Tag: Streptococcus pneumoniae

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Ailmemts & Remedies

Epiglottitis

Alternative Name: Supraglottitis

Definition:
Epiglottitis is an inflammation of the epiglottis – the flap that sits at the base of the tongue, which keeps food from going into the trachea (windpipe). Due to its place in the airway, swelling of this structure can interfere with breathing and constitutes a medical emergency. The infection can cause the epiglottis to either obstruct or completely close off the windpipe.

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Epiglottitis tends to occur in children aged between two and seven years old, and is rare in adults, although it may occur at any age. In the UK it is no longer common, following the introduction of a vaccine to protect against Hib.

With the advent of the Hib vaccine, the incidence has been reduced, but the condition has not been eliminated. If you suspect that you or someone in your family has epiglottitis, seek emergency help immediately. Prompt treatment can prevent life-threatening complications of epiglottitis.

Symtoms:
Symptoms in children
In children, signs and symptoms of epiglottitis may develop within a matter of hours, including:

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*Fever
*Severe sore throat
*Difficult and painful swallowing
*Drooling due to severe pain when swallowing
*Anxious, restless behavior
*Greater comfort when sitting up or leaning forward

Symptoms in adults
For adults, signs and symptoms may develop more slowly, over days rather than hours. Signs and symptoms may include:

*Severe sore throat
*A muffled or hoarse voice
*Harsh, raspy breathing
*Difficulty breathing

Cases in adults are most typically seen amongst abusers of crack cocaine and have a more subacute presentation. George Washington is thought to have died of epiglottitis.

Causes:
Epiglottitis is caused by an infection or an injury.

Infection
A common cause of swelling and inflammation of the epiglottis and surrounding tissues is infection with Haemophilus influenzae type b (Hib) bacteria. Hib isn’t the germ that causes the flu, but it’s responsible for other serious conditions — including respiratory tract infections and meningitis.

Hib spreads through infected droplets coughed or sneezed into the air. It’s possible to harbor Hib in your nose and throat without becoming sick — though you still have the potential to spread the bacteria to others.

Other bacteria and viruses also can cause inflammation of the epiglottis, including:

*Streptococcus pneumoniae (pneumococcus), another bacterium that causes meningitis, pneumonia, ear infections and blood infection (septicemia)

*Streptococcus A, B and C, a group of bacteria that cause diseases ranging from strep throat to blood infections.

*Candida albicans, the fungus responsible for vaginal
yeast infections, diaper rash and oral thrush

*Varicella zoster, the virus responsible for chickenpox and shingles

Injury :
Physical injury, such as a direct blow to the throat, can cause epiglottitis. So can burns from drinking very hot liquids.

You also may develop signs and symptoms similar to those of epiglottitis if you:

*Swallow a chemical that burns your throat

*Swallow a foreign object

*Smoke drugs, such as crack cocaine

Risk Factors:
Certain factors increase the risk of developing epiglottitis, including:

*Sex. Epiglottitis affects more males than females.

*Weak immune system. If your immune system has been weakened by illness or medication, you’re more susceptible to the bacterial infections that may cause epiglottitis.

*Inadequate vaccination. Delayed or skipped immunizations can leave a child vulnerable to Hib and increases the risk of epiglottitis.

Possible Complications:
*Spasm may cause the airways to close abruptly. In this case, death follows within minutes.

*Some patients may develop pneumonia, lymphadenopathy or septic arthritis.

*The airways may become totally blocked, which could result in death.

Diagnosis:
Diagnosis is confirmed by direct inspection using laryngoscopy, although this may provoke airway spasm. If it is suspected, attempts to visualise the epiglottis using a tongue depressor are STRONGLY discouraged for this reason. A paediatric, anaesthesia or ENT specialist should be alerted immediately. Imaging is rarely useful, and treatment should not be delayed for this test to be carried out.

The epiglottis and arytenoids are cherry-red and swollen. The most likely differential diagnostic candidates are croup, peritonsillar abscess, and retropharyngeal abscess.

On lateral C-spine X-ray, the thumbprint sign (or just “thumb sign”) describes a swollen enlarged epiglottis.

Treatment:
Epiglottitis may require urgent tracheal intubation to protect the airway, though this is not always the case. In some cases, epiglottitis requires the use of antibiotics while a patient is experiencing the benefits of a breathing tube. In more serious cases, tracheal intubation is necessary. In such cases, it is not advised to immediately head in the direction of intubation because the inflammed epiglottis is very sensitive and if you irritate the epiglottis with the laryngoscope you can cause the epiglottis to close off completely forcing the use of a surgical airway (cricothyrotomy). Most children can be managed by letting the child be in a position of comfort, keep the lights down low and keep the child calm. Intubation is a good thing to have in the back of your mind and it may become necessary if the child starts to rapidly decompensate and show signs of impending respiratory arrest (decreased work of breathing with abnormal skin signs) given in the initial stages to reduce symptoms, but this will not treat the underlying cause. It should also be noted that if stridor becomes quieter, obstruction is likely to follow, and thus intubation should be expedited even further.

In addition, patients should be given antibiotic such as second- or third generation cephalosporins (either alone or in combination with penicillin or ampicillin for streptococcal coverage).
Prognosis: Epiglottitis can be a life-threatening emergency. However, with proper treatment, the outcome is usually good.

Prevention:
Hib vaccine
Immunization with the Hib vaccine is an effective way to prevent epiglottitis caused by Hib. In the United States, children usually receive the vaccine in three or four doses:

*At 2 months
*At 4 months
*At 6 months if your child is being given the four-dose vaccine
*At 12 to 15 months

The Hib vaccine is generally not given to children older than age 5 or to adults because they’re less likely to develop Hib infection. But the Centers for Disease Control and Prevention recommends the vaccine for older children and adults whose immune systems have been weakened by:

*Sickle cell disease
*HIV/AIDS
*Spleen removal
*Chemotherapy
*Medications to prevent rejection of organ or bone marrow transplants

Vaccine side effects
Possible side effects of the Hib vaccine include redness, warmth or swelling at the injection site, and a fever. Rarely, a serious allergic reaction may cause difficulty breathing, wheezing, hives, weakness, a rapid heartbeat or dizziness within minutes or a few hours after the shot. If you have an allergic reaction to the vaccine, seek medical help immediately.

Common-sense precautions :
Of course, the Hib vaccine doesn’t offer guarantees. Immunized children have been known to develop epiglottitis — and other germs can cause epiglottitis, too. That’s where common-sense precautions come in:

*Don’t share personal items.
*Wash your hands frequently.
*Use an alcohol-based hand sanitizer if soap and water aren’t available.

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.bbc.co.uk/health/physical_health/conditions/epiglottitis2.shtml
http://en.wikipedia.org/wiki/Epiglottitis
http://www.nlm.nih.gov/medlineplus/ency/article/000605.htm
http://www.mayoclinic.com/health/epiglottitis/DS00529
http://www.healthline.com/adamimage?contentId=1-000605&id=1052

http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=303&id=178

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Health Quaries

Some Health Quaries & Answers

Q: I have terrible dreams every night when I feel I am falling over a mountain or am locked in a box. I don’t feel refreshed when I wake up. I am also drowsy all day.

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A: No one knows exactly why people dream, where dreams originate, what they mean or what the purpose of dreaming is for the body or the mind. But we do know that dreams are strongly associated with REM (Rapid Eye Movement) sleep. This can be picked up by an EEG (electroencephalogram) which records electrical signals in the brain. REM shows up as typical wave patterns. During an average lifespan, a human being spends about six years’ time dreaming. This works out to almost two hours each night. Most dreams last for only 5-20 minutes.

One way to sleep well is to go for a 45-minute walk half an hour after dinner, and then drink a cup of warm milk before going to bed.

I suspect cancer :
Q: My father has been taking aryuvedic medicine for his arthritis. He has developed black patches on his skin and tongue. I am afraid it is cancer.

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A: Cancer of the tongue is more likely to appear as a painless white patch or a nodule. Black patches on the skin and tongue are probably due to consumption of metals like silver, gold, mercury and lead which are present in Aryuvedic medications. These metals are not eliminated from the body. The concentration builds up and they get deposited in the bones and muscles. It is advisable to stop the medications and see an allopathic physician. If necessary, have a biopsy done to rule out cancer.

That unrelieved feeling:
Q: I have problem moving my bowels. I never manage to finish the business before leaving for work. The whole day I feel the “urge” but cannot evacuate as I do not use the office toilet, which is unhygienic.

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A: Constipation, especially long standing, can be due to improper diet lacking in sufficient fibre and fluids. It may also be due to a disease process like thyroid malfunction or a block in the intestine. In your case the former seems more likely as you have suffered for years and your health does not seem to have deteriorated in any way.

If there is no disease process (ascertained by a medical evaluation), try increasing water intake to three litres a day and eating 4-6 helpings of fruit and vegetables. If this does not work, you can try 2tsp isabgol husk in a glass of water at night to increase the bulk in your food. Walking for 45 minutes a day and doing abdominal exercises will help tone your muscles. This in turn will help regulate your bowels. Also try getting up earlier so that you can spend time in the toilet without tension and anxiety.

Otitis media
Q: My five-year-old daughter has enlarged adenoids (I don’t know what that is) and because of that (according to the paediatrician) she has frequent attacks of middle ear infection. She has been advised pneumococcal vaccine. Is it necessary?

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A: Adenoids are paired structures situated at the back of the throat, close to the opening of the middle ear into the throat. With bacterial and viral infections they can also get enlarged, the condition being called otitis media. They can block the opening of the middle ear and cause unequal pressures, build up of secretions and ear ache, eventually leading to infections.

Two common bacterial organisms causing ear infection are the H. influenza and pneumococcus. Immunisation against H. influenza is given with DPT/HepB at six weeks, 10 weeks and 14 weeks of age as part of the recommended extended immunisation schedule. Prevanar (against pneumococcus) can be given at the same time. If this is missed, Pneumo 23 can be given after the age of two years. The vaccines are safe.

Vaporising mosquito repellents can lead to allergic swelling of the adenoids. Use of a feeding bottle while sleeping, particularly at night, compounds the problem. These two factors should be removed, otherwise the infections will self perpetuate despite immunisation.

High BP at youth
Q: I am 26 years old and have hypertension, which is well controlled. I also have anxiety. I am on medications which I want to discontinue.

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A: You are too young to have hypertension. This needs to be evaluated as there are several correctable diseases that cause secondary hypertension. Continue the medications at present and try to consult an endocrinologist or nephrologist to evaluate the hypertension and hopefully find a cause. Meanwhile, to reduce anxiety, try jogging for 40 minutes a day and practise meditation or yoga regularly.

Sources: The Telegraph (Kolkata, India)

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Ailmemts & Remedies

Pneumonia

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Pneumonia is an inflammation of the lungs, usually caused by an infection of the lung tissue by one of many different microorganisms (germs). It is very common in the UK – it affects around 1 in every 100 people each year. Babies and people over 65 most commonly get pneumonia and most infections occur in the autumn or winter.

 

Most types of pneumonia can usually be treated effectively with antibiotics. However it can also be a serious illness, especially for people who are elderly and frail or already ill.


Types of pneumonia
Pneumonia is often divided into two main categories (‘community-acquired pneumonia’ and ‘hospital-acquired pneumonia’) depending on whether you were infected while living at home (in the community) or while staying in hospital.

There are different types of pneumonia within these categories caused by various infections, which are described below.

Typical pneumonia
There are a range of bacteria that may cause an infection leading to ‘typical pneumonia’ including Streptococcus pneumoniae which causes pneumococcal pneumonia. This is the most common cause of pneumonia.

Viruses can also be a source of infection including influenza – or flu.

An infection with a bacterium and a virus can occur at the same time. A Streptococcus pneumoniae infection is usually ‘secondary’ to a person having flu for example. This is known as a ‘secondary infection‘ and can slow down recovery significantly.

Atypical pneumonia
Less commonly, microorganisms can cause other forms of pneumonia. These illnesses are classed as “atypical pneumonia” and include:

Legionnaire’s disease (caused by a bacterium)
SARS – severe acute respiratory syndrome (caused by a virus)
Weakened immune system
People with a weakened immune system (such as people with AIDS or those that have had an organ transplant and are taking immunosuppressant drugs) may get additional pneumonia-causing infections.

These include an infection with the fungus-like organism Pneumocystis carinii. This infection is rarely the cause of pneumonia in people who have a fully-functioning immune system.

Aspiration pneumonia
Pneumonia can also be caused by inhaling substances, such as caustic chemicals, food or vomit into the lungs. This is known as “aspiration” pneumonia and is not infectious.

Symptoms:
The first symptom that you will spot in pneumonia the pulse is rapid, and breathing becomes shallow and painful. On a longer duration of pneumonia, you may complain of shortness of breath and chest pain. This happens because the oxygen is not able to reach the blood properly due to inflamed lungs.

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Pneumonia is usually difficult to spot. Many people mimic a cold or the flu with pneumonia, so get panic very soon that they are suffering from a serious condition. The signs and symptoms of pneumonia varies largely depending on the age of child and the cause of his infection. Only your doctor can provide you complete information about the signs and symptoms with adequate diagnosis.

The person suffering from pneumonia may experience:
a cough that produces greenish or yellow sputum.
a very high fever, which may be accompanied by shaking chills.
rapid breathing.
chest pain.
a sharp or stabbing pain.
experience headaches.
exhaustion.
vomiting.
develop sweaty and clammy skin.
wheezing.
loss of appetite (in older children) or poor feeding (in infants).
Other symptoms may include:
Loss of appetite.
Excessive Fatigue.
Blueness of the skin.
Nausea.
Person may experience joint pains and muscle aches.
Infants with pneumonia may have many of the symptoms above, but in many cases, they are simply sleepy or have decreased appetite. In serious cases, children may develop bluish or gray color of the lips and fingernails.

Your symptoms will depend on how much of your lung is affected and the type of infection that you have. Symptoms may come on quite suddenly and include:
in the beginning, a dry cough, which progresses to be a cough with phlegm that is often green/yellow or rust-coloured and may be smelly
breathlessness
pain in the side of your chest that can make breathing and coughing uncomfortable
fever
Complications
Complications are more common in older people and may include:
a build up of fluid around the lungs called a pleural effusion
breathing difficulties, which will need treatment in hospital
spread of the infection to your blood, called septicaemia or “blood poisoning” – this can be very dangerous

Causes:
The main cause of pneumonia is the infection of the lung tissue by one of many different microorganisms including bacteria, viruses, fungi and some parasites. These may be present in the body for some time before causing illness.

You may get pneumonia from the germs present in food, liquids and chemicals. In some cases, it is caused by breathing in small droplets containing the organisms that cause pneumonia. These organisms come into air from an infected person, when the person coughs or sneezes. In other cases, pneumonia is caused when bacteria or viruses that are usually present in the mouth, throat, or nose inadvertently enter the lung.

Though, pneumonia can be caused to anyone at any age, but very young and very old people are the most susceptible to pneumonia. Pneumonia very easily develops after an illness such as flu or cold.

How do you get pneumonia?
The microorganisms (germs) that cause pneumonia may be present in your body for some time before causing illness. Or, they may also be spread between people through droplets in the air. Coughing and sneezing create droplets.

There are a number of factors that affect your body’s ability to fight off infection and put you more at risk of developing pneumonia.They include:
being in poor health
age – the very young and old (over 65) are most susceptible to pneumonia
smoking (as smoking damages your lungs which makes it easier to get an infection)
heavy drinking
heart disease
having a lung disease, such as asthma or chronic obstructive pulmonary disease (COPD)
a low immunity to infection – if you have an illness such as AIDS or are having some types of chemotherapy for example.
Hospital-acquired pneumonia
People in hospital are vulnerable to pneumonia for a number of reasons. These include:

having a weakened immune system, which increases your risk of getting pneumonia
a reduced cough reflex following surgery or severe illness – a cough reflex is the body’s way of clearing things out of the airways that may irritate them, an automatic reaction that defends the body against infections
the types of bacteria responsible for pneumonia caught in hospital, which tend to be different from those that cause community-acquired pneumonia – they may also be resistant to the standard antibiotics (such as resistant strains of the bacterium Staphylococcus aureus)
Diagnosis
Your doctor will examine you and ask you about your symptoms. He or she will tap on your chest and listen to how your breath sounds with a stethoscope.

Your doctor may suggest that you have an X-ray to determine the location and extent of the infection.An important test for detecting pneumonia in unclear situations is a chest x-ray. Chest x-rays can reveal areas of opacity (seen as white) which represent consolidation. Pneumonia is not always seen on x-rays, either because the disease is only in its initial stages, or because it involves a part of the lung not easily seen by x-ray. In some cases, chest CT (computed tomography) can reveal pneumonia that is not seen on chest x-ray. X-rays can be misleading, because other problems, like lung scarring and congestive heart failure, can mimic pneumonia on x-ray. Chest x-rays are also used to evaluate for complications of pneumonia.

If an individual is not getting better with antibiotics, or if the health care provider has concerns about the diagnosis, a culture of the person’s sputum may be requested. Sputum cultures generally take at least two to three days, so they are mainly used to confirm that the infection is sensitive to an antibiotic that has already been started. A blood sample may similarly be cultured to look for infection in the blood (blood culture). Any bacteria identified are then tested to see which antibiotics will be most effective.

Your doctor may take a sample of blood or phlegm for testing. The sample will be sent to a laboratory for examination to find out what type of infection you haveA complete blood count may show a high white blood cell count, indicating the presence of an infection or inflammation. In some people with immune system problems, the white blood cell count may appear deceptively normal. Blood tests may be used to evaluate kidney function (important when prescribing certain antibiotics) or to look for low blood sodium. Low blood sodium in pneumonia is thought to be due to extra anti-diuretic hormone produced when the lungs are diseased (SIADH). Specific blood serology tests for other bacteria (Mycoplasma, Legionella and Chlamydophila) and a urine test for Legionella antigen are available. Respiratory secretions can also be tested for the presence of viruses such as influenza, respiratory syncytial virus, and adenovirus.
This will help your doctor to decide how to treat you.

Modern Treatment
If you have pneumonia you should drink plenty of fluids. If you have pain you should take painkillers that you would normally take for a headache.

Drug treatments
If you have community-acquired pneumonia, your doctor will prescribe you antibiotics immediately, often prior to tests on the phlegm sample. Antibiotics treat pneumonia caused by bacteria. Antibiotics are usually given straight away as bacterial infections are the most common cause of pneumonia and antibiotics are generally very effective. It is usually safe to assume that the infection will respond to standard antibiotics such as amoxicillin. Generally for chest infections you should take antibiotics for about seven days and you must complete the full course.

If you have a weakened immune system you may be offered a long-term, daily dose of preventive antibiotics.

If test results show that you have pneumonia caused by a virus, antibiotics will not work and your body will need to fight the infection on its own. It may therefore take longer to recover. However, if you have an infection caused by the chickenpox or herpes viruses, you may be prescribed antiviral drugs if the infection was caught early. You may also need antibiotics if you have a secondary bacterial infection.

If you have fungal pneumonia, you may be given antifungal drugs that you can take as tablets or you may need to take them intravenously.

You should get better at home without needing to go for hospital treatment. Provided you do not have any complications, your symptoms should begin to improve quickly with treatment and generally pneumonia should not cause any long-term damage to your lungs. If you are given drug treatments, let your doctor know if your symptoms do not improve after two days.

Hospital treatment
If you are very ill or your symptoms do not improve after drug treatment, you may need hospital treatment. This is especially important for very young and old people.

The appropriate drug therapy, as well as fluids, will be given to you through a vein (intravenously). To help you breathe, you may be given extra oxygen through a face mask.


Ayurvedic, Herbal and Home Remedies for The Treatment Of Pneumonia

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Prevention
Stopping smoking and only drinking in moderation can reduce your risk of many illnesses, including pneumonia.

You may click &  read  :  Kill The Calf

Vaccines
There are immunisations for some infections that can cause pneumonia.

A pneumococcal vaccine can prevent pneumonia caused by Streptococcus pneumoniae infection. There are two pneumococcal vaccines, brand names Pneumovax II and Prevenar. Both of these vaccines are given by injection. This vaccine is recommended to anyone with lung or heart problems and most people only need to have it once. The government plans to introduce this vaccine to the childhood immunisation programme later in 2006 and it is already available to people over 65.

A Haemophilus influenzae type B vaccine (“Hib” vaccine) can prevent you getting flu. This annual vaccination is now given routinely to babies and everybody over age 65, and those with long-term lung, heart or kidney diseases, or with a weakened immune system. You can get vaccinated at your local GP surgery each autumn. Alternatively, they are available from private.

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.

Help taken from: hcd2.bupa.co.uk, ayurvedic-medicines.org and en.wikipedia.org

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The unconquered enemy

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We humans think of ourselves as intelligent and rational. We have successfully evolved, subdued the lower animal species and conquered the world. We could not be more wrong.

The simple, single-celled bacterium has been around longer than we have, and has effectively survived the ice age, floods, drought and the chemical onslaught of antibiotics.

The medical community thought that it had finally conquered bacteria and infectious diseases after Alexander Fleming discovered penicillin in 1928. Doctors couldn’t have been more naive.

Bacteria have offensive, defensive, stealth fighter and commando manoeuvres that no human army can match. They hide in areas like pus, thick layers of skin, bone and cartilage that antibiotics can’t penetrate. They adapt and change faster than a speeding bullet. They are not bound by narrow-minded considerations like race or ethnicity; they join forces enthusiastically with bacteria of other species. When all else fails they copulate, and during the process, exchange genetic material that provides resistance to antibiotics.

Immunisation is a powerful weapon that boosts the body’s own defence mechanism

Unfortunately, human beings are collaborating in this warfare, unwittingly aiding bacterial victory. Fifty per cent of the total antibiotic production is used for animals. Farmers rearing cows, sheep, goats, chicken and fish often use animal feed fortified with antibiotics to keep their livestock healthy. Sometimes the antibiotics are administered as regular supplements. These antibiotics contaminate the environment. The sub-optimal quantities administered to the animals aren’t enough to kill all the targeted bacteria. Genetic mutations occur and resistant bacteria emerge. These eventually find their way into the human community. Treatment with the antibiotic recommended for that particular infection will then fail, requiring more potent and expensive drugs.

Sometimes doctors may be at fault. They may fail to calculate the correct dosage, particularly in case of children where it is based on the body weight. Sometimes the dosage intervals may be incorrect and the next dose is administered later than required, after the drug has been totally eliminated from the body. Also, in the absence of investigations, the chosen antibiotic may be inappropriate for that particular infection. Instructions to patients may be incomplete, without specifications on whether it is to be taken before or after food, as food may help or impede absorption.

Surgery or ICU admissions raise the spectre of post operative infection, although this should not be the case if proper sterilisation techniques are followed. To prevent this, antibiotics are administered prophylactically prior to, during and after surgery. This aids the development of resistance, as the targeted organism may not be the same as the infecting one.

Often patients, too, have unrealistic expectations. They are not willing to accept the fact that antibiotics do not work against viral infections. They find it difficult to follow a “wait and watch” policy. They fail to realise that it is antipyretics (like paracetemol) and not ad hoc doses of antibiotics that reduce fever. They tend to “doctor shop” till they find someone who will prescribe the antibiotics they want.

Diseases that compromise host immunity allow bacteria to gain a foothold and thrive. In such a scenario, higher and longer doses of antibiotics have to be used. Some of these diseases, like diabetes, can be controlled with a little effort, diet control and exercise.

Our drug control policy is somewhat lax. Pharmacies freely dispense unprescribed schedule H antibiotics in irrational combinations OTC (over the counter). Although this is illegal, their activities cannot be faulted, as “supply meets demand.”

As educated responsible citizens, we should not self medicate and perpetuate this menace. Immunisation is a powerful weapon that boosts the body’s own defence mechanisms. As soon as the invading bacteria launch an attack, the sentries and foot soldiers (white blood cells and immunoglobulins) sound the alarm, engulf and annihilate the bacteria. Immunisation is available against diphtheria, tetanus, pertussis (whooping cough), H. influenzae (meningitis, ear infections, bronchitis), Pneumococcus (pneumonia, ear infections, meningitis), Meningococcus (meningitis) and typhoid.

Researchers are trying to discover newer and stronger antibiotics to combat the menace of bacterial resistance. They cost crores to discover and test before they can be finally used. We therefore need to conserve and use what we already have. Once the rate of discovery ceases to keep pace with the mutation in the bacteria, we have lost the battle to the microbes.

So, I strongly believe that people should rely more on alternative therapy like yoga,meditation,herbal medications etc. for maintaining a good health unless there is any medical emergency .

Source:The Telegraph(Kolkata,India)

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