Candida auris

Description:
Candida auris is a species of fungus first described in 2009, which grows as yeast. It is one of the few species of the genus Candida which cause candidiasis in humans. Often, candidiasis is acquired in hospitals by patients with weakened immune systems. C. auris can cause invasive candidiasis (fungemia) in which the bloodstream, the central nervous system, and internal organs are infected. It has recently attracted increased attention because of its multiple drug resistance. Treatment is also complicated because it is easily misidentified as other Candida species. C. auris was first described after it was isolated from the ear canal of a 70-year-old Japanese woman at the Tokyo Metropolitan Geriatric Hospital in Japan in 2009. In 2011 South Korea saw its first cases of disease-causing C. auris. Reportedly, this spread across Asia and Europe, and first appeared in the U.S. in 2013. DNA analysis of four distinct but drug-resistant strains of Candida auris indicate an evolutionary divergence taking place at least 4,000 years ago, with a common leap among the four varieties into drug-resistance possibly linked to widespread azole-type antifungal use in agriculture.

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Candida auris is an emerging fungus that presents a serious global health threat. Healthcare facilities in several countries have reported that C. auris has caused severe illness in hospitalized patients. Some strains of Candida auris are resistant to all three major classes of antifungal drugs. This type of multidrug resistance has not been seen before in other species of Candida.

Symptoms:
This is where things get a little tricky. The most common symptoms are a fever and chills that don’t get better with antibiotic treatment, the CDC says. But, given that people who develop the infection usually have another underlying illness, it can be tough to spot Candida auris from symptoms alone.

Once it takes hold, the fungal infection can get into a person’s bloodstream or wounds and cause serious health issues like sepsis. “A patient’s temperature may go up, their blood pressure can go down, and they have complications of a preexisting illness because of Candida auris,” Dr. Schaffner says. The fungal infection has a high mortality rate (more than one in three patients with invasive Candida auris die, according to CDC data), but it’s tricky for doctors to say whether a person died from the fungal infection or their underlying illness. “Whatever the cause, having Candida auris doesn’t help a patient in any way,” Dr. Schaffner says.

Causes:
C. auris has caused bloodstream infections, wound infections, and ear infections. It also has been isolated from respiratory and urine specimens, but it is unclear if it causes infections in the lung or bladder.

Diagnosis:
C. auris is difficult to identify with standard laboratory methods and can be misidentified in labs without specific technology.

Healthcare facilities in several countries have reported that C. auris has been causing severe illness in hospitalized patients. In some patients, this yeast can enter the bloodstream and spread throughout the body, causing serious invasive infections. This yeast often does not respond to commonly used antifungal drugs, making infections difficult to treat. Patients who have been in the intensive care unit for a long time or have a central venous catheter placed in a large vein, and have previously received antibiotics or antifungal medications, appear to be at highest risk of infection with this yeast.

Specialized laboratory methods are needed to accurately identify C. auris. Conventional lab techniques could lead to misidentification and inappropriate treatment, making it difficult to control the spread of C. auris in healthcare settings.

CDC is concerned about C. auris for three main reasons:

1.It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections.

2.It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.

3.It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify C. auris in a hospitalized patient so that healthcare facilities can take special precautions to stop its spread.

Prevention:
In general, it comes down to “meticulous infection control,” Dr. Adalja says. That means that hospital and nursing home rooms need to be well cleaned and that people interacting with patients need to practice good hand hygiene, which will kill the infection. “There’s no other way to prevent it,” Dr. Adalja says.

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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:
https://en.wikipedia.org/wiki/Candida_auris
https://www.cdc.gov/fungal/candida-auris/index.html
https://www.medicinenet.com/candida_auris_c_auris/article.htm#candida_auris_c_auris_facts
https://www.prevention.com/health/health-conditions/a27074966/superbug-fungus-candida-auris-symptoms/

Knee Pain

Description:

Knee pain is a complaint of many people of all ages but most common with old aged ones. Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments, tendons, and cartilage (meniscus) of the knee. Knee pain can be aggravated by physical activity, as well as obesity, affected by the surrounding muscles and their movements, and be triggered by other problems (such as a foot injury). Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe. Medical conditions — including arthritis, gout and infections — also can cause knee pain.

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Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. But in some cases, however, it needs surgical repair.

Symptoms:
Signs and symptoms of knee pain include:

1.Swelling and stiffness

2.Redness and warmth to the touch

3.Weakness or instability

4.Popping or crunching noises

4.Inability to fully straighten the knee

5.Limping when walking.

6.Pain on knees at the time of walking

Causes:
Knee pain can be divided into three major categories:

  1. Acute injury: such as a broken bone, torn ligament, or meniscal tear
  2. Medical conditions: rheumatoid arthritis, osteoarthritis, infections
  3. Chronic use/overuse conditions: osteoarthritis, chondromalacia, IT band syndrome, patellar syndromes, tendinitis, and bursitis

1.Acute injury:

Some common acute injuries are:

A) ACL injury. An ACL injury is a tear of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.

B) Fractures. The bones of the knee, including the kneecap (patella), can be broken during motor vehicle collisions or falls. People whose bones have been weakened by osteoporosis can sometimes sustain a knee fracture simply by stepping wrong.

C) Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.

D) Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.

E) Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities may develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

2.Medical conditions:

Some common medical conditions are:

A) Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a pencil caught in a door hinge.

B) Iliotibial band syndrome. This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners and cyclists are especially susceptible to iliotibial band syndrome.

C) Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. In some cases, the kneecap may stay displaced and you’ll be able to see the dislocation.

D) Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can place more stress on your knee joint. In some cases, problems in the hip or foot can cause knee pain.:

Arthritis:

Types of arthritis:

More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

A) Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.

B) Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.

C) Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.

D) Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.

E) Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. Septic arthritis often occurs with a fever, and there’s usually no trauma before the onset of pain. Septic arthritis can quickly cause extensive damage to the knee cartilage. If you have knee pain with any of these symptoms, see your doctor right away.

Other Factors:
Patellofemoral pain syndrome is a general term that refers to pain arising between the kneecap (patella) and the underlying thighbone (femur). It’s common in athletes; in young adults, especially those who have a slight maltracking of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

Complications:
Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you’ll have similar injuries in the future.

Diagnosis:
During the physical exam, the doctor is likely to Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
Check to see how far you can move your lower leg in different directions
Push on or pull the joint to evaluate the integrity of the structures in your knee

Imaging tests
In some cases, your doctor might suggest tests such as:

X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.

Computerized tomography (CT) scan. CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of your body.
CT scans can help diagnose bone problems and subtle fractures. A special kind of CT scan can accurately identify gout even when the joint is not inflamed.

Ultrasound. This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee. Your doctor may want to move your knee into different positions during the ultrasound to check for specific problems.

Magnetic resonance imaging (MRI): An MRI uses radio waves and a powerful magnet to create 3D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.

Lab tests:
If your doctor suspects an infection or inflammation, you’re likely to have blood tests and sometimes a procedure called arthrocentesis, in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

Treatment:
Treatments will vary, depending upon what exactly is causing your knee pain.

Medications:
Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.

Tyherapy:
Strengthening the muscles around your knee will make it more stable. Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is causing your pain.

If you are physically active or practice a sport, you may need exercises to correct movement patterns that may be affecting your knees and to establish good technique during your sport or activity. Exercises to improve your flexibility and balance also are important.

Arch supports, sometimes with wedges on one side of the heel, can help to shift pressure away from the side of the knee most affected by osteoarthritis. In certain conditions, different types of braces may be used to help protect and support the knee joint.

Injections:
In some cases, your doctor may suggest injecting medications or other substances directly into your joint. Examples include:

Corticosteroids. Injections of a corticosteroid drug into your knee joint may help reduce the symptoms of an arthritis flare and provide pain relief that may last a few months. These injections aren’t effective in all cases.

Hyaluronic acid. A thick fluid, similar to the fluid that naturally lubricates joints, hyaluronic acid can be injected into your knee to improve mobility and ease pain. Although study results have been mixed about the effectiveness of this treatment, relief from one or a series of shots may last as long as six months.

Platelet-rich plasma (PRP). PRP contains a concentration of many different growth factors that appear to reduce inflammation and promote healing. These types of injections tend to work better in people whose knee pain is caused by tendon tears, sprains or injury.

Surgery:
If you have an injury that may require surgery, it’s usually not necessary to have the operation immediately. Before making any decision, consider the pros and cons of both nonsurgical rehabilitation and surgical reconstruction in relation to what’s most important to you. If you choose to have surgery, your options may include:

Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage (especially if it is causing your knee to lock), and reconstruct torn ligaments.

Partial knee replacement surgery. In this procedure, your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed through small incisions, so you’re likely to heal more quickly than you are with surgery to replace your entire knee.

Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

Lifestyle and home remedies:
Over-the-counter medications — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may help ease knee pain. Some people find relief by rubbing the affected knee with creams containing a numbing agent, such as lidocaine, or capsaicin, the substance that makes chili peppers hot.

Self-care measures for an injured knee include:

Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time.

Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don’t use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin.

Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee.


Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that’s lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.

Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner.
Alternative medicine

Glucosamine and chondroitin. Study results have been mixed about the effectiveness of these supplements for relieving osteoarthritis pain.

Acupuncture. Research suggests that acupuncture may help relieve knee pain caused by osteoarthritis. Acupuncture involves the placement of hair-thin needles into your skin at specific places on your body.

Yoga: Regular yoga exercises for knee pain and meditation.

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:
https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849
https://www.medicinenet.com/knee_pain_facts/article.htm#what_causes_knee_pain_continued

Star apple

Botanical Name: Chrysophyllum cainito
Family: Sapotaceae
Genus: Chrysophyllum
Species:C. cainito
Kingdom: Plantae
Order: Ericales

Synonym : Achras cainito.

Common Names: Cainito, Caimito, tar apple, star apple, purple star apple, golden leaf tree, abiaba, pomme de lait, estrella, milk fruit and aguay.

Other names: Star apple is known in Vietnam Vú S?a (literally: milky breast/nipples). In Malayalam it is called “Swarnapathry” meaning ‘[the tree with] golden leaves’. In Cambodia, this fruit is called “Plae Teuk Dos” which means milk fruit due to its milky juices inside.

Habitat: Star apple is native to the Greater Antilles and the West Indies. It has spread to the lowlands of Central America and is now grown throughout the tropics.

Description:
Star apple is a tropical tree. It grows rapidly and reaches 20 m in height.The leaves are evergreen, alternate, simple oval, entire, 5–15 cm long; the underside shines with a golden color when seen from a distance. Its trunk is usually straight, cylindrical, but often fluted or spurred at the base; buttresses are small or absent; bark surface is rough, irregularly fissured, and brown and exude white gummy latex. Young twigs are reddish-brown and pubescent.The tree is also hermaphroditic (self-fertile). It produces a strong odor.

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The tiny flowers are purplish white and have a sweet fragrant smell. Flowers are bisexual, fasciculate with 5–35 clustered, small and inconspicuous, yellowish-white flowers. Calyx is 5-lobed; lobes are ovate with obtuse to rounded apex and hairy within. Corolla is 5-lobed with ovate and glabrous lobes. Stamens are 5 along with deltoid filaments and ovoid anthers.

The fruit is globose and typically measures from 2 to 3 inches in diameter. When ripe, it usually has purple-skinned with a faint green area appearing around the calyx. A radiating star pattern is visible in the pulp. Greenish-white and yellow-fruited cultivars are sometimes available. The skin is rich in latex, and both it and the rind are not edible. The flattened seeds are light brown and hard. It is a seasonal fruit bearing tree.The fruit also exists in three colors, dark purple, greenish brown and yellow. The purple fruit has a denser skin and texture while the greenish brown fruit has a thin skin and a more liquid pulp; the yellow variety is less common and difficult to find.

Edible Uses:
The fruits are used as a fresh dessert fruit; it is sweet and often served chilled.

Medicinal Uses:
Infusions of the leaves have been used against diabetes and articular rheumatism. The fruit has antioxidant properties. The bark is considered a tonic and stimulant, and a bark decoction is used as an antitussive.

Star Apple offers 5 percent of the daily recommended values of important vitamins, such as vitamin C and vitamin A. It is a wonderful source of calcium, providing you with 10 percent of the daily recommended value of the mineral. The consumption of calcium-rich foods, such as star apple, helps strengthen bones and teeth and also reduce the symptoms of premenstrual syndrome such as abdominal bloating and cramps. Apple star is rich in phosphorus, another mineral bone healthy. So now check out few health benefits of Apple Star for Health.

Star apple is a wonderful source of dietary fiber and thus the fruit is able to keep your digestive system in good health.Another important benefit of star apple is that it helps control sugar levels in the blood and thus is an ideal food for people suffering from diabetes. It was found that the star apple fiber helps keep the blood sugar under control.

Star apple is a fruit having low fat and calories, the star apple is one of the best food choices to include in a weight loss diet.

In fruit, other plant parts such as seeds, leaves and bark are also used as natural remedies for the treatment of various diseases. The cooking of the leaves or bark is used in the Philippines to treat dysentery and diarrhea. According to a survey, the shell of the star apple tree has traditionally been used to treat malaria and yellow fever. The leaves have emollient properties and are used for the treatment of stomach pain, diarrhea and skin rash. In Western Nigeria, the cotyledons of the star apple seeds are used for the preparation of ointments for treatment of vaginal and skin infections.

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/Chrysophyllum_cainito
https://www.healthbenefitstimes.com/star-apple/

Tantrum

Other Names: Temper tantrum and Hissy fit

Definition:
A tantrum is an emotional outburst, usually associated with those in emotional distress, that is typically characterized by stubbornness, crying, screaming, violence, defiance, angry ranting, a resistance to attempts at pacification, and, in some cases, hitting, and other physically violent behavior. Physical control may be lost; the person may be unable to remain still; and even if the “goal” of the person is met, he or she may not be calmed. A tantrum may be expressed in a tirade: a protracted, angry speech.

In tantrum children throw, shout, scream, roll on the ground, kick and beat — when their demands, often unreasonable, are not met. Most of these outbursts occur between the ages of one and three years. Thereafter, they slowly subside in normal children.

Tantrums are usually signs of frustration. They can occur when the child is hungry, in pain, sleepy or denied something. Children who are mentally challenged or have autism are more likely to throw tantrums. They are unable to articulate their problem. Taking care of the immediate need or distracting the child usually works.

Problems arise when others interfere. The child very soon figures out that by screaming and rolling on the floor they can get their way.

Children grow out of tantrums when they go to school. If a child continues this behaviour of biting, kicking or throwing things in school, in front of strangers and in public, it is no longer normal. If it continues into middle school, medical evaluation is required. It may be due to unrecognised ADHD, anxiety or depression.

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Causes:
Tantrums are one of the most common forms of problematic behavior in young children, but tend to decrease in frequency and intensity as the child grows older. For the toddler, tantrums can be considered as normal, even as gauges of a developing strength of character.

While tantrums are sometimes seen as a predictor of future anti-social behaviour, in another sense they are simply an age-appropriate sign of excessive frustration, and will diminish over time given a calm and consistent handling. Parental containment where a child cannot contain itself—rather than what the child is ostensibly demanding—may be what is really required.

Selma Fraiberg warned against “too much pressure or forceful methods of control from the outside” in child-rearing: “if we turn every instance of pants changing, treasure hunting, napping, puddle wading and garbage distribution into a governmental crisis we can easily bring on fierce defiance, tantrums, and all the fireworks of revolt in the nursery”.

Intellectual disabilites:
Some people who have psychiatric disorders such as autism, ADHD, and intellectual disability could be more vulnerable to tantrums than others, although anyone experiencing brain damage (temporary or permanent) can suffer from tantrums. Anyone may be prone to tantrums once in a while, regardless of gender or age. However, a meltdown due to sensory overload (which even neurotypical children can experience) is not the same as a temper tantrum.

Aberrations:
Freud considered that the Wolf Man’s development of temper tantrums was connected with his seduction by his sister: he became “discontented, irritable and violent, took offence on every possible occasion, and then flew into a rage and screamed like a savage”. Freud linked the tantrums to an unconscious need for punishment driven by feelings of guilt—something which he thought could be generalised to many other cases of childhood tantrums.

Heinz Kohut contended that tantrums were narcissistic rages, caused by the thwarting of the infant’s grandiose-exhibitionist core. The blow to the inflated self-image, when a child’s wishes are (however justifiably) refused, creates fury because it strikes at the feeling of omnipotence.

Jealousy over the birth of a sibling, and resulting aggression, may also provoke negativistic tantrums, as the effort at controlling the feelings overloads the child’s system of self-regulation.

Solutions:
If there is no medical reason for the tantrum, and it is not due to an epileptic seizure, these personality traits need to be tackled. Beating the child or shouting is not an answer. A “time out” with the premise that the problems will be tackled later on works with older children. With younger ones, discipline needs to be enforced. A firm “no” should remain just that — a “no”. Once it is changed to a “yes”, the child gets confused and soon figures out that there is a higher court of appeal. Structured sports activities and training in martial arts give a child mental discipline, emotional control, physical endurance and channels aggression.

As children grow, they realise the difference between appropriate and inappropriate anger. Parents have a great deal to do with this, showing the child the limits enforced by society. Physically abusive or alcoholic fathers tend to raise similar children.

Anger is not always bad, it can also be good. It activates the body’s natural defences to a dangerous situation, releasing chemicals that raise the heart rate and blood pressure. The muscles become tense and sweating may occur.

Some adults have not matured enough to realise that anger is a negative emotion. They are chronically angry. It may eventually result in “intermittent explosive disorder” when the reaction is out of proportion to the precipitating event. These episodes of increased energy, racing thoughts and palpitations result in tirades and heated arguments. Society does not accept such behaviour. It may result in the loss of a job and a breakdown in personal relationships. It may lead to alcohol or drug abuse and self-harm. Chronic anger over a long time can result in depression.

To manage anger, lead a disciplined life with regular physical activity, yoga and meditation. If these do not work, professional help may be required. Medication like antidepressants may also help.

We need to rule our mind and control it. This has to be learnt from a young age. Otherwise, we are at the mercy of the caprices of our emotions.

Help to prevent tantrum in children:

Try to prevent tantrums from happening in the first place, whenever possible. Here are some ideas that may help:

  1. Give plenty of positive attention.: Get in the habit of catching your child being good. Reward your little one with praise and attention for positive behavior.

2.Try to give toddlers some control over little things.: Offer minor choices such as “Do you want orange juice or apple juice?” or “Do you want to brush your teeth before or after taking a bath?” This way, you aren’t asking “Do you want to brush your teeth now?” — which inevitably will be answered “no.”

  1. Keep off-limits objects out of sight and out of reach.: This makes struggles less likely. Obviously, this isn’t always possible, especially outside of the home where the environment can’t be controlled.

4.Distract your child.: Take advantage of your little one’s short attention span by offering something else in place of what they can’t have. Start a new activity to replace the frustrating or forbidden one. Or simply change the environment. Take your toddler outside or inside or move to a different room.

5.Help kids learn new skills and succeed.: Help kids learn to do things. Praise them to help them feel proud of what they can do. Also, start with something simple before moving on to more challenging tasks.

5.Consider the request carefully when your child wants something.: Is it outrageous? Maybe it isn’t. Choose your battles.
Know your child’s limits. If you know your toddler is tired, it’s not the best time to go grocery shopping or try to squeeze in one more errand.

Resources:
https://en.wikipedia.org/wiki/Tantrum
https://kidshealth.org/en/parents/tantrums.html
https://www.telegraphindia.com/health/how-to-manage-temper-tantrums/cid/1689765?ref=health_health-page

Mullaca

Botanical Name : Physalis angulata
Family: Solanaceae
Kingdom: Plantae
Order: Solanales
Genus: Physalis
Species: P. angulata

Synonyms: Physalis capsicifolia, Physalis lanceifolia, Physalis ramosissima.

Common Names: English common names include: angular winter cherry, balloon cherry, cutleaf groundcherry, gooseberry, hogweed, wild tomato, camapu, and occasionally other common names for the genus Physalis.In Malayalam it is known as njottanjodiyan and mottaampuli.

Alternative Names:
Bolsa Mullaca, Battre-Autour, Camapu, Cape Gooseberry, Capulí Cimarrón, Cecendet, Dumadu Harachan, Hog Weed, Juá-De-Capote, Mullaca, Nvovo, Polopa, Saca-Buche, Topatop, Thongtheng, Tino-Tino, Urmoa Batoto Bita, Wapotok.

Habitat : . It is native to the Americas, but is now widely distributed and naturalized in tropical and subtropical regions worldwide

Description:
Mullaca or Physalis angulata is an erect, herbaceous, annual plant belonging to the nightshade family Solanaceae. It reproduces by seed. Its leaves are dark green and roughly oval, often with tooth shapes around the edge. The flowers are five-sided and pale yellow; the yellow-orange fruits are born inside a balloon-like calyx. It is native to the Americas, but is now widely distributed and naturalized in tropical and subtropical regions worldwide.

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MULLACA PLANT

Medicinal Used of Mullaca Power:
It is helpful in the treatment of arthritis. • Use of mullaca powder is believed to help patients having gout. • Physalis angulata is also believed to have diuretic effects. Therefore, it is also used for the treatment of conditions pertaining to bladder and kidney. • It is also used as a blood thinner. • It is considered an immunity booster. • Mullaca is believed to have anti-bacterial and anti-viral effects. • Spasms are often treated with the use of mullaca powder.

TRIBAL AND HERBAL MEDICINE USES:
Mullaca has long held a place in natural medicine in the tropical countries where it grows. Its use by rainforest Indians in the Amazon is well documented, and its edible sweet-tart fruits are enjoyed by many rainforest inhabitants, animal and human alike. Indigenous tribes in the Amazon use a leaf infusion as a diuretic. Some Colombian tribes believe the fruits and leaves have narcotic properties and also decoct them as an anti-inflammatory and disinfectant for skin diseases; others use a leaf tea for asthma. Indigenous peoples in the Peruvian Amazon use the leaf juice internally and externally for worms and the leaves and/or roots for earache, liver problems, malaria, hepatitis, and rheumatism. Indigenous tribes in the Brazilian Amazon use the sap of the plant for earaches and the roots for jaundice. Mullaca has also been used by indigenous peoples for female disorders. In the Solomon Islands, the fruit of mullaca is decocted and taken internally to promote fertility. A tea is made of the entire plant and/or the leaves in the West Indies and Jamaica to prevent miscarriages. In Peru the leaf is infused and used to treat postpartum infections.

Mullaca is employed in herbal medicine systems today in both Peru and Brazil. In Peruvian herbal medicine the plant is called mullaca or bolsa mullaca. To treat diabetes, the roots of three mullaca plants are sliced and macerated in 1/4 liter of rum for seven days. Honey is added, and 1/2 glass of this medicine is taken twice daily for 60 days. In addition, an infusion of the leaves is recommended as a good diuretic, and an infusion of the roots is used to treat hepatitis. For asthma and malaria, the dosage is 1 cup of tea made from the aerial parts of the plant. In Brazilian herbal medicine the plant is employed for chronic rheumatism, for skin diseases and dermatitis, as a sedative and diuretic, for fever and vomiting, and for many types of kidney, liver, and gallbladder problems.

PLANT CHEMICALS:
Phytochemical studies on mullaca reveal that it contains many types of biologically active, naturally occurring chemicals including flavonoids, alkaloids, and many different types of plant steroids, some of which have never before been seen in science. Mullaca has been the subject of recent clinical research (which is still ongoing), based on the preliminary studies showing that it is an effective immune stimulant, is toxic to numerous types of cancer and leukemia cells, and that it has antimicrobial properties. The new steroids found in mullaca have received the most attention, and many of the documented anti-cancerous, anti-tumorous and anti-leukemic actions are attributed to these steroids.

Various extracts of mullaca, as well as these extracted plant steroids called physalins, have shown strong in vitro and in vivo (mice) activity against numerous types of human and animal cancer cells including lung, colon, nasopharynx, liver, cervix, melanoma and glioma (brain) cancer cells. This cancer research began in the early 1980s with researchers in Thailand and the U.S. and was verified with research performed at the University of Taiwan in 1992 (where they demonstrated a significant effect against five human cancer cell lines and three animal cancer cell lines). Then in 2001, researchers at the University of Houston isolated yet another new chemical in mullaca which demonstrated remarkable toxicity against nasopharynx cancer cells, lung (adenocarcinoma) cancer cells as well as leukemia in mice. The same Taiwanese researchers had already published a separate study on mullaca’s other anti-leukemic phytochemicals in 1992, reporting that two physalin chemicals inhibited the growth of five types of acute leukemia, including lymphoid (T & B), promyelocytic, myeloid and monocytic.

Other researchers in China and Russia independently demonstrated significant immunomodulatory effects against blastogenesis (a process triggered in leukemia) while boosting other immune functions which might account for the anti-leukemic effects in mice seen by other researchers. With tumor cells, research suggests that several of the steroidal chemicals in mullaca act on an enzyme level to arrest the normal cell cycle in cancer cells as well as cause DNA damage inside of cancer cells (making them unable to replicate).

The main plant chemicals isolated in mullaca thus far include: ayanin, chlorogenic acid, choline, ixocarpanolide, myricetin, phygrine, physagulin A thru G, physalin A thru K, physangulide, sitosterol, vamonolide, withaminimin, withangulatin A, withanolide D, withanolide T, and withaphysanolide.

BIOLOGICAL ACTIVITIES AND CLINICAL RESEARCH:

In addition to mullaca’s anticancerous and antileukemic actions, several research groups have confirmed mullaca’s antibacterial and antiviral activity. Most recently in 2002 and 2000, mullaca was shown to be active in vitro against several strains of mycobacteriums and mycoplasmas (both very stubborn types of bacteria which are not widely susceptible to standard antibiotics). In addition to these actions, mullaca has demonstrated effective antibacterial properties in vitro against numerous types of gram positive and gram negative bacteria, including Pseudomonas, Staphylococcus and Streptococcus. Other research groups in Japan have been focusing on mullaca’s antiviral actions and preliminary studies show that it is active in vitro against Polio virus I, Herpes simplex virus I, the measles virus, and HIV-I – demonstrating reverse transcriptase inhibitory effects.

Mullaca has also been reported to reduce spasms in guinea pigs, lower blood pressure in cats and to contract isotonic muscles in toads. In the test tube, mullaca was shown to have an anticoagulant effect. Western scientists did somewhat validate the indigenous use for diabetes when they reported a mild hypoglycemic effect in mice fed a water extract of the root. One must wonder what the results would have been if they had followed native customs and employed an alcohol extract instead.

CURRENT PRACTICAL USES:
Interestingly enough, much of the clinical research has ignored the local and indigenous uses of the plant; thus, many of its effective uses in herbal medicine remain unexplained. Its tested antibacterial properties could validate its use as a antiseptic and disinfectant for skin diseases and its use to treat gonorrhea. Its antiviral properties could well explain its long history of use for hepatitis, although scientists have not tested it specifically against hepatitis. Possibly the antispasmodic and muscle contractive properties documented for mullaca might explain its widespread use for asthma and female disorders as well. Yet its widespread use throughout the rainforests for malaria and fevers remains unexplained by science.

Herbal practitioners in both South and North America today rely on mullaca for various bacterial and viral infections as well as a complementary therapy for cancer and leukemia. Although not widely available here in the U.S., it is found as an ingredient in various herbal formulas and in bulk supplies. The animal studies conducted to date indicate no toxicity at any of the dosages used indicating that is a safe natural remedy.

Precautions:
Nothing can be said about the safety of Physalis angulata (Mullaca) due to the shortage of reliable information. Lactation and Pregnancy – Nursing and pregnant females should avoid the use of mullaca powder because there is lack of information that could support the safety of use of this herb during lactation or pregnancy.

Side Effects :
The herbalists from both North and South America depend on the use of mullaca powder for the preparation of a number of anti-viral, anti-bacterial and a wide variety of complementary medicines used for the treatment of cancers and leukemia. Although pure isolated Physalis angulata is not very easily available in the US, but still it is found as a component of countless herbal preparations. Generally it is considered very safe and no serious side effects have been reported so far with the use of mullaca containing products.

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/Physalis_angulata
http://www.amazondiscovery.com/products/mullaca-powder/
http://www.rain-tree.com/mullaca.htm