10/29/2008

Food Poisoning: An Introduction

Food poisoning is an acute gastroenteritis caused by the consumption of a food material or a drink which contains the pathogenic micro organism or their toxins or poisonous chemicals.Food poisoning is common in hostels,hotels,communal feedings, and festivel seasons.

A group of persons will be affected with same type of symptoms ,and they give a history of consumption of a common food before few hours.

Types of food poisoning...

1) Bacterial food poisoning:
Here the micro organisms called bacteria are responsible.The food material may contain the pathogenic bacteriae or their toxin and will be ingested along with the food.

2) Non bacterial food poisoning:
Due to the presence of toxic chemicals like fertilizers,insectisides,heavy metals and ect.

Since bacterial food poisoning is common it is discussed here.
Bacterial food poisoning:
All bacteria are not harmful.There are some pathogenic bacteria which secrete toxins and cause clinical manifestations.These organisms enter the human body through food articles or drinks.

How food poisoning occures:
1) Presence of bacteria in the water.
2) The raw materials for the food may contain toxins.
3) Premises where the food is prepared may contain micro organisms or toxins.
4) Food handlers may have some infectious diseases.
5) Some animals like dogs,rats may contaminate the food.
6) If prepared food is kept in the room temperature for a long time and heated again can make a chance for food poisoning.
7) Purposely some body mixing toxins in the food.

Some common bacterial food poisonings.
1) Salmonella food poisoning:
There are three different varieties of salmonella bacteria.(salmonella typhimurium,salmonella cholera suis,salmonella enteritidis) These bacteria are present in milk, milk products and eggs. Symptoms of this food poisoning include nausea, vomiting and diarrhoea. Fever is also common.

2) Botulism:
This is the dangerous type of food poisoning caused by clostridium botulinum. The spores of these organisms are seen in the soil and enters the human body through pickles and canned fish ect.Compared to other food poisonings here vomiting and diarrhoea are rare Mainly the nervous system is affected.The symptoms starts with double vision,numbness with weakness.Later there will be paralysis with cardiac and respiratory failure ending in death.

3) Staphylococcal food poisoning:
It is caused by staphylo coccus aureus. These organisms usually cause skin troubles like boils and eruptions.It causes mastitis in cow.Through the milk and milk products it enders and causes gastroenteritis.There will be vomiting,abdominal cramps with diarrhoea.

4) Closteridium food poisoning:
This is caused by closteridium perfringens.They are present in stool,soil and water. They enter the body through,meat,meat dishes and egg ect.If food articles are cooked and kept in room temperature for a long time and heated again before eating can result this food poisoning.Symptoms include vomiting ,diarrhoea and abdominal cramps.

5) Bacillus cereus:
The spores of these organisms can survive cooking and causes enteritis. Diarrhoea and vomiting is common in this infection.

How to investigate food poisoning?
1) Examine each and every person affected.
2) Water sample should be tested.
3) Kitchen, store room and food samples should be examined.
4) The cook and food handlers should be questioned and examined.
5) Samples of vomitus and stool of all victims should be tested to identify the bacteria.

How to prevent food poisoning:-
1) Only purified water should be used.
2) Hygiene should be maintained by all persons keeping contact with food.
3) Workers should use masks, cap and gloves during cooking and serving.
4) Sick individuals should not come in contact with food materials.
5) Kitchen and premises should be neat and clean.
6) Vessels should be washed with soap and hot water.
7) Should not keep the prepared food for a long time in room temperature.
8) All food materials should be kept in closed containers.
9) Animals like dog, cat, rat ect should not come in contact with food materials.
10) Vegetables should be washed before cooking.
11) Meat should be fresh and should be purchased from recognised slaughter house.

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Alchohol: Membranous deteriorations

In order to make perfectly clear to your mind the action and use of these membranous expansions, and the way in which alcohol deteriorates them, and obstructs their work, we quote again from Dr. Richardson:

"The animal receives from the vegetable world and from the earth the food and drink it requires for its sustenance and motion. It receives colloidal food for its muscles: combustible food for its motion; water for the solution of its various parts; salt for constructive and other physical purposes. These have all to be arranged in the body; and they are arranged by means of the membranous envelopes. Through these membranes nothing can pass that is not, for the time, in a state of aqueous solution, like water or soluble salts.

Water passes freely through them, salts pass freely through them, but the constructive matter of the active parts that is colloidal does not pass; it is retained in them until it is chemically decomposed into the soluble type of matter. When we take for our food a portion of animal flesh, it is first resolved, in digestion, into a soluble fluid before it can be absorbed; in the blood it is resolved into the fluid colloidal condition; in the solids it is laid down within the membranes into new structure, and when it has played its part, it is digested again, if I may so say, into a crystalloidal soluble substance, ready to be carried away and replaced by addition of new matter, then it is dialysed or passed through, the membranes into the blood, and is disposed of in the excretions....

"See, then, what an all-important part these membranous structures play in the animal life. Upon their integrity all the silent work of the building up of the body depends. If these membranes are rendered too porous, and let out the colloidal fluids of the blood the albumen, for example the body so circumstanced, dies; dies as if it were slowly bled to death.

If, on the contrary, they become condensed or thickened, or loaded with foreign material, then they fail to allow the natural fluids to pass through them. They fail to dialyse, and the result is, either an accumulation of the fluid in a closed cavity, or contraction of the substance inclosed within the membrane, or dryness of membrane in surfaces that ought to be freely lubricated and kept apart.

In old age we see the effects of modification of membrane naturally induced; we see the fixed joint, the shrunken and feeble muscle, the dimmed eye, the deaf ear, the enfeebled nervous function.

"It may possibly seem, at first sight, that I am leading immediately away from the subject of the secondary action of alcohol. It is not so. I am leading directly to it. Upon all these membranous structures alcohol exerts a direct perversion of action. It produces in them a thickening, a shrinking and an inactivity that reduces their functional power. That they may work rapidly and equally, they require to be at all times charged with water to saturation.

If, into contact with them, any agent is brought that deprives them of water, then is their work interfered with; they cease to separate the saline constituents properly; and, if the evil that is thus started, be allowed to continue, they contract upon their contained matter in whatever organ it may be situated, and condense it.

"In brief, under the prolonged influence of alcohol those changes which take place from it in the blood corpuscles, extend to the other organic parts, involving them in structural deteriorations, which are always dangerous, and are often ultimately fatal."

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Alcohol Effect on Membranes

The parts which first suffer from alcohol are those expansions of the body which the anatomists call the membranes. "The skin is a membranous envelope. Through the whole of the alimentary surface, from the lips downward, and through the bronchial passages to their minutest ramifications, extends the mucous membrane. The lungs, the heart, the liver, the kidneys are folded in delicate membranes, which can be stripped easily from these parts.

If you take a portion of bone, you will find it easy to strip off from it a membranous sheath or covering; if you examine a joint, you will find both the head and the socket lined with membranes. The whole of the intestines are enveloped in a fine membrane called peritoneum .

All the muscles are enveloped in membranes, and the fasciculi, or bundles and fibres of muscles, have their membranous sheathing. The brain and spinal cord are enveloped in three membranes; one nearest to themselves, a pure vascular structure, a network of blood-vessels; another, a thin serous structure; a third, a strong fibrous structure.

The eyeball is a structure of colloidal humors and membranes, and of nothing else. To complete the description, the minute structures of the vital organs are enrolled in membranous matter."

These membranes are the filters of the body. "In their absence there could be no building of structure, no solidification of tissue, nor organic mechanism. Passive themselves, they, nevertheless, separate all structures into their respective positions and adaptations."

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Alchohol Effect On Our Blood

Dr. Richardson, in his lectures on alcohol, given both in England and America, speaking of the action of this substance on the blood after passing from the stomach, says:

"Suppose, then, a certain measure of alcohol be taken into the stomach, it will be absorbed there, but, previous to absorption, it will have to undergo a proper degree of dilution with water, for there is this peculiarity respecting alcohol when it is separated by an animal membrane from a watery fluid like the blood, that it will not pass through the membrane until it has become charged, to a given point of dilution, with water.

It is itself, in fact, so greedy for water, it will pick it up from watery textures, and deprive them of it until, by its saturation, its power of reception is exhausted , after which it will diffuse into the current of circulating fluid."

It is this power of absorbing water from every texture with which alcoholic spirits comes in contact, that creates the burning thirst of those who freely indulge in its use. Its effect, when it reaches the circulation, is thus described by Dr. Richardson:...

"As it passes through the circulation of the lungs it is exposed to the air, and some little of it, raised into vapor by the natural heat, is thrown off in expiration. If the quantity of it be large, this loss may be considerable, and the odor of the spirit may be detected in the expired breath.

If the quantity be small, the loss will be comparatively little, as the spirit will be held in solution by the water in the blood. After it has passed through the lungs, and has been driven by the left heart over the arterial circuit, it passes into what is called the minute circulation, or the structural circulation of the organism. The arteries here extend into very small vessels, which are called arterioles, and from these infinitely small vessels spring the equally minute radicals or roots of the veins, which are ultimately to become the great rivers bearing the blood back to the heart.

In its passage through this minute circulation the alcohol finds its way to every organ. To this brain, to these muscles, to these secreting or excreting organs, nay, even into this bony structure itself, it moves with the blood. In some of these parts which are not excreting, it remains for a time diffused, and in those parts where there is a large percentage of water, it remains longer than in other parts.

From some organs which have an open tube for conveying fluids away, as the liver and kidneys, it is thrown out or eliminated, and in this way a portion of it is ultimately removed from the body. The rest passing round and round with the circulation, is probably decomposed and carried off in new forms of matter.

"When we know the course which the alcohol takes in its passage through the body, from the period of its absorption to that of its elimination, we are the better able to judge what physical changes it induces in the different organs and structures with which it comes in contact. It first reaches the blood; but, as a rule, the quantity of it that enters is insufficient to produce any material effect on that fluid. If, however, the dose taken be poisonous or semi-poisonous, then even the blood, rich as it is in water and it contains seven hundred and ninety parts in a thousand is affected.

The alcohol is diffused through this water, and there it comes in contact with the other constituent parts, with the fibrine, that plastic substance which, when blood is drawn, clots and coagulates, and which is present in the proportion of from two to three parts in a thousand; with the albumen which exists in the proportion of seventy parts; with the salts which yield about ten parts; with the fatty matters; and lastly, with those minute, round bodies which float in myriads in the blood (which were discovered by the Dutch philosopher, Leuwenhock, as one of the first results of microscopical observation, about the middle of the seventeenth century), and which are called the blood globules or corpuscles.

These last-named bodies are, in fact, cells; their discs, when natural, have a smooth outline, they are depressed in the centre, and they are red in color; the color of the blood being derived from them. We have discovered that there exist other corpuscles or cells in the blood in much smaller quantity, which are called white cells, and these different cells float in the blood-stream within the vessels.

The red take the centre of the stream; the white lie externally near the sides of the vessels, moving less quickly. Our business is mainly with the red corpuscles. They perform the most important functions in the economy; they absorb, in great part, the oxygen which we inhale in breathing, and carry it to the extreme tissues of the body; they absorb, in great part, the carbonic acid gas which is produced in the combustion of the body in the extreme tissues, and bring that gas back to the lungs to be exchanged for oxygen there; in short, they are the vital instruments of the circulation.

"With all these parts of the blood, with the water, fibrine, albumen, salts, fatty matter and corpuscles, the alcohol comes in contact when it enters the blood, and, if it be in sufficient quantity, it produces disturbing action. I have watched this disturbance very carefully on the blood corpuscles; for, in some animals we can see these floating along during life, and we can also observe them from men who are under the effects of alcohol, by removing a speck of blood, and examining it with the microscope. The action of the alcohol, when it is observable, is varied.

It may cause the corpuscles to run too closely together, and to adhere in rolls; it may modify their outline, making the clear-defined, smooth, outer edge irregular or crenate, or even starlike; it may change the round corpuscle into the oval form, or, in very extreme cases, it may produce what I may call a truncated form of corpuscles, in which the change is so great that if we did not trace it through all its stages, we should be puzzled to know whether the object looked at were indeed a blood-cell.

All these changes are due to the action of the spirit upon the water contained in the corpuscles; upon the capacity of the spirit to extract water from them. During every stage of modification of corpuscles thus described, their function to absorb and fix gases is impaired, and when the aggregation of the cells, in masses, is great, other difficulties arise, for the cells, united together, pass less easily than they should through the minute vessels of the lungs and of the general circulation, and impede the current, by which local injury is produced.

"A further action upon the blood, instituted by alcohol in excess, is upon the fibrine or the plastic colloidal matter. On this the spirit may act in two different ways, according to the degree in which it affects the water that holds the fibrine in solution. It may fix the water with the fibrine, and thus destroy the power of coagulation; or it may extract the water so determinately as to produce coagulation."

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CombiHair:Things You need To Know

Hair combing is a routine activity of almost all people.Some people keep a particular hair style throughout their life and some especially younger generation adopt new styles according to new trends and fashion.

Hair styles has got close relation with the personality of a person.The hair of an unhygeinic person is usually tangled and dirty because of lack of washing and combing.To have a healthy scalp hair proper nutrition is needed.General health has got direct relation with the quality and quantity of hair.Regular washing,use of hair oil,proper combing ect are also needed to make the hair beautiful.General hints for combing is discussed here.

1) Different varieties of combs are available in the market.The best comb is selected by considering the nature of hair(hard or soft,long or short) ,style and convenience.

2) Combing should be done with utmost care and concentration.Some people especially gents think about some other matters and comb without any care which may be harmful to the hairs.

3) Combing should be gentle .A vigorous combing can increase hairfalling.

4) Do not comb if the hair is wet. First dry it with a towel and then put some oil and gently massage it.Now the combing will be easy and harmless.

5) Should not be combed in the opposite direction of hairs.This can increase hair falling.

6) Vigorous combing in backward direction can produce traction baldness.

7) Frequent combing can damage the scalp and the hair follicles.Those who carry pocket comb use it frequently and make it a habit.Combing two or three times in a day is sufficient.

8) The tooth of the comb should not be sharp and it should not be pressed too tightly on the scalp.

9) Always clean the comb before and after use because hair and dirt deposited in the gap will make combing diffucult and painful.

10) Others comb should not be used.This helps to prevent fungal and bacterial infections.Head lice can also spread from one person to other by sharing the combs.

11) Combing the tangled hair is difficult and painful.Hence use some shampoo for cleaning and after drying put oil and make the hairs free for an easy combing.

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Bad Bread Threatment

Bad breath is a common health problem in the society.Offenssive smell from the mouth may be due to various reasons.The main reason is the presence of anaerobic bacteria in the biofilm formed on the tongue.These bacteria degrades the proteins present in the food resulting in the production of some offenssive gases like hydrogen sulphide,skatol ect.

Bad odor from the mouth in the early morning is seen in almost all individuals.This can be controlled by maintaining oral hygiene.Even after cleaning the mouth some individuals may suffer from bad breath due to some problem in the mouth or in the nearby areas.Some general disease condition can also produce bad breath.Exact cause has to be identified and should be treated accordingly.Some common measures to cure or reduce bad breath are discussed here...

1) Oral hygiene:
Mouth should be kept clean every time to reduce the bacterial action.After food gargling with lukewarm water is very essential.Even after small food articles like snacks,sweets,buscuits cleaning with water is needed.Brushing should be done twice daily.It is said that early morning brushing is for beauty and bed time brushing is for good health.

2) Brushing techniques:
Normal brushing technique should be followed for better result.Many people brush vigorously causing damage to the gums.Brushing after every food and drink can damage the enamel .Bristles of the tooth brush should be smooth but hard enough to remove the food particles from the gaps.The direction of brushing is the most important thing.The upper teeth should be brushed in a downward direction and the lower in upward direction.This is applicable to both inner and outer surfaces.Next comes the crown of the teeth;here brushing is done in anterior and posterior direction keeping the brush in same direction.This applicable to both upper and lower set of teeth.

3) Tongue cleaning:
White or yellowish coating on the tongue can cause bad breath.This is more well marked in the morning and should be removed twice daily with the healp of a tongue cleaner. Tongue cleaner must be used gently without damaging the taste buds on the tongue.

4) Tooth pick:
Tooth pick is a small strip of wood or plastic with a pointed end.This is used to remove food particles lodged between the gaps.Very useful after eating meat and fish.Should be used gently to avoid damage to gums.

5) Gargling:
After every meal gargling with lukewarm water is useful.For better result little common salt is dissolved in the lukewarm water .Different types of mouth wash is available in the market in different trade names.Gargling with mouth wash can also reduce bad breath.

6) Food habits:
Protein containing food articles are known to produce bad breath. Example; meat, milk, fish, egg etc. If these food articles are taken proper cleaning is essential.Some food articles are known to produce particular smell which may be unpleasent for others. Raw onion is the best example.It is said that an apple a day keeps the doctor away and a raw onion a day keep every body away.Small food articles taken in between can also cause bad smell(nuts,fried items etc).Maintaining regularity in food timing is the most important thing.

7) Water intake:
Dryness in the mouth can make a favourable condition for the bacterial activity resulting in bad odor.saliva is needed to keep the mouth moist and to reduce the bacterial proliferation.Production of saliva is closely related with water balance of the body and hence sufficient quantity of water should be taken to maintain the production of saliva.

8) Mouth freshners:
Natural and artificial mouth freshners can reduce the intensity of bad breath to some extent.Spicy articles are commonly used for this purpose.Chewing spices like clove,cumin seed,cardomom,cinnamon,ginger ect are useful. All citrus fruits can reduce bad odor.Mouth freshners and chewing gums are available in the market.these products are also helpful ,but some may cause damage hence should be used with caution.

If the above things doesn't work then what to do? The Alternative can be consider the following:

1) Remove the cause:
Bad breath is common in some general and systemic diseases like diabetes,fevers,gastric disorders,liver diseases and ect.By removing or reducing the primary cause the bad breath will go automatically.

2) Modern medicine:
If bad breath is due to any infection suitable antibiotics,anti fungal or anti viral medicines will help.If it is due to any autoimmune or chronic inflamatory conditions steroids may also be used.Saliva producing tablets can also be used.

3) Dental cleaning:
Dental cleaning done by a dentist can remove the dental plaques and tartar. This can reduce the severity of bad breath.Visit your dentist atleast once in a year.

4) Filling of caries:
Since caries are one of the main cause for bad breath it should be filled by a dentist.Earlier silver amalgam was used ,nowadays it is replaced by synthetic materials.If the pulp cavity is affected by the caries root canal treatment can be done.

5) Tooth extraction:
If caries are deep with destruction of teeth with bad smell extraction is the better choice and a dental implant can be kept in the gap.

6) Tonsillectomy:
Patients with recurrent tonsillitis can have bad breath due to offenssive discharges and release of pasty materials from the crypts of tonsils.Such patients get great relief after tonsillectomy(removal of tonsils).

7) Psychological counselling:
Those who suffer from bad breath may be very much depressed and they be away from the public .This isolation hampers their daytoday activities.Such people should understand the fact that all humanbeings are having bad breath, but with slight differences in intensities.Mostly all people control it by taking personal care.Every human body has got it's own smell,that may or may not be tolerable for others.They should be adviced to do all hygienic meashures to reduce the intensity of smell.Improving the quality of life by all possible means can also help.Moral support from friends and family members are needed for such people.

Some individuals visit the doctor for bad breath without any real problem.It is included under somatisation disorder.They usually complain about pain, breathlessness,abdominal discomfort,bad smell ect.proper diagnosis is needed to rule out any real causes.These patients should be managed with a psychological approach.

8) Homoeopathy:
In Homoeopathy medicines are selected on the basis of physical ,mental,emotional,and social aspects of the diseased person.Considering the whole aspects a constitutional homoeopathic medicine is selected and given in suitable potency and dose.By this all health related problems including bad breath will be solved.On the basis of coating on the tongue,type of smell,cause for bad breath,and other associated complaints a medicine can be given to get relief from bad breath.In the homoeopathic medical repertory by Dr Robin Murphy there are 140 homoeopathic drugs mentioned for bad breath.On the basis of signs and symptoms of the individual a suitable medicine is given.Commonly used drugs are arnica, antim crud, pulsatilla, sulphur, psorinum, nux vomica, ars alb, merc sol, kreosot, hekla lava, silicea, asafoitida, graphites, kali bich, acid nitric etc.

Homoeopathic mother tinctures like cinnamon Q,kreosot Q,zingiber Q,rhus glabra Q,menthol Q and ect can be used for gargling after diluting in water.


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BAD BREATH

Bad breath is a common health problem which greately affects the daytoday activities of somany people. The offenssive odor from the mouth is unpleasent to those who come in close contact with bad breathers.

The problem will be doubled by psychological trauma leading to depression. The sufferers from this problem wil be isolated from the society. This can even lead to marital disharmony.

Literally speaking all humanbeings are badbreathres. Oral cavity contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrifies them. This process results in the formation of offenssive gases like hydrogen sulphide,methyl mescaptan,cadaverin,skatol,putrescine ect causing bad odor.

If oral hygiene is not maintained properly all will suffer from bad breath. Most of us control this by regular brushing,tongue cleaning and gargling. Even after maintining cleanliness in the mouth some individuals suffer from offenssive smell due to various causes which has to be diagnosed and treated properly.

Some common causes of bad breath:

1) Poor oral hygiene:
If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offenssive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken inbetween meals can also produce bad breath because of improper cleaning.

Badbreath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva has got some antibacterial properties which help to keep the mouth clean. Saliva conains oxygen molecules which is needed to make oral cavity aerobic. So the reduction in it's quantity during sleep makes a favourable condition for anaerobic bacteria.

2) Food habits:
The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favours bad breath. Meat,fish,milk products, eggs,cakes,nuts,pear and ect can cause bad breath. Some food articles can produce particular type of smell which may be unpleasent. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away,a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food. Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.

3) Biofilm:
There is formation of a thin sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteriae are seen .The thick coating on the tongue is always associated with badbreath. Even a thin biofilm can make anaerobic condition favourable for bacterial proliferation.

4) Dental caries:
This is a destructive process causing decalcification with distruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli . Food particles are deposited inside these cavities and are putrified by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrified completely. Caries are common in schoolgoing children and in those who donot maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.

5) Gingivitis:
Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling,pain and discharge. If the condition become worse the infection spread towards peridontal area leading to continuous discharge called pyorrhoea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis.All these conditions can produce offenssive smell.

6) Gum retraction:
When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps between the teeth and gum. This will provide shelter for the food debris and bacteria causing bad breath.

8) Ulcerative lesions& coatings:
Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria,viruses,food allergies or due to autoimmune disorders. Apthous ulcer is the commonest amoung ulcerative lesions. Others are herpes,fungal infections,vincents angina,infectious mononucleosis,scarlet fever,diphtheria,drug reactions and ect. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating(candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth & tongue. It is considered as a precancerous condition. Offenssive breath is associated with these conditions.

9) Diseases of the salivary glands:
Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavourable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity. Some times the salivary duct is obstructed by stones or tumors.Cancer of the salivary gland is associated with offenssive odor. In suppurative parotitis purulant dischrge in to the mouth causes bad breath.

10) Tonsillitis:
Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques & tonsillar fluid:
If bad breath persists even after maintaining proper oral hygeine there is possibility of this condition. Serous fluid secreated from the folds of tonsil is very offenssive. Some patients complain that they hawk some cheesy materials from the throat;which are very offenssive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteriae. In such conditions tonsillectomy gives noticiable relief from bad breath.

12) Pharyngitis& pharyngial abscess:
Pharynx is a fibromuscular tube which forms the upper part of the digestive & respiratory tract. Inflmmation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offenssive discharge of pus in to the throat.

13) Dentures:
Denture users may complain about bad smell due to lodgement of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:
Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasent for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhoea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these causes offenssive smell.

15) Smoking:
Smokers always have bad smell. It can also produce lesions in the mouth & lungs causing bad breath.Smoking increases carbon dioxide in the oral cavity & reduces oxygen level,causing a favourable condition for bacteria. Smoking reduses appetite & thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose & ear:
Bad breath is occasionally seen in sinusitis(infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the eustachian tube(passage from middle ear to the throat)can also cause offenssive odor. Chronic rhinitis(infection of mucus membrane of nose) and forign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:
Mostly all diabetic patients suffer from bad breath. Coated tongue,ulcers &coatings in the mouth ,increased sugar level in tissues ect are responsible for bad breath.Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:
Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis , AIDS ect produce bad smell.

19) Fasting & dehydration:
Dry mouth favours bacterial activity. So any condition which produce dryness in the mouth makes the breath offenssive. Eventhough the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:
Bedridden patients suffer from offenssive breath due to thick coating on the tongue. water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favours anaerobic bacteria to become active.

21) Diseases of stomach & esophagus:
Eructation of gas and food produce unpleasent smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis,gastric ulcer and cancer of stomach.

22) Intestinal diseases:
Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative collitis..Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis ect

23) Diseases of lungs:
Lung diseases like pneumonia, lung abscess,chronic bronchitis,bronchiectasis,tuberculosis, lung cancer ect can produce bad odor during expiration.

24) Liver disorders:
Liver diseases like hepatitis, cirrhosis,can cause bad breath.Gall bladder diseases with vomiting also causes unpleasent odor.

25) Psychiatric patients:
Bad breath is common in psychotic patients due to poor hygiene,irregular food habits,less water intake and ect.

26) Somatisation disorder:
This is a psychiatric disorder charecterised by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain,nausea difficult respiration, bad smell ect. This condition is diagnosed after detailed examination of the patient with all investigations.Since this is a psychiatric disorder it has to be managed with a psychological approach.

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Back Pain: What Cause It

Low back pain is a usual symptom amoung the modern civilised people.It affects mainly the middle aged and young adults of both sexes.People who work on the chair with out exercise and those who carry heavy loads regularly are prone to get this complaint.

We can hardly find a person who has not suffered from back pain atleast once in life.The causes of low backpain ranges from simple reasons like muscular strain to cancer of spine and hence backache should not be ignored.The pain is felt in lumbar and sacral region and may radiate to nearby sites.

The following are some causes for backache:
1 Backache due to diseases in the back injuries :

1) Compression fracture of the vertebral column.
2) Rupture of intervertebral discs.
3) Injuries to ligaments and muscles of back.
4) Lumbosacral strain.
5) Intervertebral joint injuries.
6) Fracture of processes of vertebra.

b) Functional backache due to imbalance:-

1) During pregnancy.
2) Pot belly.
3) Diseases of the hip joint.
4) Curvature in the spine due to congenital defect.
5) Short leg in one side.

c) Backache due to inflammatory conditions:-

1) Infection of the bone due to bacteria.
2) Tuberculosis of the spine.
3) Arthritis.
4) Brucellosis.
5) Lumbago or fibrositis.
6) Inflamation of the muscles.
7) Anchylosing spondylitis.

d) Backache due to degenerative diseases in the back.

1) Osteoarthritis.
2) Osteoporosis in old people.
3) Degenaration of the intervertebral disc.

e) Tumour in the spine:--

1) Primory tumour of the bones in the spine.
2) Metastatic tumours from other sites like prostate,lungs,kidneys,intestine ect.

2. Backache due to gynaecological problems:
a) After childbirth.
b) After gynaecological operations.
c) Prolapse of the uterus.
d) Pelvic inflammatory diseases.
e) Cancerous lesions of the pelvic organs.
f) Endometriosis.

3. Backache due to problems in other parts of the body.
a) Renal stones.
b) Ureteric stone.
c) Cancer of prostate.
d) Pancreatitis.
e) Biliary stones.
f) Peptic ulcer.
g) Inflammations of pelvic organs.
h) Occlusion of aorta and illiac arteries.

Investigation of a case of backache
1) Complete blood count.
2) Routine urine examination.
3) Ultrasonography of the abdomen and pelvis.
4) X-ray of the lumbar and sacral region.
5) MRI of the spine.
6) CT scan of abdomen and pelvic region.
7) Examination of rectum,prostate,genito urinary organs.

Treatment of back ache
1) Removing the cause for backache.
2) Symptomatic treatement.
3) Back exercises.
4) Traction.
5) Yoga.
6) Surgery.
7) Homoeopathy.

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Alcohol and Body Fit

If alcohol does not contain tissue-building material, nor give heat to the body, it cannot possibly add to its strength. "Every kind of power an animal can generate," says Dr. G. Budd, F.R.S., "the mechanical power of the muscles, the chemical (or digestive) power of the stomach, the intellectual power of the brain accumulates through the nutrition of the organ on which it depends.

Dr. F.R. Lees, of Edinburgh, after discussing the question, and educing evidence, remarks: "From the very nature of things, it will now be seen how impossible it is that alcohol can be strengthening food of either kind. Since it cannot become a part of the body, it cannot consequently contribute to its cohesive, organic strength, or fixed power; and, since it comes out of the body just as it went in, it cannot, by its decomposition, generate heat force."

Sir Benjamin Brodie says: "Stimulants do not create nervous power; they merely enable you, as it were, to use up that which is left, and then they leave you more in need of rest than before."



Baron Liebig, so far back as 1843, in his "Animal Chemistry," pointed out the fallacy of alcohol generating power. He says: "The circulation will appear accelerated at the expense of the force available for voluntary motion, but without the production of a greater amount of mechanical force.

In his later "Letters," he again says: "Wine is quite superfluous to man, it is constantly followed by the expenditure of power" whereas, the real function of food is to give power. He adds: "These drinks promote the change of matter in the body, and are, consequently, attended by an inward loss of power, which ceases to be productive, because it is not employed in overcoming outward difficulties i.e., in working." In other words, this great chemist asserts that alcohol abstracts the power of the system from doing useful work in the field or workshop, in order to cleanse the house from the defilement of alcohol itself.

The late Dr. W. Brinton, Physician to St. Thomas', in his great work on Dietetics, says: "Careful observation leaves little doubt that a moderate dose of beer or wine would, in most cases, at once diminish the maximum weight which a healthy person could lift. Mental acuteness, accuracy of perception and delicacy of the senses are all so far opposed by alcohol, as that the maximum efforts of each are incompatible with the ingestion of any moderate quantity of fermented liquid. A single glass will often suffice to take the edge off both mind and body, and to reduce their capacity to something below their perfection of work."
Dr. F.R. Lees, F.S.A., writing on the subject of alcohol as a food, makes the following quotation from an essay on "Stimulating Drinks," published by Dr. H.R. Madden, as long ago as 1847: "Alcohol is not the natural stimulus to any of our organs, and hence, functions performed in consequence of its application, tend to debilitate the organ acted upon.

Alcohol is incapable of being assimilated or converted into any organic proximate principle, and hence, cannot be considered nutritious.

The strength experienced after the use of alcohol is not new strength added to the system, but is manifested by calling into exercise the nervous energy pre-existing.

The ultimate exhausting effects of alcohol, owing to its stimulant properties, produce an unnatural susceptibility to morbid action in all the organs, and this, with the plethora superinduced, becomes a fertile source of disease.

A person who habitually exerts himself to such an extent as to require the daily use of stimulants to ward off exhaustion, may be compared to a machine working under high pressure. He will become much more obnoxious to the causes of disease, and will certainly break down sooner than he would have done under more favorable circumstances.

The more frequently alcohol is had recourse to for the purpose of overcoming feelings of debility, the more it will be required, and by constant repetition a period is at length reached when it cannot be foregone, unless reaction is simultaneously brought about by a temporary total change of the habits of life.

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Alchohol And Production of heat

The first usual test for a force-producing food," says Dr. Hunt, "and that to which other foods of that class respond, is the production of heat in the combination of oxygen therewith.

This heat means vital force, and is, in no small degree, a measure of the comparative value of the so-called respiratory foods. If we examine the fats, the starches and the sugars, we can trace and estimate the processes by which they evolve heat and are changed into vital force, and can weigh the capacities of different foods.

We find that the consumption of carbon by union with oxygen is the law, that heat is the product, and that the legitimate result is force, while the result of the union of the hydrogen of the foods with oxygen is water. If alcohol comes at all under this class of foods, we rightly expect to find some of the evidences which attach to the hydrocarbons."

What, then, is the result of experiments in this direction? They have been conducted through long periods and with the greatest care, by men of the highest attainments in chemistry and physiology, and the result is given in these few words, by Dr. H.R. Wood, Jr., in his Materia Medica. "No one has been able to detect in the blood any of the ordinary results of its oxidation." That is, no one has been able to find that alcohol has undergone combustion, like fat, or starch, or sugar, and so given heat to the body.

Reduction of temperature
instead of increasing it; and it has even been used in fevers as an anti-pyretic. So uniform has been the testimony of physicians in Europe and America as to the cooling effects of alcohol, that Dr. Wood says, in his Materia Medica, "that it does not seem worth while to occupy space with a discussion of the subject." Liebermeister, one of the most learned contributors to Zeimssen's Cyclopaedia of the Practice of Medicine, 1875, says: "I long since convinced myself, by direct experiments, that alcohol, even in comparatively large doses, does not elevate the temperature of the body in either well or sick people." So well had this become known to Arctic voyagers, that, even before physiologists had demonstrated the fact that alcohol reduced, instead of increasing, the temperature of the body, they had learned that spirits lessened their power to withstand extreme cold. "In the Northern regions," says Edward Smith, "it was proved that the entire exclusion of spirits was necessary, in order to retain heat under these unfavorable conditions."



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alchohol: Is There Benefit of it

As Dr. Henry Monroe says, "every kind of substance employed by man as food consists of sugar, starch, oil and glutinous matter mingled together in various proportions. These are designed for the support of the animal frame. The glutinous principles of food fibrine, albumen and casein are employed to build up the structure while the oil, starch and sugar are chiefly used to generate heat in the body".

Now it is clear that if alcohol is a food, it will be found to contain one or more of these substances. There must be in it either the nitrogenous elements found chiefly in meats, eggs, milk, vegetables and seeds, out of which animal tissue is built and waste repaired or the carbonaceous elements found in fat, starch and sugar, in the consumption of which heat and force are evolved.

"The distinctness of these groups of foods," says Dr. Hunt, "and their relations to the tissue-producing and heat-evolving capacities of man, are so definite and so confirmed by experiments on animals and by manifold tests of scientific, physiological and clinical experience, that no attempt to discard the classification has prevailed.

To draw so straight a line of demarcation as to limit the one entirely to tissue or cell production and the other to heat and force production through ordinary combustion and to deny any power of interchangeability under special demands or amid defective supply of one variety is, indeed, untenable. This does not in the least invalidate the fact that we are able to use these as ascertained landmarks".

How these substances when taken into the body, are assimilated and how they generate force, are well known to the chemist and physiologist, who is able, in the light of well-ascertained laws, to determine whether alcohol does or does not possess a food value.

For years, the ablest men in the medical profession have given this subject the most careful study, and have subjected alcohol to every known test and experiment, and the result is that it has been, by common consent, excluded from the class of tissue-building foods.

"We have never," says Dr. Hunt, "seen but a single suggestion that it could so act, and this a promiscuous guess. One writer (Hammond) thinks it possible that it may 'somehow' enter into combination with the products of decay in tissues, and 'under certain circumstances might yield their nitrogen to the construction of new tissues.' No parallel in organic chemistry, nor any evidence in animal chemistry, can be found to surround this guess with the areola of a possible hypothesis".

Dr. Richardson says: "Alcohol contains no nitrogen; it has none of the qualities of structure-building foods; it is incapable of being transformed into any of them; it is, therefore, not a food in any sense of its being a constructive agent in building up the body." Dr. W.B. Carpenter says: "Alcohol cannot supply anything which is essential to the true nutrition of the tissues." Dr. Liebig says: "Beer, wine, spirits, etc., furnish no element capable of entering into the composition of the blood, muscular fibre, or any part which is the seat of the principle of life." Dr. Hammond, in his Tribune Lectures, in which he advocates the use of alcohol in certain cases, says: "It is not demonstrable that alcohol undergoes conversion into tissue." Cameron, in his Manuel of Hygiene, says: "There is nothing in alcohol with which any part of the body can be nourished." Dr. E. Smith, F.R.S., says: "Alcohol is not a true food. It interferes with alimentation." Dr. T.K. Chambers says: "It is clear that we must cease to regard alcohol, as in any sense, a food".

"Not detecting in this substance," says Dr. Hunt, "any tissue-making ingredients, nor in its breaking up any combinations, such as we are able to trace in the cell foods, nor any evidence either in the experience of physiologists or the trials of alimentarians, it is not wonderful that in it we should find neither the expectancy nor the realization of constructive power."

Not finding in alcohol anything out of which the body can be built up or its waste supplied, it is next to be examined as to its heat-producing quality.

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Alchohol and Internal Organ

The organic deteriorations caused by the continued use of alcohol are often of a fatal character. The organ which most frequently undergoes structural changes from alcohol, is the liver. Normally, the liver has the capacity to hold active substances in its cellular parts.

In instances of poisoning by various poisonous compounds, we analyse liver as if it were the central depot of the foreign matter. It is practically the same in respect to alcohol. The liver of an alcoholic is never free from the influence of alcohol and it is too often saturated with it.

The minute membranous or capsular structure of the liver gets affected, preventing proper dialysis and free secretion. The liver becomes large due to the dilatation of its vessels, the surcharge of fluid matter and the thickening of tissue.

This follows contraction of membrane and shrinking of the whole organ in its cellular parts. Then the lower parts of the alcoholic becomes dropsical owing to the obstruction offered to the returning blood by the veins. The structure of the liver may be charged with fatty cells and undergo what is technically designated 'fatty liver'.

Consumption of alcohol greatly affects the heart. The quality of the membraneous structures which cover and line the heart changes and are thickened, become cartilaginous or calcareous.

Then the valves lose their suppleness and what is termed valvular disorder becomes permanent. The structure of the the coats of the great blood-vessel leading from the heart share in the same changes of structure so that the vessel loses its elasticity and its power to feed the heart by the recoil from its distention, after the heart, by its stroke, has filled it with blood.

Again, the muscular structure of the heart fails owing to degenerative changes in its tissue. The elements of the muscular fibre are replaced by fatty cells or, if not so replaced, are themselves transferred into a modified muscular texture in which the power of contraction is greatly reduced.

Those who suffer from these organic deteriorations of the central and governing organ of the circulation of the blood learn the fact so insidiously, it hardly breaks upon them until the mischief is far advanced.

They are conscious of a central failure of power from slight causes such as overexertion, trouble, broken rest or too long abstinence from food. They feel what they call a 'sinking' but they know that wine or some other stimulant will at once relieve the sensation.

Thus they seek to relieve it until at last they discover that the remedy fails. The jaded, overworked, faithful heart will bear no more. it has run its course and the governor of the blood-streams broken. The current either overflows into the tissues gradually damming up the courses or under some slight shock or excess of motion ceases wholly at the centre.

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