Tag Archives: Tuberculosis

Impatiens walleriana

Botanical Name : Impatiens walleriana
Family: Balsaminaceae
Genus: Impatiens
Species:I. wallerana
Kingdom:Plantae
Order: Ericales

Synonyms:
*Impatiens giorgii De Wild.
*Impatiens holstii Engl. & Warb.
*Impatiens lujai De Wild.
*Impatiens sultani Hook.f.

Common Names: Busy Lizzie (United Kingdom), Balsam, Sultana, or Simply impatiens

Habitat :Impatiens walleriana is native to eastern Africa from Kenya to Mozambique.

Description:
Impatiens walleriana is a herbaceous perennial flowering plant growing to 15–60 cm (6–24 in) tall, with broad lanceolate leaves 3–12 cm long and 2–5 cm broad. Leaves are mostly alternate, although they may be opposite near the top of the plant. The flowers are profusely borne, 2–5 cm diameter, with five petals and a 1 cm spur. The seedpod explodes when ripe in the same manner as other Impatiens species, an evolutionary adaptation for seed dispersal. The stems are semi-succulent, and all parts of the plant (leaves, stems, flowers, roots) are soft and easily damaged.

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Edible Uses:
Root – cooked. It is a source of ’salep’, a fine white to yellowish-white powder that is obtained by drying the tuber and grinding it into a powder. Salep is a starch-like substance with a sweetish taste and a faint somewhat unpleasant smell. It is said to be very nutritious and is made into a drink or can be added to cereals and used in making bread etc. One ounce of salep is said to be enough to sustain a person for a day.

Medicinal Uses:
Salep is very nutritive and demulcent. It has been used as a diet of special value for children and convalescents, being boiled with water, flavored and prepared in the same way as arrowroot. Rich in mucilage, it forms a soothing and demulcent jelly that is used in the treatment of irritations of the gastro-intestinal canal. One part of salep to fifty parts of water is sufficient to make a jelly.

This essence of the remedy addresses mental stresses and tensions. It calms feelings of impatience and irritability. It slows the tendency to move too quickly without care or forethought. Calming. Allows one to deepen his/her life experience without experiencing burnout.

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:
https://en.wikipedia.org/wiki/Impatiens_walleriana
http://healthyhomegardening.com/Plant.php?pid=2173

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Cynanchum stauntonii

Botanical Name: Cynanchum stauntonii
Family:    Apocynaceae
Subfamily:Asclepiadoideae
Genus:    Cynanchum
Kingdom:    Plantae
Order:    Gentianales
Common Chinese Name :Bai Qian

Habitat :
These species are found worldwide in the tropics and subtropics. Several species also grow in temperate regions along water edges where it is shady and damp. Sunny places in moist woodland, water-logged lands at low to moderate elevations.

Description:
Cynanchum stauntonii  is a perennial  climbing  herb,erect half-shrub, high 30 ~ 60cm. Stems cylindrical, with thin edges. 6-13cm,width of .03-0.5cmLeaves opposite, lanceolate or linear-lanceolate, long 6 ~ 13cm, width of 0.3 ~ 0.5cm, ends acuminate, midrib apparent. Cymes axillary, 3 to 8 flowers; Calyx 5 parted; Corolla purple, radial, inner surface is pilose, lobes narrowly triangular; Vice corolla lobes peltate, apex slightly thicker and the inner volume; stamens 5, and co-generation core column pistil, anther 2 rooms; stigma convex, including the films in the anther.  Fruit solitary follicles. Flowering 5 to 8 months, the fruit of 9 to 10 months
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Slender cylindrical roots, branching, slightly curved, long 4 ~ 15cm, diameter of 1.5 ~ 4mm; surface yellow-white or yellowish brown, for length of 1.5 ~ 4.5cm, the top of a residual stem; crisp, hollow cross section. Tufted slender curved section at the root, long up to 10cm, diameter of less than 1mm, there was hair to be like many branches, often twisting into the group. Gas micro, slightly sweet taste.

Cultivation:
We have very little information on this species and do not know if it will be hardy in Britain, though judging by its native range it could succeed outdoors in many parts of this country. It probably does not have any special cultivation requirements and will probably succeed in most soils in a sunny position.

Propagation:
Seed – sow spring in the greenhouse. When they are large enough to handle, prick the seedlings out into individual pots and grow them on in the greenhouse for at least their first winter. Plant them out into their permanent positions in late spring or early summer, after the last expected frosts. Division in spring.

Medicinal Uses:
The dried root, decocted with other herbs, is anodyne, antitussive and expectorant. A decoction of the root is used in the treatment of coughs and asthma. Decoctions of all parts are used as a febrifuge and for treating internal fever. The roots are used medicinally for pulmonary tuber-culosis, infantile malnutrition due to intestinal parasites, influenza, cough, and chronic bronchitis.

Known Hazards:  There are some reports of toxins in this genus

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

Resources:
http://www.answers.com/topic/cynanchum
http://www.herbnet.com/Herb%20Uses_AB.htm
http://tool.zyy123.com/zybbg/ht/bq.htm
http://www.pfaf.org/user/Plant.aspx?LatinName=Cynanchum+stauntonii

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Sputum

Definition:
Sputum is matter that is expelled from the respiratory tract, such as mucus or phlegm, mixed with saliva, which can then be spat from the mouth. It is usually associated with air passages in diseased lungs, bronchi, or upper respiratory tract and also a case of pneumonia.Common types of sputum are mucus and phlegm.

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It can be found to contain blood if a chronic cough is present, possibly from severe cases of tuberculosis.

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A sputum sample is the name given to the mucus that is coughed up from the lower airways. It is usually used for microbiological investigations of respiratory infections.

The best sputum samples contain very little saliva, as this contaminates the sample with oral bacteria. This event is assessed by the clinical microbiologist by examining a Gram stain of the sputum. More than 25 squamous epithelial cells at low enlargement indicates salivary contamination.

When a sputum specimen is plated out, it is best to get the portion of the sample that most looks like pus onto the swab. If there is any blood in the sputum, this should also be on the swab.


Microbiological sputum samples

Microbiological sputum samples are usually used to look for infections by Moraxella catarrhalis, Mycobacterium tuberculosis, Streptococcus pneumoniae and Haemophilus influenzae. Other pathogens can also be found.

Purulent Sputum is that containing, or consisting of, pus.
It is usually associated with air passages in diseased lungs, bronchi, or upper respiratory tract and also a case of pneumonia. It can be found to contain blood if a chronic cough is present, possibly from severe cases of tuberculosis. A sputum sample is the name given to the mucus that is coughed up from the lower airways. It is usually used for microbiological investigations of respiratory infections. The best sputum samples contain very little saliva, as this contaminates the sample with oral bacteria. This event is assessed by the clinical microbiologist by examining a Gram stain of the sputum. More than 25 squamous epithelial cells at low enlargement indicates salivary contamination. When a sputum specimen is plated out, it is best to get the portion of the sample that most looks like pus onto the swab. If there is any blood in the sputum, this should also be on the swab.

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Sputum can be:

1.Bloody (often found in tuberculosis) (Hemoptysis)

2.Rusty colored – usually caused by pneumococcal bacteria (in pneumonia)

3.Purulent – containing pus. The color can provide hints as to effective treatment in Chronic Bronchitis Patients:-
……………..I) a yellow-greenish (mucopurulent) color suggests that treatment with antibiotics can reduce symptoms. Green color is caused by Neutrophil Myeloperoxidase.
…………….II)a white, milky, or opaque (mucoid) appearance often means that antibiotics will be ineffective in treating symptoms. (This information may correlate with the presence of bacterial or viral infections, though current research does not support that generalization.)

4.Foamy white – may come from obstruction or even Edema

Resources:
http://en.wikipedia.org/wiki/Sputum
http://www.righthealth.com/topic/Sputum

http://forsah.net/medical/en/image/Sputum

http://www.nlm.nih.gov/medlineplus/ency/imagepages/9945.htm

Atibala

Botanical Name : MALVACEAE
Family Name: ABUTILON INDICUM
Family:
Malvaceae
syn.: Sida indica L.
Common Name:Indian Abutilon, Indian Mallow,Abutilon [US] Atibala, Khangi [India] Dong kui zi, Mi lan cao [China] Guimauve [Guadaloupe]

Latin Name: Abutilon indicum

vernacular Name: Sans,;Atibala, Hind; Kanghi Eng; Country mallow
Kingdom: Plantae
Order: Malvales
Genus: Abutilon
Species: A. indicum
Similarly used species: Abutilon grandifolium
Parts Used: Seeds, leaves, bark and root.
Habitat: The plant grows throughout India and in Sri Lanka, at about an elevation of 1000-1, 500 metres

Description: The perennial shrub grows 1.25-2 metres in height. The leaves are oblong, opposite, toothed, smooth and covered with fine white hair. The flowers are yellow, 2.5 cm in diameter. The fruits are round and have edges on the circumference like a seal, hence called mudra. There are two varieties of atibala, viz. big and small. The plant flowers in June and bears fruits in November.

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YOU MAY CLICK TO SEE PICTURES OF DIFFERENT SPECIS:

The other, big variety is named as Abutilon hirtum. From the roots non – drying oil consisting of various fatty acids vix. Linoleic, oleic, stearic, palmitic. Lauric, myristic, caprylic, capric and unusual fatty acid having C17 carbon skeleton besides sitosterol, and amyrin from unsaponifiable matter is yielded. This oil showed significant analgestic activity. (Indian Drugs 2984, 22,69) . From the leaves amino acids, glucose, fructose and galactose have been isolated. Gossypetin-8 and 7 glucosides and cynidin – 3 – rutinoside is also isolated (Phytochemistry 1972. 11, 1518) Caryophyllene and its oxide, cineole, pinene, geraniol, gerany acetate, eudesmol, farnesol and borneol are identified in oil.

Properties: Atibala is sweet in taste , sweet in the post digestive effect and has cold potency . It alleviates vata and pitta dosa. It possesses oily , slimy and heavy attributes. It is mainly useful in gout, raktapitta and tuberculosis. (Bhavaprakasa Nighantu)

Medicinal Uses
All the four balas, balacatustaya, have sweet taste, sweet post digestive effect and cold potency. They possess oily and slimy attributes and alleviate all the three dosas. Their chief properties are tonic ond oja vardhaka – augment ojas, the subtle essence of all vital fluids, responsible for health, harmony and spiritual growth. They are beneficial in treating gout, tuberculosis and raktapitta bleeding disorders. (Kaiyadeva Nighantu).

Atibala, is used externally, to alleviate the pain and swelling. Internally, the roots and seeds are used for medicinal purpose. In tuberculosis, with cavitation, atibala is valuable as it nourishes the mamsa dhatu (muscle tissue) and augments the strength. It also augments the seminal fluids and normalizes the sukra ksaya, which many a times is a cause of tuberculosis according to Ayurvedic concept. Atibala is salutary in raktapitta to arrest the bleeding tendencies. It is useful as an adjunct in vata diseases like paralysis, facial palsy, cervical spondylosis etc. The diuretic like property of the plant is useful in urinary disorders like dysuria. It sorks well as a uterine tonic as well as an aphrodisiac.

Classical Ayurvedic Proparations:-
Atibala svarasa (juice)
Atibala taila (oil)

It is tikta, katu, subdues deranged vata, anthelminitic, cures burning sensation,allays thirst, antidotal, antiemetic, anti fatigue’

Atibala is considered balya in Ayurveda, which means that it increases strength, vigor and vitality. It is used in facial paralysis and joint disorders. It is also indicated as a uterine tonic as well as an aphrodisiac.

Therapeutic Uses: This plant is often used as a medicinal plant.

Seeds: in piles; laxative, expectorant; in chronic cystitis,gleet and gonorrhoea;

Leaves: demulcent, locally applied to boils and ulcers and as a fomentation to painful parts of the body; Decoction used in toothache and tender gums; given internally for inflammation ofladder;

Infusion of leaves or root: demulcent and diuretic; prescribed in fever, chest affection, and urethritis; bark: astringent and diuretic.

Western Actions: Lowers fever, anti-inflammatory, expectorant, increases flow of urine. [China] Aphrodesiac, increases flow of urine, tonic, protects lung and bladder mucous membranes. [India]

Energetic Actions: Clears heat and dampness. Opens the orifices. Invigorates blood.[China]

Different Uses:
1. Deafness, ringing in the ears, earache [China] Eye problems [Africa]
2. Colds, high fever, mumps, hives [China] Fever [India]
3. Pulmonary tuberculosis [China] Cough, bronchitis (decocted) [India]
4. Lack of urination. [China] Difficult/painful urination [India]
5. Diabetes, thirst [India]
6. Painful menses [India]
7. Carbuncle [China]
8. Hemorrhoids [India] Hernia [China]
9. Diarrhea, worms. [India] [China]
10. Infusion, poultice or paste for Boils, ulcers. [India]

Combinations: For deafness with Cassia occidentalis (Wan-jiang-nan-zi, Miki-palaoa, Au-koi, Pi-honohono), 60 gm each (!?) [China]

Caution: Use with caution in pregnancy.

Preparation: Dry under sun. Decoct

Dosage: 15-30 grams

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

Resources:
http://en.wikipedia.org/wiki/Abutilon_indicum
http://www.medicineatyourfeet.com/abutilonindicum.html
http://www.herbalcureindia.com/herbs/atibala.htm

http://www.ayurvedkisanjivani.co.uk/ayurveda-herbs.php?herb=Atibala
http://www.impgc.com/plantinfo_A.php?id=98&bc=

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TB (Tuberculosis) Skin Test Or Mantoux Test

Introduction :
The Mantoux skin test consists of an intradermal injection of exactly one tenth of a milliliter (mL) of PPD tuberculin. The size of induration is measured 48–72 hours later. Erythema (redness) should not be measured.The Mantoux test (also known as the Mantoux screening test, Tuberculin Sensitivity Test, Pirquet test, or PPD test for Purified Protein Derivative) is a diagnostic tool for tuberculosis. It is one of the two major tuberculin skin tests used in the world, largely replacing multiple-puncture tests such as the Tine test. Until 2005, the Heaf test was used in the United Kingdom, but the Mantoux test is now used. The Mantoux test is also used in Australia, Canada, Hungary, The Netherlands, Portugal, South Africa and the United States and is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention (CDC). It was also used in the USSR and is now prevalent in most of the former Soviet states

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The Mantoux skin test consists of an intradermal injection of exactly one tenth of a milliliter (mL) of PPD tuberculin.

 

The size of induration is measured 48–72 hours later. Erythema (redness) should not be measured.
.Tuberculosis is a bacterial infection that most often involves the lungs, but can involve many other organs. Although antibiotics can treat most cases, TB remains one of the most common causes of death worldwide. The TB skin test, also called the purified protein derivative (PPD) test or Mantoux test, shows if you’ve ever been infected with the bacteria that cause tuberculosis. Infections with these bacteria can be active or inactive. In active infections, the bacteria are reproducing rapidly, and the person is contagious when he or she coughs. In people with inactive infections, the bacteria are alive deep within the lungs, but “asleep.” Because inactive infections can later “wake up” and become active, it is important to recognize and treat both types of TB infections.

History:
Tuberculin is a glycerine extract of the tubercule bacilli. Purified protein derivative (PPD) tuberculin is a precipitate of non-species-specific molecules obtained from filtrates of sterilized, concentrated cultures. It was first described by Robert Koch in 1890. The test is named after Charles Mantoux, a French physician who developed on the work of Koch and Clemens von Pirquet to create his test in 1907.

In 1939, M. A. Linnikova in the USSR created a modified version of PPD. In 1954, the Soviet Union started mass production of PPD-L, named after Linnikova.

Procedure:
A standard dose of 5 Tuberculin units (0.1 mL) (The standard Mantoux test in the UK consists of an intradermal injection of 2TU of Statens Serum Institute (SSI) tuberculin RT23 in 0.1ml solution for injection.) is injected intradermally (between the layers of dermis) and read 48 to 72 hours later. A person who has been exposed to the bacteria is expected to mount an immune response in the skin containing the bacterial proteins.

The reaction is read by measuring the diameter of induration (palpable raised hardened area) across the forearm (perpendicular to the long axis) in millimeters. If there is no induration, the result should be recorded as “0 mm”. Erythema (redness) should not be measured.

If a person has had a history of a positive tuberculin skin test, another skin test is not needed

How do you prepare for the test?
Because vaccinations and steroids can affect the results of the test, tell your doctor if you’ve recently been vaccinated for an infectious disease or if you’re taking a steroid medication.

Classification of tuberculin reaction:
The results of this test must be interpreted carefully. The person’s medical risk factors determine at which increment (5 mm, 10 mm, or 15 mm) of induration the result is considered positive.  A positive result indicates TB exposure.

*5 mm or more is positive in

*HIV-positive person

*Recent contacts of TB case

*Persons with nodular or fibrotic changes on chest x-ray consistent with old healed TB

*Patients with organ transplants and other immunosuppressed patients

*10 mm or more is positive in

*Recent arrivals (less than 5 years) from high-prevalence countries

*Injection drug users

*Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)

*Mycobacteriology lab personnel

*Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc)

*Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories

*15 mm or more is positive in

*Persons with no known risk factors for TB

*(Note: Targeted skin testing programs should only be conducted among high-risk groups)

A tuberculin test conversion is defined as an increase of 10 mm or more within a 2-year period, regardless of age.

False positive result:
A false positive result may be caused by nontuberculous mycobacteria or previous administration of BCG vaccine. Prior vaccination with BCG may result in a false-positive result for many years afterwards

BCG vaccine and the Mantoux test:
There is disagreement about the role of Mantoux testing in people who have been vaccinated. The US recommendation is that tuberculin skin testing is not contraindicated for BCG-vaccinated persons and that prior BCG vaccination should not influence the interpretation of the test. The UK recommendation is that interferon-? testing should be used to help interpret positive Mantoux tests, and that serial tuberculin skin testing must not be done in people who have had prior BCG vaccination. Please refer to the chapter on latent tuberculosis for a discussion of the two approaches. In general, the US recommendation results in a much larger number of people being falsely diagnosed with latent tuberculosis, while the UK approach probably misses patients with latent tuberculosis who should be treated.

According to the U. S. guidelines, latent TB infection (LTBI) diagnosis and treatment for LTBI is considered for any BCG-vaccinated person whose skin test is 10 mm or greater, if any of these circumstances are present:

*Was in contact with another person with infectious TB

*Was born or has lived in a high TB prevalence country

*Is continually exposed to populations where TB prevalence is high.

Anergy testing:
In cases of anergy, a lack of reaction by the body’s defence mechanisms when it comes into contact with foreign substances, the tuberculin reaction will occur weakly, thus compromising the value of Mantoux testing. For example, anergy is present in AIDS, a disease which strongly depresses the immune system. Therefore, anergy testing is advised in cases where suspicion is warranted that it is present. However, routine anergy skin testing is not recommended.

Two-step testing:
Some people who were previously infected with TB may have a negative reaction when tested years after infection, as the immune system response may gradually wane. This initial skin test, though negative, may stimulate (boost) the body’s ability to react to tuberculin in future tests. Thus, a positive reaction to a subsequent test may be misinterpreted as a new infection, when in fact it is the result of the boosted reaction to an old infection.

Use two-step testing for initial skin testing of adults who will be retested periodically (e.g., health care workers). This ensures that any future positive tests can be interpreted as being caused by a new infection, rather than simply a reaction to an old infection.

*Return to have first test read 48–72 hours after injection

*If first test is positive, consider the person infected.

*If first test is negative, give second test 1–3 weeks after first injection

*Return to have second test read 48–72 hours after injection

*If second test is positive, consider person previously infected

*If second test is negative, consider person uninfected [6]

A person who is diagnosed as “infected” on two-step testing is called a “tuberculin converter”. The US recommendation that prior BCG-vaccination be ignored results in almost universal false diagnosis of tuberculosis infection in people who have had BCG (mostly foreign nationals). Please refer to the chapter on BCG for a discussion of boosting. The UK guidelines avoid this error

Recent developments:
As a replacement for the Mantoux test, several other tests are being developed. QuantiFERON-TB Gold is a blood test that measures the patient’s immune reactivity to the TB bacteria and is useful for initial and serial testing of persons with an increased risk of latent or active tuberculosis infection. Guidelines for the use of QuantiFERON-TB Gold were released by the CDC in December 2005. QuantiFERON-TB Gold is FDA approved in the United States, has CE Mark approval in Europe and has been approved by the MHLW in Japan.

Heaf Test:
The Heaf test is a tuberculin skin test formerly used in the United Kingdom, but discontinued in 2005.

The equivalent Mantoux test positive levels done with 10 TU (0.1 mL 100 TU/mL, 1:1000) are

*<5 mm induration (Heaf 0-1)

*5-15 mm induration (Heaf 2)

*>15 mm induration (Heaf 3-4)

Risk Factors:There are no risks.

Results:The result is known two to three days later when the skin is examined. If the test is positive, your doctor may do blood or urine tests and x-rays of the chest and possibly other parts of the body to look for evidence of an active infection. If you do not have an active infection, your doctor might prescribe an antibiotic given over several months, to help prevent you from developing active tuberculosis. If you do have an active infection, a much more intensive treatment involving multiple antibiotics is required.

Sources:
https://www.health.harvard.edu/fhg/diagnostics/tb-skin-test.shtml
http://en.wikipedia.org/wiki/Mantoux_test

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