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Ailmemts & Remedies

Hemolytic Uremic Syndrome (HUS)

Alternative names:  Haemolytic-uraemic syndrome, HUS

Definition:
Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys‘ filtering system. Red blood cells contain hemoglobin—an iron-rich protein that gives blood its red color and carries oxygen from the lungs to all parts of the body.

CLICK & SEE THE PICTURES

When the kidneys and glomeruli—the tiny units within the kidneys where blood is filtered—become clogged with the damaged red blood cells, they are unable to do their jobs. If the kidneys stop functioning, a child can develop acute kidney injury—the sudden and temporary loss of kidney function. Hemolytic uremic syndrome is the most common cause of acute kidney injury in children.

It is a disease characterized by hemolytic anemia (anemia caused by destruction of red blood cells), acute kidney failure (uremia), and a low platelet count (thrombocytopenia). It predominantly, but not exclusively, affects children. Most cases are preceded by an episode of infectious, sometimes bloody, diarrhea acquired as a foodborne illness or from a contaminated water supply and caused by E. coli O157:H7, although Shigella, Campylobacter and a variety of viruses have also been implicated. It is now the most common cause of acquired acute renal failure in childhood. It is a medical emergency and carries a 5–10% mortality; of the remainder, the majority recover without major consequences but a small proportion develop chronic kidney disease and become reliant on renal replacement therapy.

The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder.

Symptoms:
STEC-HUS occurs after ingestion of a strain of bacteria, usually types of E. coli, that expresses verotoxin (also called Shiga-like toxin). Bloody diarrhea typically follows. HUS develops about 5–10 days after onset of diarrhea, with decreased urine output (oliguria), blood in the urine (hematuria), kidney failure, thrombocytopenia (low levels of platelets) and destruction of red blood cells (microangiopathic hemolytic anemia). Hypertension is common. In some cases, there are prominent neurologic changes.

A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritis—an inflammation of the lining of the stomach, small intestine, and large intestine—such as

*vomiting
*bloody diarrhea
*abdominal pain
*fever and chills
*headache

As the infection progresses, the toxins released in the intestine begin to destroy red blood cells. When the red blood cells are destroyed, the child may experience the signs and symptoms of anemia—a condition in which red blood cells are fewer or smaller than normal, which prevents the body’s cells from getting enough oxygen.

Signs and symptoms of anemia may include:-

*fatigue, or feeling tired
*weakness
*fainting
*paleness

As the damaged red blood cells clog the glomeruli, the kidneys may become damaged and make less urine. When damaged, the kidneys work harder to remove wastes and extra fluid from the blood, sometimes leading to acute kidney injury.

Other signs and symptoms of hemolytic uremic syndrome may include bruising and seizures.

When hemolytic uremic syndrome causes acute kidney injury, a child may have the following signs and symptoms:

*edema—swelling, most often in the legs, feet, or ankles and less often in the hands or face
*albuminuria—when a child’s urine has high levels of albumin, the main protein in the blood
*decreased urine output
*hypoalbuminemia—when a child’s blood has low levels of albumin
*blood in the urine

Causes:
A number of things can cause hemolytic uremic syndrome, but the most common cause — particularly in children — is an infection with a specific strain of E. coli, usually the strain known as O157:H7. However, other strains of E. coli have been linked to hemolytic uremic syndrome, too.

Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream. The toxins travel through the bloodstream and can destroy the red blood cells. E. coli O157:H7 can be found in:

*Contaminated meat or produce
*Swimming pools or lakes contaminated with feces
*undercooked meat, most often ground beef
*unpasteurized, or raw, milk
*unwashed, contaminated raw fruits and vegetables
*contaminated juice

Less common causes, sometimes called atypical hemolytic uremic syndrome, can include:-

*taking certain medications, such as chemotherapy
*having other viral or bacterial infections
*inheriting a certain type of hemolytic uremicsyndrome that runs in families

Children who are more likely to develop hemolytic uremic syndrome include those who
are younger than age 5 and have been diagnosedwith an E. coli O157:H7 infection

*have a weakened immune system
*have a family history of inherited hemolyticuremic syndrome
*Hemolytic uremic syndrome occurs in about two out of every 100,000 children.

Most people who are infected with E. coli, even the more dangerous strains, won’t develop hemolytic uremic syndrome. It’s also possible for hemolytic uremic syndrome to follow infection with other types of bacteria.

In adults, hemolytic uremic syndrome is more commonly caused by other factors, including:

*The use of certain medications, such as quinine (an over-the-counter muscle cramp remedy), some chemotherapy drugs, the immunosuppressant medication cyclosporine (Neoral, Sandimmune) and anti-platelet medications

*Pregnancy

*Certain infections, such as HIV/AIDS or an infection with the pneumococcal bacteria

*Genes, which can be a factor because a certain type of HUS — atypical hemolytic uremic syndrome — may be passed down from your parents

The cause of hemolytic uremic syndrome in adults is often unknown

Diagnosis:
The Doctor diagnoses hemolytic uremic syndrome with

*a medical and family history
*a physical exam
*urine tests
*a blood test
*a stool test
*kidney biopsy

The similarities between HUS, aHUS, and TTP make differential diagnosis essential. All three of these systemic TMA-causing diseases are characterized by thrombocytopenia and microangiopathic hemolysis, plus one or more of the following: neurological symptoms (e.g., confusion, cerebral convulsions, seizures); renal impairment (e.g., elevated creatinine, decreased estimated glomerular filtration rate [eGFR], abnormal urinalysis ); and gastrointestinal (GI) symptoms (e.g., diarrhea, nausea/vomiting, abdominal pain, gastroenteritis).The presence of diarrhea does not exclude aHUS as the etiology of TMA, as 28% of patients with aHUS present with diarrhea and/or gastroenteritis. First diagnosis of aHUS is often made in the context of an initial, complement-triggering infection, and Shiga-toxin has also been implicated as a trigger that identifies patients with aHUS. Additionally, in one study, mutations of genes encoding several complement regulatory proteins were detected in 8 of 36 (22%) patients diagnosed with STEC-HUS. However, the absence of an identified complement regulatory gene mutation does not preclude aHUS as the etiology of the TMA, as approximately 50% of patients with aHUS lack an identifiable mutation in complement regulatory genes.

Diagnostic work-up supports the differential diagnosis of TMA-causing diseases. A positive Shiga-toxin/EHEC test confirms an etiological cause for STEC-HUS, and severe ADAMTS13 deficiency (i.e., ?5% of normal ADAMTS13 levels) confirms a diagnosis of TTP

Complications:
Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.1
However, children with hemolytic uremic syndrome may have serious and sometimes life-threatening complications, including

*acute kidney injury
*high blood pressure
*blood-clotting problems that can lead to bleeding
*seizures
*heart problems
*chronic, or long lasting, kidney disease
*stroke
*coma

Treatment:
The Doctor will treat a child’s urgent symptoms and try to prevent complications by

*observing the child closely in the hospital
*replacing minerals, such as potassium and salt, and fluids through an intravenous (IV) tube
*giving the child red blood cells and platelets—cells in the blood that help with clotting—through an IV
*giving the child IV nutrition
*treating high blood pressure with medications

Treating Acute Kidney Injury:
If necessary,the Doctor will treat acute kidney injury with dialysis—the process of filtering wastes and extra fluid from the body with an artificial kidney. The two forms of dialysis are hemodialysis and peritoneal dialysis. Most children with acute kidney injury need dialysis for a short time only.

Treating Chronic Kidney Disease:
Some children may sustain significant kidney damage that slowly develops into CKD. Children who develop CKD must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation.

In most cases, The Doctor treat CKD with a kidney transplant. A kidney transplant is surgery to place a healthy kidney from someone who has just died or a living donor, most often a family member, into a person’s body to take over the job of the failing kidney. Though some children receive a kidney transplant before their kidneys fail completely, many children begin with dialysis to stay healthy until they can have a transplant. click to know more

Prevention:

Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys’ filtering system.
The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system.
Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream.
A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritis, an inflammation of the lining of the stomach, small intestine, and large intestine.

Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.
Some children may sustain significant kidney damage that slowly develops into chronic kidney disease (CKD).

Parents and caregivers can help prevent childhood hemolytic uremic syndrome due to E. coli O157:H7 by

*avoiding unclean swimming areas
*avoiding unpasteurized milk, juice, and cider
*cleaning utensils and food surfaces often
*cooking meat to an internal temperature of at least 160° F
*defrosting meat in the microwave or refrigerator
*keeping children out of pools if they have had diarrhea
*keeping raw foods separate
*washing hands before eating
*washing hands well after using the restroom and after changing diapers

When a child is taking medications that may cause hemolytic uremic syndrome, it is important that the parent or caretaker watch for symptoms and report any changes in the child’s condition to the Doctor as soon as possible.

Prognosis:
Acute renal failure occurs in 55-70% of patients with STEC-HUS, although up to 70-85% recover renal function. Patients with aHUS generally have poor outcomes, with up to 50% progressing to ESRD or irreversible brain damage; as many as 25% die during the acute phase. However, with aggressive treatment, more than 90% of patients survive the acute phase of HUS, and only about 9% may develop ESRD. Roughly one-third of persons with HUS have abnormal kidney function many years later, and a few require long-term dialysis. Another 8% of persons with HUS have other lifelong complications, such as high blood pressure, seizures, blindness, paralysis, and the effects of having part of their colon removed. The overall mortality rate from HUS is 5-15%. Children and the elderly have a worse prognosis.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://kidney.niddk.nih.gov/KUDiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/
http://en.wikipedia.org/wiki/Hemolytic-uremic_syndrome
http://www.mayoclinic.org/diseases-conditions/hemolytic-uremic-syndrome/basics/causes/con-20029487

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Herbs & Plants

Sophora Flavescens

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Botanical Name : Sophora Flavescens
Family: Fabaceae
Subfamily:Faboideae
Tribe: Sophoreae
Genus: Sophora
Species:S. flavescens
Kingdom:Plantae
Order: Fabales

Common Names:Ku Shen, Shrubby sophora

Habitat:Sophora Flavescens is native to Eastern Asia -(From Russia to China.) It grows on Scrub on mountain slopes, river valleys, especially on sandy soils. Grassy places in lowland and waste ground, Central and South Japan

Description:
An evergreen Shrub growing to 1.5m by 1m at a slow rate. It is hardy to zone 6. It is in leaf all year, in flower from July to August, and the seeds ripen in September. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Insects. It can fix Nitrogen. The plant prefers light (sandy), medium (loamy) and heavy (clay) soils and requires well-drained soil. The plant prefers acid, neutral and basic (alkaline) soils. It cannot grow in the shade. It requires moist soil….CLICK & SEE THE PICTURES

Sophora flavescens is a species of plant in the genus Sophora a genus of the Fabaceae family, that contains about 52 species, nineteen varieties, and seven forms that are widely distributed in Asia, Oceanica, and the Pacific islands.About fifteen species in this genus have a long history of use in traditional Chinese medicines. The root is known as Ku shen. is a typical traditional Chinese medicine
Cultivation:
Succeeds in a well-drained moderately fertile soil in full sun. Requires the protection of a sunny wall if it is to flower, and succeeds only in the mildest areas of the country. It grows best in the warmer areas of the country where the wood will be more readily ripened and better able to withstand winter cold. Although hardy to at least -15°c, this species does not do very well in the relatively cool summers of Britain, the plant gradually weakens and eventually succumbs. It can be grown in the milder areas of the country and be treated like a herbaceous perennial, growing afresh from the base each spring. An important medicinal herb in China. Plants should be container-grown and planted out whilst young, older plants do not transplant well. A polymorphic species. The flowers are produced on the current years growth. Plants in this genus are notably resistant to honey fungus. This species has a symbiotic relationship with certain soil bacteria, these bacteria form nodules on the roots and fix atmospheric nitrogen. Some of this nitrogen is utilized by the growing plant but some can also be used by other plants growing nearby.

Propagation:
Seed – best sown as soon as it is ripe in a greenhouse. Pre-soak stored seed for 12 hours in hot (not boiling) water and sow in late winter in a greenhouse. Prick out the seedlings as soon as they are large enough to handle into individual pots in the greenhouse, and grow them on for 2 years under protected conditions. Plant them out into their permanent positions in early summer of their third year. Cuttings of young shoots with a heel, July/August in a frame. Air-layering
Medicinal Uses:
The Sophora Flavescen’s   root (click & see) is anthelmintic, antibacterial, antifungal, antipruritic, astringent, bitter, carminative, diuretic, febrifuge, parasiticide, pectoral, stomachic and tonic. It is used internally in the treatment of jaundice, dysentery, diarrhea and urinary infections. Sophora root is used both internally and externally in the treatment of vaginitis, eczema, pruritis, ringworm, leprosy, syphilis, scabies and itching allergic reactions. The root is harvested in the autumn and dried for later use. The plant is anthelmintic and diuretic. It also has antibacterial activity, inhibiting the growth of Mycobacterium tuberculosis and Trichomonas vaginitis.
Known Hazards: The plant contains cytosine, which resembles nicotine and is similarly toxic. The plant is poisonous when used in quantity[

Resources:
http://en.wikipedia.org/wiki/Sophora_flavescens
http://www.getwellnatural.com/sophora-flavescens.aspx
http://www.pfaf.org/user/Plant.aspx?LatinName=Sophora+flavescens

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Herbs & Plants

Glycyrrhiza Uralensis

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Botanical Name : Glycyrrhiza Uralensis
Family:    Fabaceae
Genus:    Glycyrrhiza
Species:G. uralensis
Kingdom:Plantae
Order:    Fabales

Common Name: Licorice, Gan Cao, Iriqsus, Kan T’Sao, Kan Ts’Ao, Liquirita, Madhuka, Meyankoku, Mi Ts’Ao, Regaliz, Sus Maikik,Chinese liquorice.

Common Names in Azerbaijani:Ural biyan
Common Names in Chinese:Gan Zao
Common Names in English:Chinese Licorice, Gan-Cao, Russian Licorice
Common Names in French:Réglisse De L´oural, Réglisse De Sibérie
Common Names in German:Chinesische Lakritze, Chinesisches Sübholz
Common Names in Hinese:Gan Cao
Common Names in Japanese:Gurukiruriza Urarenshisu, Uraru Kanzou,
Common Names in Kazakh:Miya-Tamr
Common Names in Russian:Solodka Ural´skaja, Solodka Uralskaya
Common Names in Thai:Cha Em Kha Kai (Central Thailand)
Common Names in Tibetan:Shing-Mngar
Common Names in Vietnamese:Cam thao

Habitat : Native to Central Asia. Licorice grows in sandy soil usually near a stream for ample water. Glycyrrhiza glabra, which is very similar medicinally, comes from the Mediterranea region.

Description:
Glycyrrhiza uralensis is a perennial  herb  growing to 0.6 m (2ft) by 0.4 m (1ft 4in).
It is hardy to zone (UK) 6. It is in flower from Jun to August, and the seeds ripen from Jul to October. The flowers are hermaphrodite (have both male and female organs)It can fix Nitrogen.....CLICK & SEE THE PICTURES

Species:
Glycyrrhiza has several Species and that include:

Glycyrrhiza acanthocarpa
Glycyrrhiza aspera
Glycyrrhiza astragalina
Glycyrrhiza bucharica
Glycyrrhiza echinata – Russian liquorice
Glycyrrhiza eglandulosa
Glycyrrhiza foetida
Glycyrrhiza foetidissima
Glycyrrhiza glabra – liquorice, licorice
Glycyrrhiza gontscharovii
Glycyrrhiza iconica
Glycyrrhiza inflata
Glycyrrhiza korshinskyi
Glycyrrhiza lepidota – American licorice
Glycyrrhiza pallidiflora
Glycyrrhiza squamulosa
Glycyrrhiza triphylla
Glycyrrhiza uralensis – Chinese liquorice
Glycyrrhiza yunnanensis

Cultivation:  
Requires a deep well cultivated fertile moisture-retentive soil for good root production. Prefers a sandy soil with abundant moisture. Slightly alkaline conditions produce the best plants. Plants are hardy to at least -15°c. This species is widely cultivated in China as a medicinal plant. Unless seed is required, the plant is usually prevented from flowering so that it puts more energy into producing good quality roots. A very deep-rooted plant, it can be difficult to eradicate once it is established. This species has a symbiotic relationship with certain soil bacteria, these bacteria form nodules on the roots and fix atmospheric nitrogen. Some of this nitrogen is utilized by the growing plant but some can also be used by other plants growing nearby.

Propagation:    
Pre-soak the seed for 24 hours in warm water and then sow spring or autumn in a greenhouse. Prick out the seedlings into individual pots when they are large enough to handle, and grow them on for their first winter in a greenhouse. Plant out in late spring or early summer when in active growth. Plants are rather slow to grow from seed. Division of the root in spring or autumn. Each division must have at least one growth bud. Autumn divisions can either be replanted immediately or stored in clamps until the spring and then be planted out. It is best to pt up the smaller divisions and grow them on in a cold frame until they are established before planting them out in the spring or summer.

Edible Uses:    
Edible Parts: Root.
The fibrous root is used as a sweetener for foods. It is boiled in water to extract the sugars etc and used as a liquorice substitute in sweets, medicines, drinks etc. The root contains glycyrrhizin, which is 50 times sweeter than sugar.

Parts Uses: Root & the whole herb

Medicinal Uses:
Anodyne, Antioxidant, Antispasmodic, Anti-inflammatory, Demulcent, Depurative, Diuretic, Emollient, Estrogenic, Expectorant, Pectoral

Glycyrrhiza Uralensis is commonly used in Chinese herbalism, where it is considered to be one of the 50 fundamental herbs. It is considered to be second in importance only to Ginseng (Panax spp). Used in excess, however, it can cause cardiac dysfunction and severe hypertension. The root is a sweet tonic herb that stimulates the corticosteroidal hormones, neutralizes toxins and balances blood sugar levels. It is also antibacterial, anti-inflammatory, antiphlogistic, antispasmodic, antitussive, cholagogue, demulcent, emollient, expectorant and laxative. It is used internally in the treatment of Addison’s disease, asthma, coughs and peptic ulcers. Externally, it is used to treat acne, boils and sore throats. It is included in almost all Chinese herbal formulae, where it is said to harmonize and direct the effects of the various ingredients. It precipitates many compounds and is therefore considered to be unsuitable for use with some herbs such as Daphne genkwa, Euphorbia pekinensis and Corydalis solida. It increases the toxicity of some compounds such as ephedrine, salicylates, adrenaline and cortisone. It should not be prescribed for pregnant women or for people with high blood pressure, kidney disease or anyone taking digoxin-based medications. Excessive doses cause water retention and high blood pressure. It can cause impotence in some people. The roots are harvested in early autumn, preferably from plants 3- 4 years old, and is dried for later use. The flowers are alterative and expectorant.

Other Uses:
Fire retardant;  Insulation.
Liquorice root, after the medicinal and flavouring compounds have been removed, is used in fire extinguishing agents, to insulate fibreboards and as a compost for growing mushrooms.

Known Hazards: Liquorice root contains glycyrrhizin, which can cause high blood pressure, salt and water retention, and low potassium levels; it could also lead to heart problems. Patients who take liquorice with diuretics or medicines that reduce the body’s potassium levels could induce even lower potassium levels. Taking large amounts of liquorice root could also affect cortisol levels as well.[citation needed] People with heart disease or high blood pressure should be cautious about taking liquorice root. Pregnant women also need to avoid liquorice root because it could increase the risk of preterm labor.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
http://www.pfaf.org/user/Plant.aspx?LatinName=Glycyrrhiza+uralensis
http://www.angelicaherbs.com/herbdetail.php?id=339&cat=latin_name&latin_name=Glycyrrhiza%20uralensis
http://zipcodezoo.com/Plants/G/Glycyrrhiza%5Furalensis/
http://www.theplantencyclopedia.org/wiki/Glycyrrhiza

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Herbs & Plants

Trichosanthes kirilowii

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Botanical Name :Trichosanthes kirilowii
Family: Cucurbitaceae
Genus: Trichosanthes
Species:T. kirilowii
Kingdom:Plantae
Order:Cucurbitales

Common Names:  Chinese cucumber in English. And Chinese snake gourd.

Habitat :Trichosanthes kirilowii found particularly in Henan, Shandong, Hebei, Shanxi, and Shaanxi. It is one of the 50 fundamental herbs used in traditional Chinese medicine.

OIt often grows at an altitude of 200-1800m hillside forest, thickets, meadows and Cunpang Tanabe, or in the natural distribution area of bone, widely cultivated. Most parts of China are distributed, located in North, South, East and Liaoning, Shaanxi, Gansu, Sichuan, Guizhou and Yunnan. Most of the country has produced. The main production Shandong, Anhui, Henan and other places.

Description:
Trichosanthes kirilowii is a flowering plant.A Climber,length up to 10m. Tubers cylindrical , fleshy , rich in starch. Stems thick, much branched , with longitudinal ribs and grooves are white stretch pubescent. Leaves alternate ; petiole length 3-10cm, with vertical stripes, is of pubescent ; tendrils 3-7 differences pubescent ; leaves low-quality , contour nearly round or nearly heart-shaped , length and width are about 5-20cm, often 3-5 ( -7 ) lobed to the crack, split or dilute parted and only ranging from large coarse teeth , diamond-shaped lobes obovate , oblong , apex obtuse, acute, often re- lobed edges , base heart-shaped , curved lack of deep 3-4cm, surface dark green , rough, back of the green, on both sides along the veins villous hairy hirsute , basal palmate veins 5 , veinlets reticulate. Dioecious ; male racemes solitary or with a single flower and students, or those in the upper branches solitary, too inflorescence total length 10-20cm, stout, with longitudinal ridges and grooves , puberulent , the top 5 -8 flower, single flower stalk about 15cm, pedicel about 3mm, small bracts obovate or broadly ovate, 1.5-2.5 (-3) cm, width 1-2cm, the upper coarsely toothed , base with handle , pubescent ; calyx tube cylindrical , long 2-4cm, apex expanded diameter of about 10mm, the lower diameter of about 5mm, pubescent , lobes lanceolate, length 10-15cm, width 3-5mm, entire; Corolla white , lobes obovate , about 20mm, width 18mm, with a central green tip apex sides fringed with filaments , pubescent ; anther connivent , about 2mm, diameter of about 4mm, filaments separated , stout, villous ; female flowers solitary, stalk length 7.5cm, pubescent ; calyx tube oblong, 2.5cm, diameter 1.2cm, with male and corolla lobes ; ovary oval, green , long- 2cm, style long 2cm, stigma 3. Fruit oval, flattened , long 11-16mm, width 7-12mm, light brown, almost at the edge of a ridge . Flowering from May to August , the fruit of August to October……CLICK & SEE THE PICTURES

Cultivation:
Requires a rich well-drained soil and plenty of moisture in the growing season. Sometimes cultivated in China for its edible fruit and medicinal uses. Male plants are favoured for root production. This species is not winter hardy in Britain and usually requires greenhouse cultivation. However, it may be possible to grow it as an annual in a very warm sheltered bed outdoors. A climbing plant, supporting itself by means of tendrils. Dioecious, male and female plants must be grown if seed is required.

Propagation:
Seed – sow March in pots in a warm greenhouse in a rich soil. Sow 2 – 3 seeds per pot and thin to the strongest plant. Grow them on fast and plant out after the last expected frosts. Give some protection, such as a frame or cloche, until the plants are growing away well.

Edible Uses:
Edible Parts: Fruit; Leaves; Oil; Oil; Root…….click & see

Fruit. The young fruits are pickled. The pulp of older fruits is eaten. Mature fruits are about 10cm long. Leaves and young shoots – cooked and used as a vegetable. An edible starch is obtained from the root. It requires leeching, which probably means that it has a bitter flavour. The root is harvested in the autumn, cut into thick slices, soaked for 4 – 5 days in water, changing the water daily until the root disintegrates and can be mashed into a fine pulp. It is then steamed into cakes or used for making dumplings. An edible oil is obtained from the seed.

Chemical components: The plant is a source of the toxic anti-HIV type I ribosome-inactiving lectin trichosanthin

Medicinal Uses:
Trichosanthes kirilowii is commonly used in Chinese herbalism, where it is considered to be one of the 50 fundamental herbs. Recent research has isolated a protein called “trichosanthin” in the roots and this is undergoing trials as a possible remedy for AIDS. Skin, vulnerary. The leaf and the stem are febrifuge. The fruit is antibacterial, anticholesterolemic, antifungal, depurative, emollient, expectorant and laxative. It is used in the treatment of pulmonary infections with yellow and thick sputum, chest pains, stuffy feelings in the chest, constipation and dry stool. It has an antibacterial action against E. coli, Bacillus dysenteriae, B. typhi, B. paratyphi, Pseudomonas, Vibrio cholerae, V. Proteus etc. The fruit is traditionally prepared as a winter soup to ward off colds and influenza. The fruit is harvested in the autumn and dried for later use. The rind of the fruit is used to treat a number of ailments, including cancer, jaundice, retained placenta, bronchial infections with thick phlegm and sore throat. The seed is antitussive, emollient and expectorant. The root is antibiotic, anti-inflammatory, febrifuge, galactogogue, laxative, oxytocic, sialagogue and uterine tonic. The fresh root has been noted for centuries as an abortifacient – a sponge soaked in its juice was placed in the vagina and induced an abortion in the second trimester of pregnancy. The root is taken internally in the treatment of diabetes, dry coughs, and to assist in the second stage of labour. The root is harvested in the autumn and dried for later use. The root and/or the seed is powdered and used in the treatment of mammary cancer.

Other Uses:
Oil; ……..An oil from the seed is used for lighting.
Known Hazards: Root extracts are extremely toxic. Intravenous administration can cause pulmonary oedema, cerebral oedema, cerebral haemorrhage and myocardial damage. Seizures and fever in HIV patients with parenteral administration. Self-medication of root not advised
Resources:
http://en.wikipedia.org/wiki/Trichosanthes_kirilowii
http://www.mdidea.com/products/new/new05602.html
http://www.naturalmedicinalherbs.net/herbs/t/trichosanthes-kirilowii=chinese-cucumber.php
http://www.pfaf.org/user/Plant.aspx?LatinName=Trichosanthes+kirilowii

Categories
Ailmemts & Remedies

Cholangitis

Definition:
Cholangitis is an infection of the common bile duct, the tube that carries bile from the liver to the gallbladder and intestines. Bile is a liquid made by the liver that helps digest food.

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Cholangitis can be life-threatening, and is regarded as a medical emergency. Characteristic symptoms include yellow discoloration of the skin or whites of the eyes, fever, abdominal pain, and in severe cases, low blood pressure and confusion. Initial treatment is with intravenous fluids and antibiotics, but there is often an underlying problem (such as gallstones or narrowing in the bile duct) for which further tests and treatments may be necessary, usually in the form of endoscopy to relieve obstruction of the bile duct.
Symptoms:
The following symptoms may occur:

*Pain on the upper right side or upper middle part of the abdomen. It may also be felt in the back or below the right shoulder blade. The pain may come and go and feel sharp, cramp-like, or dull.

*Fever and chills

*Dark urine and clay-colored stools

*Nausea and vomiting

*Yellowing of the skin (jaundice), which may come and go
Physical examination findings typically include jaundice and right upper quadrant tenderness.Charcot’s triad is a set of three common findings in cholangitis: abdominal pain, jaundice, and fever. This was assumed in the past to be present in 50–70% of cases, although more recently the frequency has been reported as 15–20%.Reynolds’ pentad includes the findings of Charcot’s triad with the presence of septic shock and mental confusion. This combination of symptoms indicates worsening of the condition and the development of sepsis, and is seen less commonly still.

In the elderly, the presentation may be atypical; they may directly collapse due to septicemia without first showing typical features. Those with an indwelling stent in the bile duct (see below) may not develop jaundice.

Causes:
Cholangitis is most often caused by a bacterial infection. This can occur when the duct is blocked by something, such as a gallstone or tumor. The infection causing this condition may also spread to the liver.

Bile duct obstruction, which is usually present in acute cholangitis, is generally due to gallstones. 10–30% of cases, however, are due to other causes such as benign stricturing (narrowing of the bile duct without an underlying tumor), postoperative damage or an altered structure of the bile ducts such as narrowing at the site of an anastomosis (surgical connection), various tumors (cancer of the bile duct, gallbladder cancer, cancer of the ampulla of Vater, pancreatic cancer, cancer of the duodenum), anaerobic organisms such as Clostridium and Bacteroides (especially in the elderly and those who have undergone previous surgery of the biliary system). Parasites which may infect the liver and bile ducts may cause cholangitis; these include the roundworm Ascaris lumbricoides and the liver flukes Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus. In people with AIDS, a large number of opportunistic organisms has been known to cause AIDS cholangiopathy, but the risk has rapidly diminished since the introduction of effective AIDS treatment. Cholangitis may also complicate medical procedures involving the bile duct, especially ERCP. To prevent this, it is recommended that those undergoing ERCP for any indication receive prophylactic (preventative) antibiotics.

The presence of a permanent biliary stent (e.g. in pancreatic cancer) slightly increases the risk of cholangitis, but stents of this type are often needed to keep the bile duct patent under outside pressure

Diagnosis:
Routine blood tests show features of acute inflammation (raised white blood cell count and elevated C-reactive protein level), and usually abnormal liver function tests (LFTs). In most cases the LFTs will be consistent with obstruction: raised bilirubin, alkaline phosphatase and ?-glutamyl transpeptidase. In the early stages, however, pressure on the liver cells may be the main feature and the tests will resemble those in hepatitis, with elevations in alanine transaminase and aspartate transaminase.

Blood cultures are often performed in people with fever and evidence of acute infection. These yield the bacteria causing the infection in 36% of cases, usually after 24–48 hours of incubation. Bile, too, may be sent for culture during ERCP (see below). The most common bacteria linked to ascending cholangitis are gram-negative bacilli: Escherichia coli (25–50%), Klebsiella (15–20%) and Enterobacter (5–10%). Of the gram-positive cocci, Enterococcus causes 10–20%.

You may have the following tests to look for blockages:

*Abdominal ultrasound

*Endoscopic retrograde cholangiopancreatography (ERCP)

*Magnetic resonance cholangiopancreatography (MRCP)

*Percutaneous transhepatic cholangiogram (PTCA)

*You may also have the following blood tests:

#Bilirubin level
#Liver enzyme levels
#Liver function tests
#White blood count (WBC)
Treatment:
Quick diagnosis and treatment are very important.Antibiotics to cure infection is the first treatment done in most cases. ERCP or other surgical procedure is done when the patient is stable.Patients who are very ill or are quickly getting worse may need surgery right away.

Cholangitis requires admission to hospital. Intravenous fluids are administered, especially if the blood pressure is low, and antibiotics are commenced. Empirical treatment with broad-spectrum antibiotics is usually necessary until it is known for certain which pathogen is causing the infection, and to which antibiotics it is sensitive. Combinations of penicillins and aminoglycosides are widely used, although ciprofloxacin has been shown to be effective in most cases, and may be preferred to aminoglycosides because of fewer side effects. Metronidazole is often added to specifically treat the anaerobic pathogens, especially in those who are very ill or at risk of anaerobic infections. Antibiotics are continued for 7–10 days. Drugs that increase the blood pressure (vasopressors) may also be required to counter the low blood pressure.
Prognosis:
Acute cholangitis carries a significant risk of death, the leading cause being irreversible shock with multiple organ failure (a possible complication of severe infections). Improvements in diagnosis and treatment have led to a reduction in mortality: before 1980, the mortality rate was greater than 50%, but after 1980 it was 10–30%. Patients with signs of multiple organ failure are likely to die unless they undergo early biliary drainage and treatment with systemic antibiotics. Other causes of death following severe cholangitis include heart failure and pneumonia.

Risk Factors:
Risk factors include a previous history of gallstones, sclerosing cholangitis, HIV, narrowing of the common bile duct, and, rarely, travel to countries where you might catch a worm or parasite infection.

Risk factors indicating an increased risk of death include older age, female gender, a history of liver cirrhosis, biliary narrowing due to cancer, acute renal failure and the presence of liver abscesses. Complications following severe cholangitis include renal failure, respiratory failure (inability of the respiratory system to oxygenate blood and/or eliminate carbon dioxide), cardiac arrhythmia, wound infection, pneumonia, gastrointestinal bleeding and myocardial ischemia (lack of blood flow to the heart, leading to heart attacks).

Prevention:
Treatment of gallstones, tumors, and infestations of parasites may reduce the risk for some people. A metal or plastic stent that is placed in the bile system may be needed to prevent the infection from returning.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000290.htm
http://en.wikipedia.org/wiki/Ascending_cholangitis

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