Saturday 30 November 2013

Eating Disorders: Anorexia nervosa - The Complications

Anorexia nervosa
Anorexia nervosa is a type of eating disorder usually develop in the teen years and effect over 90% of female, because of excessive food restriction and irrational fear to become fat due the wrongly influenced media as attractiveness is equated to thinness.
The Complications
Anorexia nervosa may cause severe complications in every major organ system in the body  as a result of malnutrition due to self-imposed starvation.
A.1. Dermatologic signs of anorexia nervosa
Some researchers suggested that Dermatologic symptoms are almost always detectable in patients with severe anorexia nervosa (AN) and bulimia nervosa (BN), and awareness of these may help in the early diagnosis of hidden AN or BN. These manifestations include xerosis, lanugo-like body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrheic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, generalized pruritus, acquired striae distensae, slower wound healing, prurigo pigmentosa, edema, linear erythema craquele, acral coldness, pellagra, scurvy, and acrodermatitis enteropathica(21). Other suggested that the most frequent skin manifestations were xerosis (58.3%), hair effluvium (50%), nail changes (45.8%), cheilitis (41.6%), acne (41.6%), gingivitis (33.3%), acrocyanosis (29%), diffuse hypertrichosis (25%), carotenoderma (20.8%), generalized pruritus (16.6%), hyperpigmentation (12.5%), striae distensae (12.5%), factitial dermatitis, seborrheic dermatitis (8.3%), poor wound healing, melasma and Russell's sign (4.1%). In the patients with the bulimic type of AN, hair effluvium, acne, gingivitis, nail changes and generalized pruritus were more frequent than in the patients with the restrictive type(22).

A.2. Possible medical complications of anorexia nervosa
In the study of Eating disorders. A review and update, Dr. Haller E. at the University of California, indicated that Patients with eating disorders are usually secretive and often come to the attention of physicians only at the insistence of others. Practitioners also should be alert for medical complications including hypothermia, edema, hypotension, bradycardia, infertility, and osteoporosis in patients with anorexia nervosa and fluid or electrolyte imbalance, hyperamylasemia, gastritis, esophagitis, gastric dilation, edema, dental erosion, swollen parotid glands, and gingivitis in patients with bulimia nervosa. Treatment involves combining individual, behavioral, group, and family therapy with, possibly, psychopharmaceuticals. Primary care professionals are frequently the first to evaluate these patients, and their encouragement and support may help patients accept treatment. The treatment proceeds most smoothly if the primary care physician and psychiatrist work collaboratively with clear and frequent communication(23).
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Sources
(22) http://www.ncbi.nlm.nih.gov/pubmed/20808514
(23) http://www.ncbi.nlm.nih.gov/pubmed/1475950

 

Eating Disorders: Anorexia nervosa - Cause and Risk factors

Anorexia nervosa
Anorexia nervosa is a type of eating disorder usually develop in the teen years and effect over 90% of female, because of excessive food restriction and irrational fear to become fat due the wrongly influenced media as attractiveness is equated to thinness.
Cause and Risk factors
A. Causes
Some researchers suggested that The most commonly mentioned perceived causes were dysfunctional families, weight loss and dieting, and stressful experiences and perceived pressure(12). Others showed that Eating disorders (EDs) manifest as abnormal patterns of eating behavior and weight regulation driven by low self-esteem due to weight preoccupation and perceptions toward body weight and shape and Several lines of evidence indicate that brain-derived neurotrophic factor (BDNF) plays a critical role in regulating eating behaviors and cognitive impairments in the EDs(13).

B. Risk factors
1. Virtue of thin-ideal internalization, body dissatisfaction
Dr. Stice E, and the researchers team at the Oregon Research Institute, in the treatment of Anorexia nervosa showed that there is evidence that selective prevention programs that target young women at elevated risk for eating pathology by virtue of thin-ideal internalization, body dissatisfaction, and negative affect produce significant larger intervention effects than do universal programs offered to unselected populations(14)

2.  Gender
If you are girls and women, you are at higher risk to develop Anorexia nervosa, because of growing social pressures. In a community sample of young adults (n = 1,056) completed a questionnaire that contained the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorder Inventory, as well as probes for inappropriate compensatory behaviors, excessive exercise, and episodes of binge eating, showed that Women had substantially elevated scores on all of the factors except excessive exercise, for which men had significantly higher scores(15).

3. Gene mutation
Mutation of certain genes can cause increased risk of Anorexia nervosa, but certain gene change have been rule out such as , but some have been confirmed including Allele 13 of the marker D11S911 as it is significantly over represented in the anorexia nervosa population suggesting that a mutation in linkage disequilibrium with this locus may form part of the genetic component of AN. Further work is now required to try to reproduce these data in a second independent cohort and to further characterise this region of the human genome(15). Others found the linkage regions on chromosomes 1, 3, and 4 (anorexia nervosa) and 10p (bulimia nervosa)(16).

4. Family history
If you parent or siblings Anorexia nervosa, you are at increased risk to develop the disease. In the tduy to evaluate 420 first-degree relatives of 14 patients with anorexia nervosa, 55 patients with bulimia, and 20 patients with both disorders, Dr. Hudson JI, and the research team showed that the morbid risk for affective disorder in the families of the eating disorder probands was similar to that found in the families of patients with bipolar disorder; but was significantly greater than that found in the families of patients with schizophrenia or borderline personality disorder. These results add to the growing evidence that anorexia nervosa and bulimia are closely related to affective disorder(17).

5. Loss Weight intentionally
Dr. Müller MJ, and the team of scientists suggested that In regard to clinical practice, dietary approaches to both weight loss and weight gain have to be reconsidered. In underweight patients (e.g., patients with anorexia nervosa), weight gain is supported by biological mechanisms that may or may not be suppressed by hyperalimentation. To overcome weight loss-induced counter-regulation in the overweight, biological signals have to be taken into account. Computational modeling of weight changes based on metabolic flux and its regulation will provide future strategies for clinical nutrition(18).

6. Stress
People who are at stress and anxiety for what ever reason are at higher risk to anorexia nervosa. There is a case of report of athirty-five-year-old woman suffering from anorexia nervosa visited our hospital complaining of severe general weakness. She was diagnosed with stress-induced cardiomyopathy and mural thrombus using a transthoracic echocardiogram(19).

7. Occupations 
Certain occupation such as Athletes, actors and television personalities, dancers, and models are at higher risk of anorexia. In a detailed interview (the Eating Disorder Examination), models reported significantly more symptoms of eating disorders than controls, and a higher prevalence of partial syndromes of eating disorders was found in models than in controls. A body mass index below 18 was found for 34 models (54.5%) as compared with 14 controls (12.7%). Three models (5%) and no controls reported an earlier clinical diagnosis of anorexia nervosa. Further studies will be necessary to establish whether the slight excess of partial syndromes of eating disorders among fashion models was a consequence of the requirement in the profession to maintain a slim figure or if the fashion modeling profession is preferably chosen by girls already oriented towards symptoms of eating disorders, since the pressure to be thin imposed by this profession can be more easily accepted by people predisposed to eating disorders(20).

8. Etc.  
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Sources
(13) http://www.ncbi.nlm.nih.gov/pubmed/15209840
(14) http://www.ncbi.nlm.nih.gov/pubmed/22614677
(15) http://www.ncbi.nlm.nih.gov/pubmed/1502972
(16) http://www.ncbi.nlm.nih.gov/pubmed/17950174
(17) http://www.ncbi.nlm.nih.gov/pubmed/15785332
(18) http://www.ncbi.nlm.nih.gov/pubmed/16380317
(19) http://www.ncbi.nlm.nih.gov/pubmed/2323585
(20) http://www.ncbi.nlm.nih.gov/pubmed/15282695

Eating Disorders: Anorexia nervosa - Symptoms and Signs

 Eating Disorders are defined as a group of abnormal eating habits associated to a person preoccupation weight, involving either insufficient or excessive food intake.
Anorexia nervosa
Anorexia nervosa is a type of eating disorder usually develop in the teen years and effect over 90% of female, because of excessive food restriction and irrational fear to become fat due the wrongly influenced media as attractiveness is equated to thinness.

II. Symptoms and signs
A. Most common symptoms
1. Weight loss, sometime severe as a result of malnutrition.

2.  Refusal to maintain a normal or minimally above normal body mass index for their age and Dieting despite being thin or dangerously underweight
Dr. Evelyn Attia and B. Timothy Walsh, in the article of Anorexia Nervosa indicated that Anorexia nervosa is a serious mental illness characterized by the maintenance of an inappropriately low body weight, a relentless pursuit of thinness, and distorted cognition about body shape and weight(1).

3. Intense fear of gaining weight and primary or secondary amenorrhea
In the study Eating disorders. A review and update by Haller E. at the University of California indicated  Anorexia nervosa is diagnosed when a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea(2).

4. Obsession with calories and fat content of food and and try to avoid eating altogether. They deny hunger and will usually avoid eating around others as well as avoiding situations where food might be present(3).

5. Disturbance to body image the person hold of him/herself
In the study of  Eating disorders. A review and update, Dr E Haller indicated that , Anorexia nervosa is diagnosed when a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea(4).


8. Becomes intolerant to cold and frequently complains of being cold due to fat loss as a result of malnutrition(9)

9. Swelling cheek
Swelling cheek is considered Gradual onset of anorexia due to  enlargement of the salivary glands caused by excessive vomiting

10. Abdominal pain and distention
Anorexia nervosa is also associated abdominal and with  a sensation of elevated abdominal pressure and volume. There is a report of a 26-year-old female with anorexia nervosa binge/purge subtype, who presented with abdominal pain and nausea after a binge episode. Abdominal radiography and computed tomography showed a grossly dilated stomach measuring 32 cm × 17.9 cm consistent with acute gastric dilatation. She underwent exploratory laparotomy with gastrotomy and gastric decompression, and recovered uneventfully. Initially, the patient denied the binge episode, as many patients with eating disorders do, but later revealed an extensive history of anorexia nervosa binge/purge subtype. This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention(5).

11. Bad breath
The associated of  bad breath and Anorexia nervosa are of the result of from vomiting or starvation-induced ketosis. In the study of Maintaining women's oral health, Dr. McCann AL and Dr. Bonci L. stated that adolescent women are more prone to gingivitis and aphthous ulcers when they begin their menstrual cycles and need advice about cessation of tobacco use, mouth protection during athletic activities, cleaning orthodontic appliances, developing good dietary habits, and avoiding eating disorders(6).

12. Swollen joints
There is a case of anorexia for the past 10 years have never experienced swollen joints, but now that too is becoming a problem and is explained as Electrolyte Imbalances(7)

13.  Lanugo hair

In the study of  Dr. Judith M. E. Walsh and the research team posted in the Journal of General Internal Medicine, indicated that detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair)(8)

14. Etc.

B. Secondary symptoms
1. Leg pain, fatigue and general weakness
Anorexia nervosa is a disease with high prevalence in adolescents and carries the highest mortality of any psychiatric disorder, but there is a case of a 52-year old woman with longstanding anorexia nervosa was hospitalized due to progressive leg pain, weakness, and fatigue accompanied by marked weight loss. On physical examination she was cachectic but in no apparent distress. She had fine lanugo-type hair over her face and arms with an erythematous rash noted on her palms and left lower extremity.(9)

2. Depression and anxiety
Depression, anxiety and obsessive-compulsive disorder (OCD) frequently co-occur with Anorexia Nervosa (AN). In the review of all the studies done to investigate psychological factors in relation to malnutrition in AN using the keywords "Anorexia Nervosa", "depression", "anxiety", "obsessive-compulsive disorder" and "malnutrition". Only articles published between 1980 and 2010 in English or French were reviewed. From the articles on AN and depression, anxiety, and/or OCD, only the ones which investigated on the relation with malnutrition were kept(10).

3. Sleep disorder
Night eating is linked with a reduced consciousness and sleep disorders, mainly somnambulism. Patients never experience hunger, abdominal pain, nausea or hypoglycemia. Night-eating takes place invariant across weekdays, weekend and vacations. Patients consumed high caloric foods and fluids but never alcohol and purging does not occur. Diurnal bulimia is frequently associated with the sleep-related eating disorder(11)

5. Etc.
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Sources
(1) http://ajp.psychiatryonline.org/article.aspx?articleID=99258
(2) http://www.ncbi.nlm.nih.gov/pubmed/1475950
(3) http://drsandie.com/Eating.html
(4) http://www.ncbi.nlm.nih.gov/pubmed/1475950
(5) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966577/
(6) http://www.ncbi.nlm.nih.gov/pubmed/11486666
(7) http://answers.yahoo.com/question/index?qid=20100712185150AAciPvv
(8) http://www.springerlink.com/content/f7m6m410h608g046/
(9) http://www.ncbi.nlm.nih.gov/pubmed/15257758
(10) http://www.ncbi.nlm.nih.gov/pubmed/20920829 
(11) http://www.ncbi.nlm.nih.gov/pubmed/11760692 

Eating Disorders - The Types

Eating Disorders are defined as a group of abnormal eating habits associated to a person preoccupation weight, involving either insufficient or excessive food intake.

Types of eating disorder
1. Anorexia nervosa
Anorexia nervosa is a type of eating disorder usually develop in the teen years and effect over 90% of female, because of excessive food restriction and irrational fear to become fat due the wrongly influenced media as attractiveness is equated to thinness.

2. Bulimia nervosa
Bulimia nervosa is defined as a medical condition of  consuming a large amount of food in a short amount of time or one setting (binge eating), followed by self induced vomiting, taking a laxative or diuretic and/or excessive exercise, etc. to compensate for the binge. Bulimia vervosa also effects almost 90% of female.

3. Binge eating disorder
Binge eating disorder is defined as a condition of compulsive eating huge amounts of food while feeling out of control and powerless to stop. It is the common eating disorder in the United States affecting 3.5% of females and 2% of males.

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Vertigo Treatments In Traditional Chinese medicine perspective

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Treatments
In Traditional Chinese medicine perspective(76)
Traditional Chinese medicine (TCM) defines vertigo is a result of the imbalance of internal organs of that can lead to phlegm production and deficiency causes of poor blood circulation and insufficient blood supply to the brain.
1. Hyperactivity of kidney yang
a. As a result of liver qi stagnation of that lead to develop of liver fire which cause damage to the liver yin
b. TCM formula:Tian Ma Gou Teng Yin(77)
b.1. Tian Ma (Rhizoma Gastrodiae Elatae, Gastrodia Rhizome) - 9g.  -calms liver, clears wind
b.2. Gou Teng (Ramulus Cum Uncis Uncariae, Gambir Vine Stems, Gambir) - 12-15g.  -calms liver, clears wind
b.3. Shi Jue Ming (Concha Haliotidis, Abolone Shell) - 18-24g  -calms liver, clears wind
b.4. Zhi Zi (Fructus Gardeniae Jasminoidis, Cape Jasmine Fruit, Gardenia) - 9g.  -clear heat, drain fire  b.5. Huang Qin (Radix Scutellariae Baicalensis, Baical Skullcap Root, Scutellaria, Scute) - 9g.  -clear heat, drain fire
b.6. Yi Mu Cao (Herba Leonuri Heterophylli, Chinese Motherwort, Leonurus) - 9-12g.  -promote blood circulation, prevents rising of blood to the head with ascending yang
b.7. Chuan Niu Xi (RadixCyathulae Officinalis Sichuan Ox Knee) - 12g.  -promotes downward movement of blood
b.8. Du Zhong (Cortex Eucommiae Ulmoidis, Eucommia Bark) - 9-12g.  -nourish liver and kidneys
b.9. Sang Ji Sheng  (Ramulus Sangjisheng, Mulberry Mistletoe Stem, Loranthus) - 9-24g.  -nourish liver and kidneys
b.10. Ye Jiao Teng  (Caulis Polygoni Multiflori) - 9-30g.  -calms spirit  Fu Shen   (Sclerotium Poriae Cocos Pararadicis, Poria Spirit) - 9-15g.  -calms spirit

2. Retention of turbid phlegm in the middle burner
a. As a result of eating too much greasy and/or sweet foods, working too much, etc. that lead to impair the ability of spleen and stomach function
b. TCM formula: Ban Xia Bai Zhu Tian Ma Tang(78)
b.1. Ban Xia (Rhizoma Pinelliae Tematae, Pinellia Rhizome) - 4.5g.  -dries dampness, transform phlegm, direct Qi downwards
b.2. Tian Ma (Rhizoma Gastrodiae Elatae, Gastrodia Rhizome) - 3g.  -transforms phlegm, clears wind, eliminates headache and dizziness
b.3. Bai Zhu (Rhizoma Atractyloids Macrocephaelae, White Atractylodes Rhizome) - 9g.  -tonify spleen, dry dampness
b.4. Ju Hong (Pars Rubra Epicarpii Citri Erythocarpae, Red Part of the Tangerine Peel) - 3g.  -regulates Qi, transform phlegm
b.5. Fu Ling (Sclerotium Poriae Cocos,China Root, Poria, Hoelen) - 3g.  -tonify spleen, drains dampness
b.6. Gan Cao (Radix Glycyrrhizae Uralensis, Licorice Root) - 1.5g.  -harmonize herbs within formula, regulates middle jiao
b.7. Sheng Jiang (Rhizoma Zingiberis Officinalis Recens, Fresh Ginger Rhizome) - 1 slice  -harmonize stomach and spleen
b.8. Da Zao (Fructus Ziziphi Jujubae, Chinese Date, Jujube) - 2 pieces  -harmonize stomach and spleen

3. Deficiency of kidney essence (yin)
a. Most case of Deficiency of kidney essence are the result of congenital deficiency, aging, or excessive stress on the kidney system
b. TCM formula: Liu Wei Di Huang Wan(79)
b.1. Shu Di Huang (Rehmanniae Glutinosae Conquitae, Rehmannia (cooked)) - 240g.  -tonify kidney yin and essense
b.2. Shan Zhu Yu (Fructus Corni Officinalis, Asiatic Comelian Cherry Fruit, Cornus) - 120g.  -nourish liver, stops essence leakage
b.3. ShanYao (Radix Dioscoreae Oppositae, Chinese Yam, Dioscorea) - 120g.  -stabilizes essence, tonify spleen
b.4. Mu Dan Pi (Cortex Moutan Radicis, Cortex of the Tree Peony Root, Moutan) - 90g.  -clears liver fire
b.5. Fu Ling (Sclerotium Poriae Cocos, China-root, Poria, Hoelen) - 90g.  -drains dampness, tonify spleen
b.6. Ze Xie (Rhizoma Alismatis Orientalitis, Water Plantain Rhizome, Alisma) - 90g.  -clears and drains kidney fire

4. Deficiency of qi and blood(80)
a. Chronic illness, massive blood loss, or chronic deficiencies of spleen and stomach function can cause the deficiency of qi and blood
b. TCM formula Guipi Tang 
b.1. Huang Qi (Radix Astragali Membranaceus, Milk Vetch Root, Astragalus) - 9-12g.  -tonify spleen Qi, tonify blood
b.2. Ren Shen (Radix Ginseng, Ginseng) - 3-6g.  -tonify spleen Qi
b.3. Bai Zhu (Rhizoma Atractyloids Macrocephaeiae, Atractylodes (white) Rhizome) - 9-12g.  -tonify spleen Qi, dries dampness
b.4. Fu Shen (Sclerotium Porae Cocos Pararadicis, Poria Spirit) - 9-12g.  -calms spirit, tonify spleen  b.5. Dang Gui (Radix Angelicae Sinensis, Chinese Angelica Root, tang-kuei) - 6-9g.  -tonify blood, regulate menstruation
b.6. Mu Xiang (Radix Aucklandiae Lappae, Costus Root, Saussurea, Aucklandia) - 3-6g.  -regulates Qi  b.7. Long Yan Rou (Arillus Euphoriae Longanae, Flesh of the Longan Fruit, Longan) - 6-9g.  -tonify blood, calm spirit
b.8. Suan Zao Ren (Semen Zizyphi Spinosae, Sour Jujube Seed, Zizyphus) - 9-12g.  -calms spirit
b.9. Yuan Zhi (Radix Polygalae Tenuifoliae, Chinese Senega root, Polygala) - 3-6g.  -calms spirit, promotes heart Qi
b.10. Zhi Gan Cao (Radix Glycyrrhizae Uralensis, Licorice Root) - 3-6g.  -tonify spleen Qi

Chinese Secrets To Fatty Liver And Obesity Reversal
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Optimal Health And Loose Weight

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Sources
(76) http://www.itmonline.org/arts/tinmen.htm 
(77) http://www.chinesemedicinetools.com/theory/herbal-medicine/chinese-herbal-formulas-general/tian-ma-gou-teng-yin
(78) http://www.chinesemedicinetools.com/theory/herbal-medicine/chinese-herbal-formulas-general/ban-xia-bai-zhu-tian-ma-tang 
(79) http://www.chinesemedicinetools.com/theory/herbal-medicine/chinese-herbal-formulas-general/liu-wei-di-huang-wan
(80) http://www.chinesemedicinetools.com/theory/herbal-medicine/chinese-herbal-formulas-general/gui-pi-tang

 

Vertigo Treatments In Herbal medicine perspective

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Treatments
In herbal medicine perspective
The aim of herbal treatment is to stop the symptoms of dizziness by opening up sinus and enhancing the circulation to the central nervous system ginkgo, ginger, hawthorn, and
1. Ginkgo
Gingko biloba has been used for hundreds of years to treat various disorders such as asthma, vertigo, fatigue and, tinnitus or circulatory problems. Two of the main extracts are EGb761 and LI 1370. Most pharmacological, toxicological and clinical studies have focused on the neuroprotective value of these two main extracts. Neuroprotection is a rapidly expanding area of research. This area is of particular interest due to the fact that it represents a new avenue of therapy for a frustrating disease that may progress despite optimal treatment(66).

2. Ginger 
In the study of 78 cases were randomly divided into 2 groups, of whom 40 were treated with jinger moxibustion and 38 treated with acupuncture, showed that showed a cure rate of 72.5% with a total effective rate of 97.5% in the jinger moxibustion (Ginger moxibustion) group, while 44.7% and 73.7% respectively in the acupuncture group(67).

3. Hawthorn
a. Hypotensive effects
In the investigation of Hawthorn (Crataegus laevigata) leaves, flowers and berries used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs indicated that this is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes takin, according to "Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial" by Walker AF, Marakis G, Simpson E, Hope JL, Robinson PA, Hassanein M, Simpson HC(68)

b. Cardiac effects
In the evaluation of the potential cardiac effects of two alcohol extracts of commercially available hawthorn found that the mechanism of cardiac activity of hawthorn is via the Na(+),K(+)-ATPase and intracellular calcium concentrations are influenced, according to "A comparison of the effects of commercially available hawthorn preparations on calcium transients of isolated cardiomyocytes" by Rodriguez ME, Poindexter BJ, Bick RJ, Dasgupta A.(69)

c. Cardiovascular disease
In the analyzing the effect of hawthorn in prevention and protection of cardiovascular disease indicated that these beneficial effects may in part be due to the presence of antioxidant flavonoid components. While a number of studies have been performed to evaluate the clinical efficacy of hawthorn, an international, multicenter, prospective clinical study including a large number of New York Heart Association (NYHA) class II/III heart failure patients is ongoing to test hawthorn's long-term therapeutic effects, according to "Hawthorn: potential roles in cardiovascular disease"by Chang WT, Dao J, Shao ZH.(70)

d. Hyperlipemia
in the determination of The Yishoujiangzhi (de-blood-lipid) tablets (composed of Radix Polygori Multiflori, Rhizoma Polygonati, Fructus Lycii, Crataegus Pinnatifida and Cassia Tora) and its effect on Hyperlipemia found that in the treatment of 130 cases of hyperlipemia, achieving an effective rate of 87.0% in lowering serum cholesterol and 80.8% in lowering triglyceride, according to 'Yishou jiangzhi (de-blood-lipid) tablets in the treatment of hyperlipemia" by Guan Y, Zhao S.(71)

4. Gotu kola
a. Hyperglycemia and hypertension
In the determination of the inhibitory potential of selected Malaysian plants, including pegaga (Centella asiatica) against key enzymes related to type 2 diabetes and hypertension, found that In alpha-amylase inhibition assay, the inhibitory potential was highest in pucuk ubi for both hexane (59.22%) and dichloromethane extract (54.15%). Hexane extract of pucuk ubi (95.01%) and dichloromethane extract of kacang botol (38.94%) showed the highest inhibitory potential against alpha-glucosidase, while in ACE inhibition assay, the inhibitory potential was highest in hexane extract of pegaga (48.45%) and dichloromethane extract of pucuk betik (59.77%), according to "In vitro inhibitory potential of selected Malaysian plants against key enzymes involved in hyperglycemia and hypertension" by Loh SP, Hadira O.(72)

b. Locomotor activity
In the investigation of the asiatic acid, a triterpenoids isolated from Centella asiatica and its inhibitory effect on acetylcholinesterase (AChE) properties, excitatory post synaptic potential (EPSP) and locomotor activity. found that asiatic acid having an effect on AChE, a selective GABA(B) receptor agonist and no sedative effect on locomotor, according to "Inhibitory effect of asiatic acid on acetylcholinesterase, excitatory post synapticpotential and locomotor activity" by Nasir MN, Abdullah J, Habsah M, Ghani RI, Rammes G.(73)

c. Cognitive effects
In the assessment of the role of "Brahmi" (Bocopa monnieri and Centella asiatica) and its effect on the loss of memory, cognitive deficits, impaired mental function found that both plants possess neuroprotective properties, have nootropic activity with therapeutic implications for patients with memory loss. The field has witnessed exciting patent activity with most inventions aiming at either (i) improving the methods of herbal extraction or (ii) enrichment and purification of novel compounds from brahmi or (iii) providing novel synergistic formulations for therapeutics in various human ailments, according to "Exploring the role of "Brahmi" (Bocopa monnieri and Centella asiatica) in brain function and therapy" by Shinomol GK, Muralidhara, Bharath MM.(74)

d. Antioxidant capacity
In the identification of antioxidant effects of C. asiatica was exposed to various fermentations: no fermentation (0 min), partial fermentation (120 min) and full fermentation (24 h). Total phenolic content (TPC) and ferric-reducing antioxidant power (FRAP) of C. asiatica, found that C. asiatica herbal teas should be prepared at 100 °C for 10 min to obtain the optimum antioxidant capacity. Multiple brewing steps in C. asiatica herbal tea are encouraged due to the certain amount of antioxidant obtained, according to "Antioxidant capacity and phenolic composition of fermented Centella asiatica herbal teas" by Ariffin F, Heong Chew S, Bhupinder K, Karim AA, Huda N.(75)

5. Etc. 
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(66) http://www.ncbi.nlm.nih.gov/pubmed/22355250
(67) http://www.ncbi.nlm.nih.gov/pubmed/16705845
(68) http://www.ncbi.nlm.nih.gov/pubmed/16762125
(69) http://www.ncbi.nlm.nih.gov/pubmed/19053860
(70) http://www.ncbi.nlm.nih.gov/pubmed/15844828
(71) http://www.ncbi.nlm.nih.gov/pubmed/8569253
(72) http://www.ncbi.nlm.nih.gov/pubmed/22135867
(73) http://www.ncbi.nlm.nih.gov/pubmed/22112723
(74) http://www.ncbi.nlm.nih.gov/pubmed/22074576
(75) http://www.ncbi.nlm.nih.gov/pubmed/21987075

Vertigo Treatments In conventional medicine perspective

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Treatments
A. In conventional medicine perspective 
 1. Manoeuvres
The most common Epley maneuver is performed by a doctor, audiologist, physical therapist, or with a BPPV maneuver at home. Dr, and the research team at in the study of Diagnosis and treatment of 318 benign paroxysmal positional vertigo cases, suggested that 318 patients, 221 (69.5%) with posterior semicircular canal involvement, Epley repositioning maneuver was performed; 62 (19.5%) with horizontal semicircular canal involvement, Barbecue maneuver combined forced prolonged position maneuver were applied; 23 (7.2%) with anterior canal involvement were treated with Epley maneuver; 12 (3.8%) had the mixed type and were treated with corresponding repositioning maneuvers. After one week the total improvement rate was 82.1% (261/318) and 91.8% three months later (292/318)(58).

Some researchers suggested that Prevention begins by maintaining good hydration and avoiding rapid movements of the head can be helpful. Researchers at the Università degli Studi di Palermo, indicated that Gufoni's manoeuvre is effective in treating patients suffering from BPPV of LSC; it is simple to perform; there are not many movements to execute, it needs low time of positioning, and positions are comfortable to the patient(59). Others suggested that Vannucchi maneuver and Log Roll. For more information of the above. (60)

2. Postural restriction therapy
The treatment of benign paroxysmal positional vertigo (BPPV) consists of a repositioning maneuver in order to remove otoliths from the posterior semicircular canal and subsequent postural restrictions to prevent debris from reentering the canal.but researchers at Chonnam National University Medical School and other showed that Postural restriction therapy, practiced after the modified Epley repositioning maneuver, did not have a significant effect on the final outcomes of BPPV. Based on our results, we do not recommend this therapy since there was no significant benefit for the patients who utilized postural restrictions(61).

3. Vestibular training (VT)
In the  study on treatment effects of vestibular training (VT) for benign paroxysmal positional vertigo was performed. The VT was compared with courses of patients in three different groups: patients treated by medication, by VT, and by VT with medication during 8 weeks. Dr. Fujino A and the team of reserachers at Kitasato University found that  In the groups treated by VT, the effects were not influenced by time since onset of disease or by patient age. It is therefore assumed that VT can be used as a first-choice treatment in patients with benign paroxysmal positional vertigo, even in long-term cases or older patients(65).

3. Medication
Certain medication are used in treating vertigo depending to the underlying cause. Dr Hain TC, and Dr. Uddin M. at the , Northwestern University indicated that therapy of vertigo is optimised when the prescriber has detailed knowledge of the pharmacology of medications being administered as well as the precise actions being sought. There are four broad causes of vertigo, for which specific regimens of drug therapy can be tailored. Otological vertigo includes disorders of the inner ear such as Ménière's disease, vestibular neuritis, benign paroxysmal positional vertigo (BPPV) and bilateral vestibular paresis. In both Ménière's disease and vestibular neuritis, vestibular suppressants such as anticholinergics and benzodiazepines are used. In Ménière's disease, salt restriction and diuretics are used in an attempt to prevent flare-ups. In vestibular neuritis, only brief use of vestibular suppressants is now recommended. Drug treatments are not presently recommended for BPPV and bilateral vestibular paresis, but physical therapy treatment can be very useful in both. Central vertigo includes entities such as vertigo associated with migraine and certain strokes. Prophylactic agents (L-channel calcium channel antagonists, tricyclic antidepressants, beta-blockers) are the mainstay of treatment for migraine-associated vertigo. In individuals with stroke or other structural lesions of the brainstem or cerebellum, an eclectic approach incorporating trials of vestibular suppressants and physical therapy is recommended. Psychogenic vertigo occurs in association with disorders such as panic disorder, anxiety disorder and agoraphobia. Benzodiazepines are the most useful agents here(62).
 Other researchers suggested that treatment by medication together with two maneuvers-the particle repositioning maneuver (PRM) reported by Parnes and Price-Jones and the liberatory maneuver (LM) reported by Semont et al.-were compared with treatment by medication alone. The most important benefit of these maneuvers seemed to be the speedier recovery than with medication alone, as there was no significant difference in the late success rate after 3 months between the maneuvers and medication alone(63).
 
4. Surgery (Tenotomy)
In the study to compare the unique long-term results of tenotomy of the stapedius and tensor tympani muscles in definite Meniere's disease refractory to medical treatment and presents a hypothesis on why tenotomy seems effective, Dr. Loader B, and the research team at Medical University of Vienna showed that a statistically significant improvement of inner ear hearing levels postoperatively (p = 0.041) and a major reduction in vertigo attacks in all groups (p < 0.001) with complete absence of attacks in 26/30 patients was noted. Results remained constant up to 9 years postoperatively. Although tinnitus persisted, the intensity was lower overall (p = 0.013)(64)

5. Etc.
 
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve 
Optimal Health And Loose Weight

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Back to General health http://kylejnorton.blogspot.ca/p/general-health.html

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(58) http://www.ncbi.nlm.nih.gov/pubmed/22509688
(59) http://www.ncbi.nlm.nih.gov/pubmed/19239952
(60) http://www.dizziness-and-balance.com/disorders/bppv/lcanalbppv.htm
(61) http://www.ncbi.nlm.nih.gov/pubmed/15378315
(62) http://www.ncbi.nlm.nih.gov/pubmed/12521357
(63) http://www.ncbi.nlm.nih.gov/pubmed/9186970
(64) http://www.ncbi.nlm.nih.gov/pubmed/22201453