advances made in the field of alternative treatments for asthma which are comparatively cheap, easily available, relatively free from the problems of side effects, toxicity and developing resistance towards causative organisms.

Reference:

1. Nadkarni K. Indian Materia Medica vol 1, Bombay, India: Popular Prakashan, 1976:1252.
2. McFadden Jr., E.R. In; Harrison’s Principle of Internal Medicine, McGraw  Hill, New York, 13^th Edn., 1994 : 135–45
3. Serafin, W.E. Drug’s used in the Treatment of Asthma. In: Goodman Gillman A. (Eds.) The Pharmacological Basis of Therapeutics, McGraw Hill; New York, 9^th Edn.,1996: 661.
4. Masoli, M., Holt, C., Weatherall, M. and Beasley, R. Curr. Allergy Asthma Resp., 2004; 2 : 123–131.
5. Galbraith, A., Bullock, S. and Manias, E., In; Fundamentals of Pharmacology for Health Professionals. Addison Valley Publishing Company, Sydney.1994 : 402.
6. Kirtikar, K.R. and Basu, B.D. Eds. Indian Medicinal Plants, Lalit Mohan Basu, Allahabad, India, Reprint 2^nd Edn., Vol.–III, 1993 : 1899–1901.

In-toe walking: How serious an issue is it with kids?

Most adults walk with their toes pointing forward or slightly outward.  Some children  walk with their toes pointing in: they have an in-toe walking pattern or gait. 

Main causes of in-toe walking are as follows:

• Two thirds of children have an inwards twist to the top of their femur at the hip called femoral anteversion. Most of them outgrow by the age of 2 years while some children take longer and tend to walk with their knees and feet turned inwards. They often like to sit with their legs in the “W” position. In the vast majority of these children, this twist in the bone gradually disappears by the age of 7-8 years.  In a very few children, this persists long-term but is never a functional problem. However, this should not stop them from being physically active. In extremely rare cases of teenagers who have a severe twist that causes pain at the hips or knees, an operation may be considered to correct it.

• Some may have an inwards twist to their tibia called internal tibial torsion. This is very common in babies and toddlers due to “moulding” of the baby during pregnancy. It may persist for a few years but gradually disappears with the child's growth. Treatment with splints, plasters or braces does not alter it and is unnecessary. This does not cause any functional problems and children can participate in all physical activities without suffering any long-term problems.

• In some children may be due to the shape their feet which are curved and tend to hook inwards called metatarsus adductus or pigeon toes. This can also be due to “moulding” during pregnancy and is often seen in children who tend to sleep face down. More than 80% of children grow out of this by the age of 3-4 years.

If the foot is supple and flexible, treatment is not necessary. In some children with more pronounced problems and feet that are less flexible, the doctor may recommend special shoes, splints to be worn at night or, rarely, treatment with plaster casts. Very few children need an operation for their feet to be straightened. The vast majority of children do not complain of any symptoms, can participate in all physical activities and have no long-term problems.

Best way is to take care of a child's feet as much as we take care of his appearance. It's important to make sure that the clothes, socks, soft booties and bedclothes you put on your baby are loose and don't compress the feet and toes, giving them room to move around easily. In fact, it's a good idea to let your baby have some time every day with bare feet so she/he can exercise their feet and toes. Most cases of in-toe walking correct themselves as your child becomes more confident on their feet. Talk to your GP if the problem persists beyond toddlerhood or worsens, especially if it only seems to affect one foot, as there could be an underlying developmental problem that needs checking out. Never igonore.

Kracking news on knuckle kracking

For knuckle-crackers, the satisfying “popping” noise may be music to their ears. For those around them, it can be creepy and annoying. 

The “pop”  is caused by bubbles bursting in the synovial fluid that lubricates your tendons and joints. When stretching the fingers or bending them backward, it causes a stretch also in the capsule containing the synovial fluid. This decreases the pressure in the capsule thereby stretching the gas-filled bubbles. If stretched enough, they burst.

Ever wonder why can’t we crack the same knuckle twice in a row? It’s because you have to wait for gas to once again build up in the synovial fluid.

A lot of people think that knuckle cracking can lead to arthritis. It may seem like a logical connection, but it hasn’t been supported by research.  But it is possible that cracking knuckles a lot over a long period of time could cause problems like swelling or reduced grip strength. However, there are at least two published reports of injuries suffered while people were trying to crack their knuckles. Perhaps these people were overly vigorous in their efforts. 

On the positive side, there is evidence of increased mobility in joints right after popping. When joints are manipulated, the Golgi tendon organs which is a set of nerve endings involved in humans' motion sense are stimulated and the muscles surrounding the joint are relaxed. Backs, knees, elbows and all other movable joints are subject to the same kind of manipulation as knuckles are.

Knuckle cracking is probably a good habit to break. In addition to the chance that it might cause future problems, joint cracking can annoy other people around you.

Tai chi- Does it benefit Parkinson's patients balance

Tai chi or Tai Chi Chun is translated as 'Supreme ultimate force' is thought to be a moving form of a combination of yoga and meditation. There are a number of forms consisting of a sequence of movements, many of which are known to be derived from martial arts and perhaps even further back from the movement of birds and animals. They are performed in a slow, soft and graceful movement with smooth and even transitions between them. Tai Chi includes gentle physical exercise and stretching. The postures or movement are done in a slow, graceful way. During a session, the body stays in motion as one movement flows into the next.

Due to it slow and graceful movements, it has shown to benefit older people by maintaining balance and strength. Further research indicates the use of Tai chi with patients who suffer from Parkinson’s.

Parkinson disease, a progressive disorder of the nervous system affects the motor control and movement. It is characterised by the death of nerve cells which produces dopamine. Lower dopamine production can lead to tremors, balance problems, stiff facial expressions and muffled speech, among other problems. Although the condition usually develops after the age of 60, almost 15 percent of those who learn of the diagnosis are under the age of 50.

A study done by Fuzhong Li et al, at the Oregan research centre who practices tai chi says it is sometimes described as "meditation in motion," because it promotes serenity through gentle movements, connecting the mind to the body. The researchers looked at changes in what is called postural stability, which is important to maintain balance. They also looked at how the patients walked and their physical strength.

The findings are good news for people with Parkinson’s, who often lose the ability to maintain standing balance and have difficulty walking and are at risk for frequent falls. Although some symptoms of Parkinson’s, like tremors, can be relieved by drug therapy, balance and walking problems are typically not helped by drug treatment.

It has been shown to help with loss of balance during normal aging and can help relieve stress. Typically, the positions and postures of tai chi involve slow, focused movements that flow from one to the next. The results showed an improvement in the quality of life of patients who practised Tai chi and they had fewer falls.

However, no insight is available as to how Tai chi exactly helps in regaining strength and balance. But there is a possibility that Tai chi may work on retraining the areas of the brain that control movement. Tai chi works by may be bringing awareness of the brain to these areas of the body — thereby strengthening those areas of the brain.

Tai chi has been known to be practiced amongst Parkinson’s sufferers but it is not supported by scientific evidence or clinical validation.

Can a lizard's hormone treat diabetes?

The lizard Heloderma species, including H. horridum and H. suspectum are native to several American states and are poisonous.  Lizard venom contains a number of highly bioactive peptides including the peptides exendin-3 and exendin-4. These peptides were named exendins by Eng and Raufman in that they were isolated from an exocrine gland and were subsequently shown to have endocrine actions. Exendin-4 was initially isolated from the venom found in the saliva of a poisonous  lizard found in South America, known as the Gila monster. This lizard eats four times a year. When it eats, exendin-4 secreted in the saliva causes it’s pancreas to ‘switch on’.

Structure

Molecular formula: C184H282N50O60S.C2H4O2

Molecular structure of Exenatide Acetate

Mechanism of Action

Exenatide is a potent 39-amino acid peptide that exhibits several anti-diabetic, or glucose lowering actions. The effects on glucose control seen with exenatide treatment are thought to be due to several properties that are similar to those of the naturally occurring incretin hormone GLP-1. These actions include stimulating the insulin response in response to glucose and preventing glucagon (a hormone which raises blood sugar) release after meals.

It is the first member of a new class of therapeutic medications known as incretin mimetic agents. Exenatide (synthetic exendin-4) is being investigated for its potential to address important unmet medical needs of many people with type 2 diabetes. Clinical trials suggest that exenatide treatment decreases blood glucose toward target levels and is associated with weight loss. The effects on glucose control seen with exenatide treatment are likely due to several actions that are similar to those of the naturally occurring incretin hormone GLP-1. These actions include stimulating the body’s ability to produce insulin in response to elevated levels of blood glucose, inhibiting the release of glucagon following meals and slowing the rate at which nutrients are absorbed into the bloodstream. In animal studies exenatide administration resulted in preservation and formation of new beta cells, the insulin-producing cells in the pancreas, which fail as type 2 diabetes progresses.

How effective is it?

Unlike most other oral hypoglycaemic drugs which work by a single mechanism, exendin-4 works by several mechanisms: it stimulates insulin secretion, slows emptying of the stomach and inhibits production of glucose by the liver. It also appears to suppress appetite and helps weight loss. This would be a particular advantage with type 2 diabetes.

Side effects

In these clinical trials, exenatide was well tolerated. Most of the reported side effects were mild or moderate. Nausea was the most common reported effect.

Use

People with type 2 diabetes who are not well controlled on diet and oral agents i.e. those not achieving target HbA1c levels on sulphonylureas, metformin or thiazolidenediones.

Prodcut available in market GENERIC NAME: exenatide      BRAND NAME: Byetta 

DRUG CLASS AND MECHANISM: Exenatide is an injectable drug that reduces the level of sugar in the blood. It is used for treating type 2 diabetes. Exenatide belongs in a class of drugs called incretin mimetics because these drugs mimic the effects of incretins. Incretins, such as human-glucagon-like peptide-1 (GLP-1), are hormones that are produced and released into the blood by the intestine in response to food. GLP-1 increases the secretion of insulin from the pancreas, slows absorption of glucose from the gut, and reduces the action of glucagon (Glucagon is a hormone that increases glucose production by the liver.) All three of these actions reduce levels of glucose in the blood. In addition, GLP-1 reduces appetite. Exenatide is a synthetic (man-made) hormone that resembles and acts like GLP-1. In studies, exenatide-treated patients achieved lower blood glucose levels and experienced weight loss. Exenatide was approved by the FDA in May, 2005. 

DRUG INTERACTIONS: Exenatide slows down transit of food and drugs through the intestine and, therefore, can reduce the absorption of drugs that are taken orally. To avoid this interaction, administer oral medications one hour before exenatide is administered. Orally administered drugs that need to be administered with food should be given with a light meal or snack when exenatide is not administered. 

Advantages and disadvantages of exenatide compared with other drugs

Exenatide is unique among currently marketed drugs in its broad effects to normalize postprandial physiology. In some ways, it can be thought of as having some of the same benefits of a secretagogue plus a biguanide plus an alpha-glucosidase inhibitor, without the baggage of hypoglycemia, lactic acidosis, or flatulence. Exenatide will fundamentally transform our thinking of how to approach the patient failing one or more oral agents and broaden the options beyond adding another pill or insulin to include an option that is associated with weight loss and sustained efficacy.

Drawing a conclusion from previously proven research and trials, Exenatide is indicated as adjunctive therapy to improve glycemic control in patients with type 2 diabetes mellitus who are taking metformin, a sulfonylurea, a thiazolidinedione, a combination of metformin and a sulfonylurea, or a combination of metformin and a thiazolidinedione, but have not achieved adequate glycemic control.

References:

1. Michael A. Nauck and Juris J. Meier. Glucagon-like peptide 1 and its derivatives in the treatment of diabetes, , Pubmed [MEDLINE]

2. Exendin-4 stimulates both beta-cell replication and neogenesis, resulting in increased beta-cell mass and improved glucose tolerance in diabetic rats. Diabetes. 1999 Dec;48(12):2270-6

3. Insulinotropic glucagon-like peptide 1 agonists stimulate expression of homeodomain protein IDX-1 and increase islet size in mouse pancreas Diabetes 49:741–748, 2000

4. Exendin-4 decelerates food intake, weight gain, and fat deposition in Zucker rats. Endocrinology. 2000 Jun;141(6):1936-41

5. Insulinotropic actions of exendin-4 and glucagon-like peptide-1 in vivo and in vitro. Metabolism. 2001 May;50(5):583-9

6. Glucagon-like peptide-1 and exendin-4 stimulate beta-cell neogenesis in streptozotocin-treated newborn rats resulting in persistently improved glucose homeostasis at adult age. Diabetes. 2001 Jul;50(7):1562-70

7. Synergistic insulinotropic effects of succinic acid dimethyl ester and exendin-4 in anaesthetized rats. Int J Mol Med. 2001 Sep;8(3):269-71

8. Persistent improvement of type 2 diabetes in the Goto-Kakizaki rat model by expansion of the beta-cell mass during the prediabetic period with glucagon-like peptide-1 or exendin-4. Diabetes. 2002 May;51(5):1443-52.

9. Glucagon-like peptide-1 treatment delays the onset of diabetes in 8 week-old db/db mice. Diabetologia. 2002 Sep;45(9):1263-73

10. Glucagon-like peptide-1 receptor signaling modulates beta cell apoptosis. J Biol Chem. 2003 Jan 3;278(1):471-8

11. Role of Endogenous Glucagon-Like Peptide-1 in Islet Regeneration After Partial Pancreatectomy. Diabetes. 2003 Feb;52(2):365-371

12. Exendin-4 Prevents the Development of Diabetes in the Intrauterine Growth Retarded Rat. Diabetes. 2003 Mar;52(3):734-740.

Addiction to nicotine- Is it genetically inclined.

Cigarettes can damage the human body. Any amount of smoke is dangerous. They are perhaps the only legal product which is advertised and intended use--smoking-- is harmful to the body and causes cancer.

The nicotine in cigarette smoke causes an addiction to smoking. Nicotine is an addictive drug--just like heroin and cocaine--for 3 main reasons.

• When taken in small amounts, nicotine creates pleasant feelings that urges to smoke more
• Smokers usually become dependent on nicotine and suffer withdrawal symptoms when they stop smoking. These symptoms include nervousness, headaches, irritability, and difficulty in sleeping.
• Because nicotine affects the chemistry of the brain and central nervous system, it can affect the mood and nature of the smoker.

Some people think that switching from high tar and nicotine cigarettes to those with low tar and nicotine content makes smoking safer, but this is not always true. When people switch to lower tar and nicotine brands, they often smoke more cigarettes or more of each cigarette to get the same nicotine dose as before.

Nicotine is a poison and in large doses can kill a person by stopping their breathing muscles. Smokers usually take in small amounts that the body can quickly break down and get rid of. The first dose of nicotine causes a person to feel awake and alert, while later doses result in a calm, relaxed feeling. Nicotine can make new smokers, and regular smokers who get too much of it, feel dizzy or sick to their stomach. Nicotine plays an important role in increasing smokers' risk of heart diseaseand stroke.

Most people begin smoking as teens. Peer pressure and curiosity are the major reasons young people try smoking. Also, people with friends and parents who smoke are more likely to begin smoking than those who have nonsmoking parents. Those who begin to smoke at a younger age are more likely than late starters to develop long-term nicotine addiction. Another prevalent influence in our society is the tobacco industry's ads for its products. The tobacco industry spends billions of dollars each year to create and market ads that show smoking as an exciting, glamorous, healthy adult activity.
  
Now new reports have been showing that the nicotine addiction in an individual is actually in his or her genes. 

Many of the forbidden pleasures of the modern day-nicotine, alcohol and over-eating- appear to be linked by common genetic factors. Genetic variables appear to play a key role in every aspect of nicotine addiction, from the tendency to begin smoking, to the chances of quitting. 

One of the more interesting forms of regulation for the neuronal nicotinic receptor gene family is the paradoxical up-regulation seen in subjects chronically treated with nicotine. Chronic nicotine infusion in mice results in a dose-dependent and time-dependent tolerance to nicotine that is paralleled by dose-dependent increases in both [³H]nicotine and [¹²⁵I] -bungarotoxin binding, suggesting that both high and low affinity receptors are affected. Many other studies have replicated the increases in nicotinic receptor levels in rats, treated chronically with nicotine

In humans, far less is known about the relationship between nicotine abuse and receptor levels. Several studies suggest that brain tissues from smokers have more [³H]nicotine binding than is seen in non-smokers. It has been found that the number of [³H]nicotine binding sites is correlated with the number of cigarettes smoked per day. In the brains of smokers who had quit smoking for different periods of time before death, binding levels had returned to the normal range, suggesting that monitoring nicotinic receptor levels during smoking cessation might provide valuable information regarding responses to smoking cessation and relapse. 

A new study out of Canada suggests young people are more likely to become addicted to cigarettes if they carry a specific form of a gene that helps clear nicotine out of the liver. Those with the inactive form of the CYP2A6 gene were about three-times more likely to get hooked on the habit than those with the normal form. The interesting thing is they were also less likely to smoke as many cigarettes. In the study, which was carried out among seventh graders in 10 schools, kids with the normal gene averaged about 29 cigarettes a week, compared to just 12 for kids with the inactive form of the gene. Kids with a partially inactive version of the gene smoked about 17 cigarettes a week. The investigators believe the inactive gene causes nicotine to stay in the body longer, thus requiring people to smoke fewer cigarettes in order to satisfy their cravings. 

A whole cascade of neural transmitters, which leads to a number of [systemic] effects that nicotine increases metabolism by 5% to 8%, lessens irritability, improves mood, and enhances concentration. Consequently, when smokers quit, they are faced with a nervous system redesigned for nicotine and are unable to function well without the drug. Cigarette manufacturers are currently developing cigarettes that distill nicotine rather than burn tobacco and its harmful constituents. Like it or not, nicotine addiction won’t ever go away. 

Longer-term studies in the pipeline are looking at the safety and efficacy of methoxsalen and other potent inhibitors have found. For those who cannot seem to kick the habit, this may be their best hope.


Reference:

1. M. Ingelman-Sundberg, M. Oscarson and R.A. McLellan. Trends Pharmacol. Sci. 20 (1999), pp. 342–349.
2. Pianezza, M. L.; Sellers, E. M.; Tyndale, R. F. Nature 2000, 393, 750.
3. Sellers, E. M.; Kaplan, H. L.; Tyndale, R. F. Clin. Pharmacol. Ther. 2000, 68, 35–43.
4. A. Rautio, H. Kraul, A. Kojo, E. Salmela and O. Pelkonen. Pharmacogenetics (1992), pp. 227–233.
5. Nakajima, M.; Yamamoto, T.; Nunoya, K.; Yokoi, T.; Nagashima, K.; Inoue, K.; Funae, Y.; Shimada, N.; Kamataki, T.; Kuroiwa, Y. : Role of human cytochrome P4502A6 in C-oxidation of nicotine. Drug Metab. Dispos. 24: 1212-1217, 1996.
6. Sabol, S. Z.; Hamer, D. H. : An improved assay shows no association between the CYP2A6 gene and cigarette smoking behavior. Behav. Genet. 29: 257-261, 1999.
7. London, S. J.; Idle, J. R.; Daly, A. K.; Coetzee, G. A. : Genetic variation of CYP2A6, smoking, and risk of cancer. Lancet 353: 898-899, 1999.

Honey- Is it a medicine.

Honey is the natural sweet substance produced by honeybees from the nectar of blossoms or from the secretion of living parts of plants or excretions of plant sucking insects on the living parts of plants, which honeybees collect, transform and combine with specific substances of their own, store and leave in the honey comb to ripen and mature.


The composition of honey
The average composition of all honeys from all around the world are as follows:

• Sugars account for 95 to 99% of honey dry matter. The majority of these are the simple sugars fructose and glucose, which represent 85-95% of total sugars.

• Water is quantitatively the second most important component of honey. Its content is critical, since it affects the storage of honey. Only honeys with less than 18% water can be stored with little to no risk of fermentation. It can be reduced before or after extraction by special techniques.

• Among the minor constituents organic acids are the most important. The organic acids are responsible for the acidity of honey and contribute largely to its characteristic taste.

• Minerals are present in very small quantities, potassium being the most abundant. Dark honeys, particularly honeydew honeys are the richest in minerals.

• Other trace elements include nitrogenous compounds among which the enzymes originate from salivary secretions of the worker honeybees. They have an important role in the formation of the honey. The main enzymes in honey are invertase (saccharase) diastase (amylase) and glucose oxidase.

• Traces of other proteins, enzymes or amino acids as well as water-soluble vitamins are thought to result from pollen contamination in honey.

• Virtually absent in newly produced honey, hydroxvmethylfurfural (HMF) is a byproduct of fructose decay, formed during storage or during heating. Thus, its presence is considered the main indicator of honey deterioration.

It is more than likely that honeys from different botanical origins contain different aromatic and other substances, which contribute to the specific colours and flavours and thus allow to distinguish one honey from another. Similarly, it is very likely that, depending on their botanical origin, honeys contain traces of pharmacologically active substances. Some of them have been identified, such as those responsible for the toxicity of certain honeys.


The physiological effects of honey
Many of the traditional medicinal uses has continued until today. Few of these medicinal benefits have seen scientific confirmation and they are not always exclusive to honey. The majority is due to the high sugar content and therefore can also be found in other sweet substances with high sugar contents.
Nutritional benefits
Honey is said to facilitate better physical performance and resistance to fatigue, particularly for repeated effort; it also promotes higher mental efficiency. It is therefore used by both the healthy and the sick for any kind of weakness, particularly in the case of digestive or assimilative problems. Improved growth of non-breast fed newborn infants, improved calcium fixation in bones and curing anaemia and anorexia may all be attributed to some nutritional benefit or stimulation from eating honey.
Benefits to the digestive apparatus
Honey is said to improve food assimilation and to be useful for chronic and infective intestinal problems such as constipation, duodenal ulcers and liver disturbances. They have reported successful treatment of various gastrointestinal disorders.
Benefits to the respiratory system
In temperate climates and places with considerable temperature fluctuations, honey is a well-known remedy for colds and mouth, throat or bronchial irritations and infections. The benefits, apart from antibacterial effects, are assumed to relate to the soothing and relaxing effect of fructose.
Benefits to skin and wound healing
Honey is used in moisturizing and nourishing cosmetic creams, but also in pharmaceutical preparations applied directly on open wounds, sores, bedsores, ulcers, varicose ulcers and burns. It helps against infections, promotes tissue regeneration, and reduces scarring also in its pure, unprocessed form. If applied immediately, honey reduces blistering of burns and speeds regeneration of new tissue. A cream, applied three times per day and prepared from equal parts of honey, rye flour and olive oil, has been successfully used on many sores and open wounds -even gangrenous wounds in horses. They successfully tested a honey and cod liver oil mixture suspended in a simple non-reactive cream base on open wounds in humans, but he gave no details on proportions.
Benefit to eye disorders Clinical cases or traditional claims that honey reduces and cures eye cataracts, cures conjunctivitis and various afflictions of the cornea if applied directly into the eye. There are also case histories of ceratitis rosacea and corneal ulcers, healed with pure honey or a 3 % sulphidine ointment in which Vaseline was replaced by honey.
Medicine-like benefit
Even if no transfer of active ingredients is involved, mechanisms similar to homeopathic potentiation are possible. Empirically effective therapies such as Bach flower therapy and aromatherapy suggest that there can be much more to the medicinal value of honey than chemical analysis and quantification reveals.
Diabetes
Honey is good for diabetics. A study revealed that insulin levels were lower when compared to the uptake of equal caloric values of other foods, but blood sugar level was equal or higher than in the other compared products shortly after eating. In healthy individuals, the consumption of honey produced lower blood sugar readings than the consumption of the same quantity of sucrose.
Ayurvedic medicine
Traditional, but well-studied medicinal systems as the ayurvedic medicine of India, use honey predominantly as a vehicle for faster absorption of various drugs such as herbal extracts. Secondarily, it is also thought to support the treatment of several more specific ailments, particularly those related to respiratory irritations and infections, mouth sores and eye cataracts. It also serves as a general tonic for newborn infants, the young and the elderly, the convalescent and hard working farmers.
Other benefits
Honey is said to normalize kidney function, reduce fevers and help insomnia. It is also supposed to help recovery from alcohol intoxication and protect the liver; effects also ascribed to fructose syrups. Heart, circulation and liver ailments and convalescent patients in general improved after injection with solutions of 20 and 40% honey in water.
Energy source
As food, honey is mainly composed of the simple sugars fructose and glucose, which form the basis of almost all indications on how, when and why to use it. The main consideration is the fact that honey provides immediately available calories, from which it derives its energy value for healthy and sick people: quick access to energy without requiring lengthy or complicated digestive action. The same direct absorption also carries a risk of pathological sugar metabolism, such as diabetes and obesity.




In conclusion, although honey has been used as a medicine extensively in the past, most present day medical practitioners in the developed countries are not aware of the same and consider it as a complimentary or alternative therapy. Further research and ongoing clinical trials' success would prove useful in considering this liquid gold as a medicine than a mere sweetener.

References

1. Adam, Brother 1953. Mead. Bee World, 34(8): 149-156
2. Adams, F. 1939. The genuine works of Hippocrates. Williams & Wilkins, Baltimore, U.S.A.
3. Adjare, S.O. 1984. The golden insect, A handbook on beekeeping for beginners. IT Publications, Russell Press Ltd., Nottingham, UK, 104 pp.
4. Apimondia 1975b. The hive products: food health and beauty. Proc. of Intern. Symp. on Apitherapy. Apimondia Publishing House, Bucharest, Romania, 154 pp.
5. Armon, P.J. 1980. The use of honey in the treatment of infected wounds. Tropical Doctor, 10: 91.
6. Ask-Upmark, E. 1967. Prostatitis and its treatment. Acta Med. Scand., 181: 355-357
7. Bergman, A. Yanai, J., Weiss, I., Bell, D. and Menachem, P.D. 1983. Acceleration of wound healing by topical application of honey. An animal model. The American J. of Surgery, 145 : 374-376
8. Burlando, F. 1978. [About the therapeutic action of honey on burn wounds.] Minerva dermatolog. 113: 699-706
9. Cartland, B. 1970. The magic of honey. Corgi Books, London, UK, 160 pp.
10. Codex Alimentarius 1994. Honey. 2nd Edition, FAO/WHO, Vol.11: 21-24
11. Codex Alimentarius 1995. Standards for honey. 2nd Education, FAO/WHO Vol.13 (in preparation).

Preeclapmsia- How silent a killer is it!

Preeclampsia is a disorder that occurs only during pregnancy and the postpartum period and affects both the mother and the unborn baby. 

Affecting at least 5-8% of all pregnancies, it is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. Any type of high blood pressure occuring during pregnancy is a type of "gestational hypertension". Preeclampsia is severe high blood pressure during pregnancy, and eclampsia is very severe pregnancy gestational hypertension leading to seizures.

Preeclampsia is a condition that typically starts after the 20th week of pregnancy (in the late 2nd or 3rd trimesters or middle to late pregnancy), though it can occur earlier. Proper prenatal care is essential to diagnose and manage preeclampsia. Preeclampsia, Pregnancy Induced Hypertension (PIH) and toxemia are closely related conditions.

HELLP Syndrome and eclampsia are other manifestations of the same syndrome. It is important to note that research shows that more women die from preeclampsia than eclampsia and one is not necessarily more serious than the other. and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems). Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain. When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the world. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth. Preeclampsia and other hypertensive disorders of pregnancy are a leading global cause of maternal and infant illness and death. By conservative estimates, these disorders are responsible for 76,000 deaths each year.

Risk for preeclampsia

Preeclampsia is more common in a woman's first pregnancy and in women whose mothers or sisters had preeclampsia. The risk of preeclampsia is higher in women carrying multiple babies, in teenage mothers and in women older than age 40. Other women at risk include those who had high blood pressure or kidney disease before they became pregnant. The cause of preeclampsia isn't known.

Does high blood pressure mean preeclampsia?

Not necessarily. If your doctor sees that your blood pressure is high, he or she will watch you closely for changes that could mean you have preeclampsia. In addition to high blood pressure, women who have preeclampsia also have excessive swelling. They may also have protein in their urine. Many women with high blood pressure during pregnancy don't have protein in their urine or extreme swelling, and don't get preeclampsia.

Does swelling mean preeclampsia?

Swelling alone doesn't necessarily mean you have preeclampsia. Some swelling is normal during pregnancy. For example, your rings or shoes might become too tight. Swelling is more serious if it doesn't go away after resting, if it's very obvious in your face and hands, or if it's a rapid weight gain of more than 5 pounds in a week.

What tests can show if there is preeclampsia?

No one test diagnoses preeclampsia. Your blood pressure will be checked during each doctor's visit. A big rise in your blood pressure can be an early sign that you might have preeclampsia. A urine test can tell if there is protein in your urine. Your doctor may order certain blood tests, which may show if you have preeclampsia. If you have signs of preeclampsia, your doctor may want to see you at least once a week and possibly every day.

 Signs and tests   

• Documented weight gain
• Swelling in the upper body
• Elevated blood pressure
• Proteinuria (protein noted in urine)
• Thrombocytopenia (platelet count less than 100,000)
• Elevated liver function tests

Preeclampsia may also alter the results of some laboratory tests

What are the risks of preeclampsia to the baby and mother?

Preeclampsia can prevent the placenta (which gives air and food to your baby) from getting enough blood. If the placenta doesn't get enough blood, your baby gets less air and food. This can cause low birth weight and other problems for the baby. Most women with preeclampsia still deliver healthy babies. A few develop a condition called eclampsia (seizures caused by toxemia), which is very serious for the mother and baby, or other serious problems. Fortunately, preeclampsia is usually detected early in women who get regular prenatal care, and most problems can be prevented.

What is the treatment for preeclampsia?

Currently, the only way to cure preeclampsia is to deliver the baby. However, if that delivery would be very premature, the disease may be managed by bed rest, close monitoring, and delivery as soon as the fetus has a good chance of surviving outside the womb.

Patients are usually hospitalized, but occasionally they may be managed on an outpatient basis with careful monitoring of blood pressure, urine checks for protein, and weight. Optimally, attempts are made to manage the condition until a delivery after 36 weeks of pregnancy can be achieved. In cases of severe preeclampsia when the pregnancy is between 32 and 34 weeks, delivery is the treatment of choice. For pregnancies less than 24 weeks, the induction of labor is recommended, although the likelihood that the fetus will survive is very small.

Prolonging pregnancies has been shown to result in maternal complications, as well as infant death in approximately 87% of cases. Pregnancies between 24 and 34 weeks gestation present a "gray zone," and the medical team and the parents may decide to attempt to delay delivery in order to allow the fetus to mature. During this time, the mother is treated with steroid injections which help speed the maturity of some fetal organs including the lungs. The mother and baby are closely monitored for complications.

During induction of labor and delivery, medications are given to prevent seizures and to keep blood pressure under good control. The decision for vaginal delivery versus Cesarean section is based on how well the fetus is able to tolerate labor.

Expectations (prognosis)  

The risk of recurrent preeclampsia in subsequent pregnancies is approximately 33%. Preeclampsia does not appear to lead to chronic high blood pressure. One way to control high blood pressure when you're not pregnant is to cut the amount of salt you eat. This isn't a good idea if you have high blood pressure during pregnancy. Your body needs salt to keep up the flow of fluid in your body, so you need a normal intake of salt. Your doctor will tell you how much salt to eat each day and how much water you should drink each day.Your doctor might tell you to take aspirin or extra calcium to prevent preeclampsia. Your doctor might also tell you to lie on your left side while you are resting. This will improve blood flow and take weight off your large blood vessels. Many doctors give magnesium sulfate to their patients during labor and for a few days afterward to help prevent eclampsia.

Knowing what can go wrong is to be safer than sorry.

Resources:

BOOKS

• Mabie, William C., and Baha M. Sibai. "Hypertensive States of Pregnancy." In Current Obstetric and Gynecologic Diagnosis and Treatment, edited by Alan H. DeCherney and Martin L. Pernoll. Norwalk, CT: Appleton & Lange, 1994.

PERIODICALS

• Roberts, James M. "Prevention or Early Treatment of Preeclampsia." The New England Journal of Medicine 337, no. 2 (July 10, 1997): 124+.

REFERENCES

• DeVoe SF, O'Shaughnessy RW. Clinical manifestations and diagnosis of pregnancy-induced hypertension. Clin Obstet Gynecol 1984;27:836-853.
• Chesley LC. History and epidemiology of preeclampsia-eclampsia. Clin Obstet Gynecol 1984;27: 801-820.
• Redman CWG, Roberts JM. Management of pre-eclampsia. Lancet 1993;341:1451- 1454.
• Atrash HK, Koonin LM, Lawson HW, et al. Maternal mortality in the United States, 1979-1986. Obstet Gynecol 1990;76:1055-1060.
• Roberts JM, Redman CWG. Pre-eclampsia: more than pregnancy-induced hypertension. Lancet 1993;341: 1447-1451.
• Cunningham FG, Lindheimer MD. Hypertension in pregnancy. N Engl J Med 1992;326:927-932.
• Cunningham FG, MacDonald PC, Gant NF, et al. Hypertensive disorders of pregnancy. In: Williams obstetrics. 19th ed. Norwalk, CT: Appleton & Lange, 1993:763-817.

Supporting Research

• Berkow R, ed. Merck Manual of Diagnosis and Therapy. 16th edition. Rahway, NJ: The Merck Publishing Group; 1992.
• Berkow R, Beers MH, Fletcher AJ, eds. Merck Manual, Home Edition. Rahway, NJ: Merck & Co; 1997.