Acute Suppurative Otitis Media

Acute supperative otitis media is a pyogenic bacterial infection of the middle ear. It is a common disorder occurring at all ages and particularly in children.

Aetiology:

The predisposing factors include the following:

i. Nasopharyngeal or nasal packs

ii. Adenoids

iii. High deviated nasal septum.

iv. Nasal polyp

v. Rhinitis and sinusitis

vi. Tumours of the nose and nasopharynx.

vii. Anatomical factor: Short, straight and wide Eustachian tube in young children.

viii. Carelessness on the part of the mother in keeping the baby in a flat position while feeding, thus allowing milk to regurgitate into the nasopharynx and to the middle ear cavity through Eustachian tube.

Eustachian tube is the commonest route through which the infection travels from the nose and nasopharynx to the middle ear. The attack usually follows a common cold or influenza. The viral infection damages the mucosal barrier and bacteria invade as secondary organisms. The commonest organisms include betahemolytic and non-hemolytic streptococcus, Hemophilus influenza, Pneumococcus and Staphylococcus aureus.

The other path by which infection may reach the middle ear is a traumatic perforation in the tympanic membrane.

Pathology and Clinical Presentation:

Stage of tympanic congestion: Hyperiaemia of the mucoperiosteum of the middle ear. Patient complains of pain and fullness in the ear. The tympanic membrane looks congested. No significant hearing loss at this stage.

Stage of exudation: In this stage exudates collects in the tympanic cavity due to constant inflammatory process. The patient complains of marked pain in the ear with deafness. The tympanic membrane shows bulging and looks more congested. Constitutional symptoms like fever and malaise occur.

Stage of suppuration: The pent up inflammatory exudates causes pressure necrosis and perforation of the tympanic membrane. The perforation is central. Intensity of pain diminishes but hearing loss persists. The mucosa of the middle ear cavity if seen through the perforation is much congested and thickened. The discharge is serosanguinous at the onset and mucopurulent later on.

Stage of convalescence or recovery: The disease subsiding and the recovery process begins.

Stage of coalescent mastoiditis: Continued infection and absence of proper therapy leads to inflammatory changes in mastoid cells. The pain which had diminished following stage of suppuration intensifies with increasing deafness and profuse discharge continues to drain from the ear. Fever and bodyache recur.

Treatment:

ASOM has been described as a self-limiting disease provided the patient does not develop a complication.

Despite these advocates, the overwhelming consensus remains that antibiotics are the initial therapy of choice for AOM for 3 very valid reasons. First, after the institution of antibiotic therapy, a marked decline in the suppurative complications of ASOM is noted. Second, practitioners cannot predict with certainty which patients will develop complications. Third, studies have demonstrated that the use of antibiotics improves patient outcomes in both the early and late phases of ASOM.

Most common antibiotics that can be used in this condition are:

Amoxicillin/ Augmentin: Adult 250 – 500 mg PO q8hr; Pediatric: 90 mg/kg/d q8 - 12hr.

Clarithromycin: Adult: 250 – 500 mg PO q12hr; Pediatric: 15 mg/kg/d q12hr

Azithromycin: Adult: 500 mg on day1 then 250 mg/d for 2 – 5 days; Pediatric: 10 mg/d on day 1 then 5 mg/d on day 2 -5 days.

Ceftriaxone: Adult: 1-2 g/d IM for 3 days; Pediatrics: 50 mg/kg/d IM for 3 days.

In Ayurveda Lakshmi Vilas Rasa, Sanjivini vati work well in this condition.

Surgical:

Tympanocentesis and myringotomy are the procedures used to treat ASOM

Developmental defects, Medicines and Folic acid!

Bulk of practice in paediatric surgery deals with correction of developmental deformities that may arise in the baby, and this is one aspect of surgery where the age old adage “Prevention is better than cure “ holds true beyond doubt.

The cause of developmental defects is unclear. Less than 20% are related to genetic causes. In 70% of the cases the cause is obscure, but in 10% of the cases, defects occur due to environmental factors such as radiation, drugs, chemicals, heat, infection etc. They had their most impact during the time the embryo develops. It is also believed that in 70% of obscure cases a good percentage may be due to an effect of exposure to chemical agents (insecticides, pesticides, paints, etc.) or intake of drugs during early pregnancy. Thus drugs seem play most important role in the environmental factors affecting the baby.
Some of the effects medicines can cause are:

· Smaller baby size (e.g. smoking)
· Limb defects (e.g. thalidomide)
· Addiction (e.g. morphine)
· Brain problems (e.g. alcohol)
· Heart or kidney problems (e.g. alcohol)
· Various malformations e.g. cleft palate.
· Problems with blood flow to the baby (e.g. Anti-inflammatory drugs)
· Behavioural problems (e.g. alcohol)
· Miscarriage (e.g. misoprostol)
· Contractions of the uterus (e.g. castor oil)
· Premature delivery.
· Sometimes problems can be delayed, e.g. stilboestrol given during pregnancy has showed problems with reproductive system during puberty of offspring.

Normally before a drug is released in the market, it is extensively tested – in the lab, on animals and finally on the target population (clinical trials). However, pregnant women and children are compulsorily excluded from such trials, which means that what ever data we have on the role of drugs in pregnancy, is case related and no pharmaceutical company or doctor can support with a foolproof guarantee, the safety of any drug used during pregnancy.

Another important fact to be borne in mind is that for a given medicine, it may be consumed during some part of the pregnancy, but can be hazardous during another part of the pregnancy. e.g. Ibuprofen, may be used with caution in the first or second trimester, but can cause bleeding or delivery problems or even heart problems in the baby if used near term.

Some genetic conditions are also caused by an interaction between the inherited genetic information and the environment such as diet and lifestyle factors. Such conditions are referred to as “multi-factorial” conditions. Examples of such birth defects include cleft lips and palate, hydrocephalus, spina bifida etc. A person will be affected by these conditions if their genetic information means that they are predisposed to the condition, and are exposed to the environmental factor that can “trigger” it. If exposure to the environmental trigger can be avoided, it may be possible to prevent the person being affected with the condition despite genetic make-up.

Some medicines have the ability to prevent or minimize the development of those multi-factorial conditions whose “environmental trigger” is now well known.

The most important ones, where the “trigger” is deficiency of folic acid (Vitamin B9) are:
- Spina Bifida.
- Anencephaly
- Cleft lip
- Cleft palate.

Spina bifida and anencephaly are problems with the development of the spine or brain. Together they are called Neural Tube Defects (NTDs).

Research has shown that 7 out of 10 cases of NTDs can be prevented by increasing the intake of the vitamin B9 (folate) or folic acid prior to and during early pregnancy. Folate is important in the growth and development of new cells and making DNA, especially embryos. It also helps to regulate the level of an amino acid called homocystine.

Folate in pregnancy also lessens the risk of cleft palate and cleft lip by 25 to 50%.

Now the question arises that how much folate is needed before and in early pregnancy?
For most women as a rule, it is necessary to have about 400 – 500 milligrams of folate each day. This can be obtained by eating a folate rich diet and/or taking a low dose folic acid tablet. However, folate will only help in preventing spina bifida or other NTDs if it is being taken at the time of conception and for the first twenty-eight days of pregnancy, or until the neural tube has completely formed. Therefore our advice is to use foloc acid supplements from ONE MONTH BEFORE planning a baby until THREE MONTHS into the pregnancy.

Foods rich in Folate:
- Leafy green vegetables, broccoli
- Wholegrain breads.
- Cereals
- Legumes (peas, dried beans and lentils, peanuts)
- Citrus fruits and juices.
- Asparagus, avocados.

Women are at increased risk if:
- They had a baby with Spina bifida, ancencephaly or other NTDs.
- They themselves have, or have had, a NTD.
- They have a close relative who has, or has had, a NTD.

These women should consult their doctor/foetal anomaly counsellor or genetic counsellor before pregnancy for advice regarding the amount of folate they should take.

Mind + Body + Soul = Individual – The biggest Myth of the century

The biggest myth of the century is that you and me – indeed all individuals are made up of mind, a body and a soul. In other words, we are a sum of three distinct parts. This myth is most evident in the way we treat our illness.
When it comes to health and healing, the modern approach has always been to treat ailments in isolation. The emphasis on treating illness in a purely physical or mechanistic way continues even as new research gives overwhelming evidence of the connection between our psychological aspects and our physical health.
Granted, there is lot of talk about the mind-body-soul connection and most modern physicians understand the psychotic conditions like stress play a role in aggravating certain symptoms. Yet, a few physicians offer life style changes as a first course treatment, proving that they pay only a lip service to the idea of what we call complete wellbeing.
For example, did you know that depression might be linked to nutrition? Recent researches suggest that depression may be caused by inflammation in the brain as a direct result of an imbalanced diet! In fact some psychiatrists are treating depression successfully by getting their patients to increase their intake of Omega-3 Fatty Acids. Yet, anti-depressant pills are prescribed by many doctors at the drop of the hat.
Take another example- of skin care. Skin care is considered to be purely a physical phenomenon. Skin problems are also usually dealt with either physical or physiologically. The idea that our psychology might affect the health of our skin is not so popular. But psycho-dermatology is an established field of medicine that is based on the evidence that our emotional states affect our skin directly. So, does this mean that your stubborn acne might be better managed by altering your emotions? Yet it does! And why just your skin? Evidence are springing up about how emotions are responsible for healing or preventing even critical illnesses such as coronary heart disease, cancer and diabetes.
The incontrovertible truth is that we are not sum of parts. You and me are not a Mind + a Body + a Soul. We are an integrated whole. This mind, body and the soul are terms that only describe the various dimensions of an individual and his/her life and experience.
What does that mean? It means that what we feel, what we think, and what we do make up what we are in totality. It means that being fit and healthy is not just about maintaining a good diet, exercising regularly, and staying in a hygienic environment. To be sure, these are necessary conditions. But by no means they are sufficient. Emotional health, mental health or physical health are misnomers. Health is singular. An illness, whether emotional or physiological is an illness and must not be treated uni-dimensionally.
Based on these evidences modern science is now considering that every disease is psycho – somatic.
Therefore the first step towards achieving complete well being is to break the notion that we are sum of parts. Purge this myth from your life and acknowledge your instincts of being a living, breathing miracle that medical science is only beginning to understand, but which you have known all long. Then only true wellness can be attained.

Food stuff and Doshas - Interrelation

Tridoshas form the fundamentals of Ayurveda treatment. According to ayurveda whole of the human body and the Universe at large are made up of and are governed by these three doshas only viz Vata, Pitta and Kapha. Any disturbance in any one of these components leads to a disease condition and by bringing these in harmony we can cure the disease and lead a healthy life. For this Samanya and Vishesha siddhanta is applied in Ayurveda i.e. The food stuffs which contain a specific guna will increase the respective dosha in the body ( when consumed) and will decrease the opposite dosha. Viz.
Vata foods: Foods containing vayu and little of pitta or kapha strengthen the nervous system but weaken the mucous and circulatory system.
Pitta foods: strengthen circulation but weaken the mucous and nervous system.
Kapha foods: Strengthen the mucous system, weakening nervous system and circulation.
Vata-Pitta foods: Strengthens nervous and circulation at the expense of mucous system.
Vata-Kapha foods: Stengthen nerves and mucous, weakens circulation and increases the concentration of heat.
Pitta-Kapha foods: Promotes circulation and lubrication, weakening the nervous system.
Vata – Pitta-Kapha foods: Promote proper function of all bodily systems. Foods containing all these elements are fresh whole milk, fresh cream, black pepper and fish. The milk and cream must be of the same day’s milking otherwise the vayu and pitta properties are lost, leaving only kapha (the only property left in stored – purchased milk). Whole milk or cream should be taken only after heating to just below theboiling point.
Some of the food stuffs and the doshas to which they are associated are given below:

Avocado - Kapha
Banana – Vata-Pitta
Beets – Vata-Kapha
Brccoli – Vata
Cabbage – Kapha
Carrots – Vata-Kapha
Cauliflower – Kapha
Celery – Pitta
Chestnuts – Vata – Kapha
Chocolate – Pitta
Coffee – Pitta
Corn – Vay –Kapha
Corn flakes – Vayu
Cream – Vata-Pitta-Kapha
Cream cheese – Vata - Kapha.
Curd – Pitta
Date – Vata-Kapha
Escarol – Kapha
Grape fruit – Kapha
Grapes – Vata – Kapha
Greens – Kapha
Honey – Kapha
Kolrabi – Kapha
Lemon – Vata
Lettuce – Kapha
Milk (fresh) – Vata-Pitta-Kapha
Milk (bottled) – Kapha
Mint – Pitta
Mushrooms – Kapha
Oat meal – Vata – Kapha

Olive (ripe) – Vata-Kapha
Onion – Pitta
Parsley – Vayu
Peanuts – Pitta
Pears – Kapha
Peas – Pitta
Pickles (Sour & hot) – Pitta
Potatoes – Pitta
Pulses – Pitta
Rice – Kapha
Salt – Vayu
Soyabeans – Pitta
Spinach – Kapha
Sugar (Raw) – Pitta
Sugar (Refined) – Vata-Pitta
Sunflower seeds – Pitta
Tea – Vata
Tomatoes – Kapha
Turnips – Kapha
Vinegar – Pitta
Walnuts – Pitta
Wheat –Pitta

Thus we see that every food is related to a particular dosha and by consuming the food in precise manner or according to the need we can stay healthy and can also cure small ailments by food only.

Yoga

Yoga

An exercise or Unification of Body, mind & soul

Think fitness and the first word that comes to mind, especially in recent times, is invariably yoga. With international celebrities like Madonna, Ricky Martin swearing by yoga, yoga as a complete fitness program has gained tremendous popularity, world-wide. Despite this most of us are still not clear about how or why yoga is beneficial. The most common reason to take to yoga has been, “It is good for us. Everyone is doing yoga these days”!

So now first take a slight peep into the world of yoga and explore why yoga is good and how it is different or even better than other forms of exercise. A common misconception that exists among many of us is to think of yoga as an exercise or its substitute. Even many learned yogis’ and babas’ are spreading this message to general public and have adopted the yoga as a means of exercise through which we can attain a healthy life and cure many disease condition. So the first step in enlightening ourselves about yoga is to clear this fallacy. Yoga is not an exercise or its substitute. It is one of the path of unification of mind, body and soul. It is the ultimate goal of yoga as is mentioned in the text , ‘Yog Sutra’ by Sage Patanjali, the main treatise for Yoga practitioners. And in preparation of the corporeal self for this tough journey towards this unification or self-evolution, asanas are practiced. The health benefits of asanas is but a natural by-product. So now we can clearly discern that the goal of yoga is entirely different and much deeper than those of conventional exercises which lie on much superficial level. Therefore propagating yoga as a simple means of exercise to cure various ailments of both body and mind is not precise and not justified by any means.
Now let us have an insight on yoga in its true sense: The word Yoga is derived from the Sanskrit root word ‘Yuj’ which means to unite. It is the true union of our will with the will of the GOD. Patanjali in his ‘Yog Sutra’ has suggested 8 stages of Yoga. These stages are known as ‘Asthangyoga’. They are as follows:
1. Yama (Social Discipline): Yama means restraint or abstenance. It contains five moral principles namely non-violence, truthfulness, non-stealing, celibacy and non-acquisitiveness.
2. Niyama (Individual Discipline): Rules of conduct towards oneself consist of certain disciplines which are physical and mental, both. These are 5 in number namely cleanliness, contentment, austerity, self-study and surrender to GOD.
3. Asana (Posture): Asanas means holding the body in a particular posture to bring stability to the body and poise to the mind. The practice of asanas help body cleanse its toxic metabolities and wastes and brings firmness to the body and vitality to the body and mind. This aspect of the yoga is now a days mostly explored leaving all other aspects.
4. Pranayama : The literal meaning of this is to control breath. But the deeper meaning is to control ones ‘Prana’ tatva that resides deep inside our body. Though breathing is also considered as a synonym of Pran but here the meaning that has to be taken is much deeper.
5. Pratyahara (Discipline of senses): The extroversion of the sense organs due to their hankering after wordly objects has to be restrained and directed inwards towards the source of all existence. This process of drawing the sense inwards is pratyahara or putting the sense under restraint.
6. Dharana (Concentration): Dharana means focussing the pure mine on one’s personal deity or individual self. The practice of dharana helps the mind to concentrate on a particular object.
7. Dhyana (Meditation): When one sustains and maintain the focus of attention through Dharana unbound by the time and Space, it is called Dhyana. It is next step of Dharana and destroys Rajas and Tamas gunas and develops Satvic Gunas.
8. Samadhi (Self-realization): The eighth and final stage of Yoga is Samadhi. At this stage, one’s identity becomes both externally and internally immersed in meditation. The meditator, the act of meditation and the object meditated upon becomes all three shred their individual characters and merge as one entity. This is the only reason that Sankaryacharya one the great Saint of Hinduism has one said ‘Aham Brahamasmi’ i.e. I am Brahm the sole creator of universe.

Hence when we talk of Yoga we should take the meaning in its original sense and try to fathom the concepts and principles laid by our ancestors for which they had devised ‘Yoga’.

Reiki- The art of Gentle Healing

The art of Gentle Healing

Reiki is a science of curing people without any medicine. It is based on the concept of energy mechanism. The basis of whole of the universe is energy only. It is this energy only which transforms into different shapes like stars, planets etc. Even the various life forms including human beings are transformations of this energy. Now scientifically also it has been proved. The big bang theory has been approved by scientists now and they further state that whole of the universe is expanding along with expansion of the constituent elements. This means that one day whole of the universal elements like planets, stars etc including life forms will disintegrate into small – smaller – smallest constituents ultimately terminating into energy. This way the cycle of formation and disintegration goes on. The theory of Einstein E = mc2 also supports these basics.

Reiki is not something that can be learnt by reading books. Here the learned teacher performs an initiation, which connects the disciple to the abundant source of cosmic energy, enabling him to tune in. It involves no medication, concentration, breathing exercises or massage; the magic is in hands.

Reiki is the Japanese word for “spiritually guided energy”. Among the renowned practitioners of Reiki the names of Buddha and Christ stand in the top list. Although the origin of Reiki was in India but in due course of time it was forgotten by masses until a Japanese Doctor, Mikao Usui, rediscovered it.

Reiki does not seek to replace medicine but it certainly plays a very important role along with medicines in treating illness. And in some cases it is reiki only that comes to rescue e.g in cases of infestation of metaphysical objects, in coma, various untreatable conditions etc. Distance healing is also possible with reiki. But since the reiki operates from the very root of the cause it takes time for the results to be seen in most cases. If properly done and if the initiation is from the learned guru the Reiki is effortless with no harm to both giver and receiver. Here the reiki healer merely acts like a dish antenna of a TV which receives cosmic energy from the universe and forward it to the receiver. In this process his own body energy is recharged. But if wrongly done the healers own body energy is depleted as he transfers it to the receiver which ultimately harms it. The most interesting part of this reiki healing is that it cannot be used to harm anyone. Since it is a positive energy which works on its own, once released the only thing it does is benefit of the recipient.

Hence when this reiki is combined in any treatment the results we get are astonishing thus making it an integral part of Holistic treatment.

Misconception and myths about excercise and weight loss

Misconceptions and myths about exercise and weight loss

How much true how much false

Now a days people are getting more conscious towards thier health and fitness. Similarly there are several common misconceptions about exercise and weight loss, but don’t let yourself be fooled! Here are the Top 6 Fitness Myths and the Truths that debunk them:

Myth #1: You can take weight off of specific body parts by doing exercises that target those areas.
Truth: This concept is called "spot training" and unfortunately, it doesn’t burn fat. When you lose weight, you are unable to choose the area in which the reduction will occur. Your body predetermines which fat stores it will use. For example, doing sit-ups will strengthen you abs but will not take the fat off of your stomach. Similarly, an activity like running burns fat all over your body, not just your legs. You can, however, compliment a balanced exercise program with a selection of weight training exercises to gradually lose weight and tone the body.

Myth #2: Women who lift weights will bulk up.
Truth: While on a weight lifting program, the right hormones (testosterone) are necessary in order to bulk up. Women’s testosterone levels are much lower than men’s, so in most cases, they are not capable of building large muscles. In fact, since muscle takes up less room than fat, women tend to lose inches when they strength train. So in addition to the physical benefits (increased metabolism, decreased risk of osteoporosis, increased strength), strength training will help you slim down too!

Myth #3: If you can’t exercise hard and strongly there is no point?
Truth: Even moderate activity is shown to reduce your risk for heart disease and stroke. If you don’t have 30 minutes in your nd often, there’s really no point.day to exercise, try splitting it up into 10-minute segments instead. Everyone can find 10 minutes to spare sometime during the day! There are simple things you can do to increase your activity without having to go to the gym: take the stairs instead of the elevator, jump rope or do body weight exercises (push ups, crunches) at commercial breaks, take a short walk after lunch. Remember that any exercise is better than none!

Myth #4: Performing abdominal exercises will give you a flat stomach.
Truth: This is similar to Myth #1 above. The fact is, the only way to get a flat stomach is to strip away the fat around the midsection. This is accomplished by doing cardio/aerobic exercise (to burn calories), strength training (to increase metabolism) and following a proper diet. Abdominal exercises will help to build muscle in your midsection, but you will never see the muscle definition unless the fat in this area is stripped away.

Myth #5: You will burn more fat if you exercise longer at a lower intensity.
Truth: The most important factor in exercise and weight control is not the percentage of fat calories burned, but the total calories burned during the activity. The faster you walk, bike or swim, for example, the more calories you use per minute. Although you will be burning fewer "fat calories", you will be burning more total calories, and in turn, will lose more weight.

Myth #6: No pain, no gain!
Truth: Exercise should not be painful! At the height of your workout, you should be sweating and breathing hard. You should not be so out of breath that you cannot answer a question, but should not be so comfortable that you can carry on a full conversation. That’s how you know you are working at a good level. It’s important to distinguish between muscle fatigue (feeling "the burn") and muscle/joint pain (sharp and uncomfortable pain during movement). Pain is your body’s way of telling you that you’re doing something wrong. Listen to your body. If it’s painful, stop!

There’s a lot of fitness information out there- some reliable, some not. The important thing is to ask questions. If you don’t understand something or question the source, simply visit our site http://www.holisticayurveda.110mb.com/ and http://www.holistic-ayurveda.blogspot.com/ for their advice and knowledge respectively. Sticking to the truths of these myths will keep you healthy, injury-free, and on track to meeting your fitness goals.