Tag Archives: Begonia

Vinca minor

Botanical Name: Vinca minor
Family: Apocynaceae
Genus: Vinca
Species: V. minor
Kingdom: Plantae
Order: Gentianales

Synonyms: Pervinca heterophyla. Pervinca minor. Pervinca procumbens. Vinca acutiflora . Vinca ellipticifolia.

Common Names: Lesser Periwinkle, Flower of Death, English Holly, Creeping Myrtle, Creeping Vinca, Common Periwink, Lesser periwinkle or Dwarf periwinkle

Other vernacular names: Small periwinkle, and Sometimes in the United States, Myrtle or Creeping myrtle

Habitat :Vinca minor is native to central and southern Europe, from Portugal and France north to the Netherlands and the Baltic States, east to the Caucasus, and also southwestern Asia in Turkey. It grows in fields, woodland edges, copses and hedgerows. Ash and oak-hornbeam woods on better soils in central Europe
Description:
Vinca minor is a trailing, viny subshrub, spreading along the ground and rooting along the stems to form large clonal colonies and occasionally scrambling up to 40 centimetres (16 in) high but never twining or climbing. The leaves are evergreen, opposite, 2–4.5 centimetres (0.79–1.77 in) long and 1–2.5 centimetres (0.39–0.98 in) broad, glossy dark green with a leathery texture and an entire margin….CLICK & SEE THE PICTURES

The flowers are solitary in the leaf axils and are produced mainly from early spring to mid summer but with a few flowers still produced into the autumn; they are violet-purple (pale purple or white in some cultivated selections), 2–3 centimetres (0.79–1.18 in) diameter, with a five-lobed corolla. The flowers of the garden periwinkle are the inspiration of the lavender blue color name periwinkle, and this viny shrub is a popular and attractive ground cover with numerous cultivars,flower colours and variegated foliage.

The closely related species Vinca major is similar, but larger in all parts, and also has relatively broader leaves with a hairy margin.
The color name periwinkle is derived from the flower.

Cultivation:
Vinca minor  is  a very easily grown plant, it succeeds in almost any soil but prefers those that are on the richer side. It grows well in heavy clay soils. Plants are very shade tolerant but they do not flower so well in deep shade. It grows well under deciduous trees, and in such a position it can succeed in dry soils. Established plants are drought tolerant. A very ornamental and polymorphic plant, there are some named forms selected for their ornamental value. Members of this genus are rarely if ever troubled by browsing deer or rabbits. This species rarely if ever sets seed in Britain. It spreads rapidly by long trailing and rooting stems once it is established and will swamp out smaller plants. Special Features:Attractive foliage, Not North American native, Naturalizing, Attractive flowers or blooms.

Propagation:
Seed – we have no information on this species but suggest sowing the seed in a cold frame as soon as it is ripe if possible. Sow stored seed in late winter in a cold frame. When they are large enough to handle, prick the seedlings out into individual pots and grow them on in the greenhouse for their first winter. Plant them out into their permanent positions in late spring or early summer, after the last expected frosts. Division in spring just before active growth commences, or in autumn. Larger divisions can be planted out direct into their permanent positions. We have found that it is best to pot up smaller divisions and grow them on in light shade in a greenhouse or cold frame until they are growing away well. Plant them out in the summer or the following spring. Cuttings of mature wood of the current seasons growth, 5 – 10 cm long, October in a cold frame. Roots quickly. High percentage

Chemical constituents:
Vinca minor contains more than 50 alkaloids, and vincamine is the molecule responsible for Vinca’s nootropic activity. Other alkaloids include reserpine, reserpinine, akuammicine, majdine, vinerine, ervine, vineridine, tombozine, vincamajine, vincanine, vincanidine, vincamone, apovincamine, vincaminol, desoxyvincaminol, vincorine and perivincine.

Vinpocetine (brand names: Cavinton, Intelectol; chemical name: ethyl apovincaminate) is a semisynthetic derivative alkaloid of vincamine.

Medicinal Uses:
Antispasmodic; Astringent; Bitter; Detergent; Homeopathy; Hypotensive; Sedative; Stomachic; Tonic.

The plant is sedative and tonic. It contains the alkaloid ‘vincamine’, which is used by the pharmaceutical industry as a cerebral stimulant and vasodilator. Since the discovery of vincamine in the leaves, the plant has been used herbally to treat arteriosclerosis and for dementia due to insufficient blood supply to the brain. The leaves are bitter, detergent and stomachic. Taken internally, they are used in the treatment of internal bleeding, heavy menstrual bleeding and nosebleeds. When crushed and applied to wounds they have astringent and healing properties. A mouthwash is used to treat gingivitis, sore throats and mouth ulcers. The leaves are gathered in the spring and dried for later use. The root is antispasmodic and hypotensive. It is used to lower the blood pressure. The root is gathered in the autumn and dried for later use. The fresh flowers are gently purgative, but lose their effect on drying. A homeopathic remedy is made from the fresh leaves. It is used in the treatment of haemorrhages.

This plant is an excellent all round astringent which can be used internally or externally.  Its most common internal use is for treating excess menstrual flow.  It is useful as a douche for treating vaginal infection.  It is used for digestive problems such as inflammation of the colon or diarrhea.  The astringent action is also used in cases of nose bleed, bleeding gums, mouth ulcers and as a gargle for sore throats. Chewing the plant relieves toothache.  The tea is sedative and is beneficial for hysteria, fits, and nervous states.  Use two teaspoons per cup, steep for 20 minutes, and take a quarter-cup doses four times a day.  Make a poultice of the herb to relieve cramps in the limbs. The leaves are used in slaves for hemorrhoids and inflammations.  Use the tea as a gargle for sore throat and tonsillitis.  The fresh flowers are made into a syrup laxative, which is excellent for small children as well as adults.  To make a syrup, boil three pounds of Sucanat in one pint of water until you get a syrup consistency, and then steep the herbs in the hot liquid for 20 minutes, or simmer the herbs in honey or maple syrup for about 10 minutes, strain, and store in the refrigerator.  It combines well with Agrimony for astringent action to treat the digestive system and skin conditions.

Other Uses:
Landscape Uses:Border, Container, Erosion control, Ground cover, Massing, Specimen.  The stems are used in basket making. A very good ground cover for covering steep banks and shady places, spreading rapidly once established and forming a dense cover within 2 years. It is less dense on dry or exposed sites. Plants are best spaced about 60cm apart each way.

Social beliefs: Venus owns this herb, and saith, That the leaves eaten by man and wife together, cause love between them. The Periwinkle is a great binder, stays bleeding both at mouth and nose, if some of the leaves be chewed. The French used it to stay women’s courses. Dioscorides, Galen, and Agineta, commend it against the lasks and fluxes of the belly to be drank in wine.
Known Hazards: Large quantities of the plant are poisonous

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/Vinca_minor
http://www.anniesremedy.com/herb_detail492.php
http://www.pfaf.org/user/Plant.aspx?LatinName=Vinca+minor

http://www.herbnet.com/Herb%20Uses_OPQ.htm

Digitalis purpurea

Botanical Name: Digitalis purpurea
Family: Plantaginaceae
Genus: Digitalis
Species: D. purpurea
Kingdom: Plantae
Order: Lamiales

Synonyms: Witches’ Gloves. Dead Men’s Bells. Fairy’s Glove. Gloves of Our Lady. Bloody Fingers. Virgin’s Glove. Fairy Caps. Folk’s Glove. Fairy Thimbles.
(Norwegian) Revbielde.
(German) Fingerhut.

Common Names: Foxglove, Common foxglove, Purple foxglove or Lady’s glove

Habitat: Digitalis purpurea is native and widespread throughout most of temperate Europe. It is also naturalised in parts of North America and some other temperate regions. The plants are well known as the original source of the heart medicine digoxin (also called digitalis or digitalin) It flourishes best in siliceous soil and grows well in loam, but is entirely absent from some calcareous districts, such as the chain of the Jura, and is also not found in the Swiss Alps. It occurs in Madeira and the Azores, but is, perhaps, introduced there. The genus contains only this one indigenous species, though several are found on the Continent.

Needing little soil, it is found often in the crevices of granite walls, as well as in dry hilly pastures, rocky places and by roadsides. Seedling Foxgloves spring up rapidly from recently-turned earth. Turner (1548), says that it grows round rabbitholes freely.
Description:
Digitalis purpurea is an herbaceous biennial or short-lived perennial plant. The leaves are spirally arranged, simple, 10–35 cm long and 5–12 cm broad, and are covered with gray-white pubescent and glandular hairs, imparting a woolly texture. The foliage forms a tight rosette at ground level in the first year.

The flowering stem develops in the second year, typically 1 to 2 m tall, sometimes longer. The flowers are arranged in a showy, terminal, elongated cluster, and each flower is tubular and pendent. The flowers are typically purple, but some plants, especially those under cultivation, may be pink, rose, yellow, or white. The inside surface of the flower tube is heavily spotted. The flowering period is early summer, sometimes with additional flower stems developing later in the season. The plant is frequented by bees, which climb right inside the flower tube to gain the nectar within….….click & see the pictures

The fruit is a capsule which splits open at maturity to release the numerous tiny (0.1-0.2 mm) seeds.

Cultivation:
The plant is popular as a garden subject, and numerous cultivars have been developed with a range of colours from white through pink to purple, such as “Dalmatian Purple”. Cultivated forms often show flowers completely surrounding the central spike, in contrast to the wild form, where the flowers only appear on one side. D. purpurea is easily grown from seed or purchased as potted plants in the spring.

Propagation: Seed – surface sow early spring in a cold frame. The seed usually germinates in 2 – 4 weeks at 20°c[175]. When they are large enough to handle, prick the seedlings out into individual pots and plant them out in the summer. If you have sufficient seed it can be sown outdoors in situ in the spring or autumn

Part Used in medicines: The Leaves.
Medicinal Uses:
Digitalis has been used from early times in heart cases. It increases the activity of all forms of muscle tissue, but more especially that of the heart and arterioles, the all-important property of the drug being its action on the circulation. The first consequence of its absorption is a contraction of the heart and arteries, causing a very high rise in the blood pressure.

After the taking of a moderate dose, the pulse is markedly slowed. Digitalis also causes an irregular pulse to become regular. Added to the greater force of cardiac contraction is a permanent tonic contraction of the organ, so that its internal capacity is reduced, which is a beneficial effect in cases of cardiac dilatation, and it improves the nutrition of the heart by increasing the amount of blood.

In ordinary conditions it takes about twelve hours or more before its effects on the heart muscle is appreciated, and it must thus always be combined with other remedies to tide the patient over this period and never prescribed in large doses at first, as some patients are unable to take it, the drug being apt to cause considerable digestive disturbances, varying in different cases. This action is probably due to the Digitonin, an undesirable constituent.

The action of the drug on the kidneys is of importance only second to its action on the circulation. In small or moderate doses, it is a powerful diuretic and a valuable remedy in dropsy, especially when this is connected with affections of the heart.

It has also been employed in the treatment of internal haemorrhage, in inflammatory diseases, in delirium tremens, in epilepsy, in acute mania and various other diseases, with real or supposed benefits.

The action of Digitalis in all the forms in which it is administered should be carefully watched, and when given over a prolonged period it should be employed with caution, as it is liable to accumulate in the system and to manifest its presence all at once by its poisonous action, indicated by the pulse becoming irregular, the blood-pressure low and gastro-intestinal irritation setting in. The constant use of Digitalis, also, by increasing the activity of the heart, leads to hypertrophy of that organ.

Digitalis is an excellent antidote in Aconite poisoning, given as a hypodermic injection.

Digoxigenin (DIG) is a steroid found exclusively in the flowers and leaves of the plants Digitalis purpurea and Digitalis lanata. It is used as a molecular probe to detect DNA or RNA. It can easily be attached to nucleotides by chemical modifications. DIG molecules are often linked to uridine nucleotides; DIG-labeled uridine (DIG-U) can then be incorporated into RNA probes via in vitro transcription. Once hybridisation occurs in situ, RNA probes with the incorporated DIG-U can be detected with anti-DIG antibodies conjugated to alkaline phosphatase. To reveal the hybridised transcripts, alkaline phosphatase can be reacted with a chromogen to produce a coloured precipitate.

Other Uses: Dye;  Preservative…..An infusion of the plant prolongs the life of cut flowers. Root crops growing near this plant store better.   An apple-green dye is obtained from the flowers.

Known Hazards:
Due to the presence of the cardiac glycoside digitoxin, the leaves, flowers and seeds of this plant are all poisonous to humans and some animals and can be fatal if ingested.

Extracted from the leaves, this same compound, whose clinical use was pioneered as digitalis by William Withering, is used as a medication for heart failure. He recognized it “reduced dropsy”, increased urine flow and had a powerful effect on the heart. Unlike the purified pharmacological forms, extracts of this plant did not frequently cause intoxication because they induced nausea and vomiting within minutes of ingestion, preventing the patient from consuming more.

The main toxins in Digitalis spp. are the two chemically similar cardiac glycosides: digitoxin and digoxin. Like other cardiac glycosides, these toxins exert their effects by inhibiting the ATPase activity of a complex of transmembrane proteins that form the sodium potassium ATPase pump, (Na+/K+-ATPase). Inhibition of the Na+/K+-ATPase in turn causes a rise not only in intracellular Na+, but also in calcium, which in turn results in increased force of myocardial muscle contractions. In other words, at precisely the right dosage, Digitalis toxin can cause the heart to beat more strongly. However, digitoxin, digoxin and several other cardiac glycosides, such as ouabain, are known to have steep dose-response curves, i.e., minute increases in the dosage of these drugs can make the difference between an ineffective dose and a fatal one.

Symptoms of Digitalis poisoning include a low pulse rate, nausea, vomiting, and uncoordinated contractions of different parts of the heart, leading to cardiac arrest and finally death.

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/Digitalis_purpurea
http://www.botanical.com/botanical/mgmh/f/foxglo30.html

Burns

Definition:
A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction. Most burns only affect the skin (epidermal tissue and dermis). Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured. Burns may be treated with first aid, in an out-of-hospital setting, or may require more specialised treatment such as those available at specialised burn centers.

click to see the picture
Managing burns is important because they are common, painful and can result in disfiguring and disabling scarring, amputation of affected parts or death in severe cases. Complications such as shock, infection, multiple organ dysfunction syndrome, electrolyte imbalance and respiratory distress may occur. The treatment of burns may include the removal of dead tissue (debridement), applying dressings to the wound, administering large volumes of intravenous fluids, administering antibiotics and skin grafting.

While large burns can be fatal, modern treatments developed in the last 60 years have significantly improved the prognosis of such burns, especially in children and young adults.  In the United States, approximately 4 out of every 100 people with injuries from burns will succumb to their injuries. The majority of these fatalities occur either at the scene or enroute to hospital.

According to the American Burn Association, an estimated 500,000 burn injuries receive medical treatment yearly in the United States.

Classification:
Burns can be classified by mechanism of injury, depth, extent and associated injuries and comorbidities.

By depth

Currently, burns are described according to the depth of injury to the dermis and are loosely classified into first, second, third and fourth degrees. This system was devised by the French barber-surgeon Ambroise Pare and remains in use today.

Note that an alternative form of reference to burns may describe burns according to the depth of injury to the dermis.

It is often difficult to accurately determine the depth of a burn. This is especially so in the case of second degree burns, which can continue to evolve over time. As such, a second-degree partial-thickness burn can progress to a third-degree burn over time even after initial treatment. Distinguishing between the superficial-thickness burn and the partial-thickness burn is important, as the former may heal spontaneously, whereas the latter often requires surgical excision and skin grafting.

First degree burn:..
A first degree burn is superficial and causes local inflammation of the skin. Sunburns often are categorized as first degree burns. The inflammation is characterized by pain, redness, and a mild amount of swelling.

click to see the picture

The skin may be very tender to touch.It takes about a week’s time to heal & there is no complecation.

Second degree (superficial partial thickness):
Second degree burns are deeper and in addition to the pain, redness and inflammation, there is also blistering of the skin. Healing time is appx.2to 3 weeks.Complecation is  Local infection/cellulities.
click to see the picture
Third Degree:
Third degree burns are deeper still, involving all layers of the skin, in effect killing that area of skin. Because the nerves and blood vessels are damaged, third degree burns appear white and leathery and tend to be relatively painless. It needs  excision. It is scarring, contractures (may require excision and skin grafting)

click to see the pictures….....(1)...……………………………………

Fourth Degree:….CLICK & SEE
It extends through skin, subcutaneous tissue and into underlying muscle and bone.Needs excision.Complecated may need  amputation, significant functional impairment.

By severity:
In order to determine the need for referral to a specialised burn unit, the American Burn Association devised a classification system to aid in the decision-making process. Under this system, burns can be classified as major, moderate and minor. This is assessed based on a number of factors, including total body surface area (TBSA) burnt, the involvement of specific anatomical zones, age of the person and associated injuries.

MajorMajor burns are defined as:
*Age 10-50yrs: Partial thickness burns >25% TBSA
*Age <10 or >50: Partial thickness burns >20% TBSA
*Full thickness burns >10%
*Burns involving the hands, face, feet or perineum
*Burns that cross major joints
*Circumferential burns to any extremity
*Any burn associated with inhalational injury
*Electrical burns
*Burns associated with fractures or other trauma
*Burns in infants and the elderly
*Burns in persons at high-risk of developing complications

These burns typically require referral to a specialised burn treatment center.

Moderate:

Moderate burns are defined as:
*Age 10-50yrs: Partial thickness burns involving 15-25% TBSA
*Age <10 or >50: Partial thickness burns involving 10-20% TBSA
*Full thickness burns involving 2-10% TBSA

Persons suffering these burns often need to be hospitalised for burn care.

Minor:
Minor burns are:
*Age 10-50yrs: Partial-thickness burns <15% TBSA
*Age <10 or >50: Partial thickness burns involving <10% TBSA
*Full thickness burns <2% TBSA without associated injuries.

These burns usually do not require hospitalisation.

By surface area:
Burns can also be assessed in terms of total body surface area (TBSA), which is the percentage affected by partial thickness or full thickness burns. First degree (erythema only, no blisters) burns are not included in this estimation. The rule of nines is used as a quick and useful way to estimate the affected TBSA. More accurate estimation can be made using Lund & Browder charts which take into account the different proportions of body parts in adults and children.The size of a person’s hand print (palm and fingers) is approximately 1% of their TBSA. The actual mean surface area is 0.8% so using 1% will slightly over estimate the size.Burns of 10% in children or 15% in adults (or greater) are potentially life threatening injuries (because of the risk of hypovolaemic shock) and should have formal fluid resuscitation and monitoring in a burns unit.

 

Symptoms:
There may be obvious and immediate damage to the skin, which can be very painful.

With partial thickness burns, the skin may be pink, red or mottled. Blistering may also be seen.

With full thickness burns, the top layer of skin is destroyed and may look white or black, and charred. Full thickness burns are painless, as the nerves carrying pain signals have been destroyed.
Causes:
Burns are caused by a wide variety of substances and external sources such as exposure to chemicals, friction, electricity, radiation, and heat.

Chemical:
Most chemicals that cause chemical burns are strong acids or bases.[11] Chemical burns can be caused by caustic chemical compounds such as sodium hydroxide or silver nitrate, and acids such as sulfuric acid.Hydrofluoric acid can cause damage down to the bone and its burns are sometimes not immediately evident.

Electrical
Electrical burns are caused by either an electric shock or an uncontrolled short circuit. (A burn from a hot, electrified heating element is not considered an electrical burn.) Common occurrences of electrical burns include workplace injuries, or being defibrillated or cardioverted without a conductive gel. Lightning is also a rare cause of electrical burns.

Since normal physiology involves a vast number of applications of electrical forces, ranging from neuromuscular signaling to coordination of wound healing, biological systems are very vulnerable to application of supraphysiologic electric fields. Some electrocutions produce no external burns at all, as very little current is required to cause fibrillation of the heart muscle. Therefore, even when the injury does not involve any visible tissue damage, electrical shock survivors may experience significant internal injury. The internal injuries sustained may be disproportionate to the size of the burns seen (if any), and the extent of the damage is not always obvious. Such injuries may lead to cardiac arrhythmias, cardiac arrest, and unexpected falls with resultant fractures or dislocations.

The true incidence of electrical burn injury is unknown. In one study of 220 deaths due to electrical injury, 40% of those associated with low-voltage (<1000 AC volts) injury demonstrated no skin burns or marks whatsoever. Most household electrical burns occur at 110 AC volts. This is sufficient to cause cardiac arrest and ventricular fibrillation but generates relatively low heat energy deposit into skin, thus producing few or no burn marks at all.

Radiation:
Radiation burns are caused by protracted exposure to UV light (as from the sun), tanning booths, radiation therapy (in people undergoing cancer therapy), sunlamps, radioactive fallout, and X-rays. By far the most common burn associated with radiation is sun exposure, specifically two wavelengths of light UVA, and UVB, the latter being more dangerous. Tanning booths also emit these wavelengths and may cause similar damage to the skin such as irritation, redness, swelling, and inflammation. More severe cases of sun burn result in what is known as sun poisoning or “heatstroke”. Microwave burns are caused by the thermal effects of microwave radiation.

Scalding :.…CLICK & SEE

Two-day-old scald caused by boiling radiator fluid.Scalding (from the Latin word calidus, meaning hot  is caused by hot liquids (water or oil) or gases (steam), most commonly occurring from exposure to high temperature tap water in baths or showers or spilled hot drinks. A so called immersion scald is created when an extremity is held under the surface of hot water, and is a common form of burn seen in child abuse.[19] A blister is a “bubble” in the skin filled with serous fluid as part of the body’s reaction to the heat and the subsequent inflammatory reaction. The blister “roof” is dead and the blister fluid contains toxic inflammatory mediators. Scald burns are more common in children, especially “spill scalds” from hot drinks and bath water scalds.

Treatment:
Cool small burns immediately under cold running water for at least ten minutes. Rinse chemical burns for 20 minutes.

Briefly rinse larger burns, avoiding excessive cooling.

Remove clothes in the area of the burn where possible, without causing further damage to the skin. Then either wrap the burned area in a clean clear plastic bag or place a clean smooth material, such as cling film, over the burn to prevent infection.

Minor burns can be treated at home with painkillers and sterile dressings (don’t pop blisters). Deep or extensive burns, or burns to the face, hands or across joints, need to be assessed and treated in hospital.

The extent of burns can be estimated using special charts. More than ten per cent burns need hospital treatment (including intravenous fluids). Burns to more than 50 per cent of the body’s surface carry a poor chance of survival.

Severe burns need specialised long-term management, which may include skin grafts or treatments to prevent contractures, as well as psychological support to deal with scarring.

Pathophysiology:
Following a major burn injury, heart rate and peripheral vascular resistance increase. This is due to the release of catecholamines from injured tissues, and the relative hypovolemia that occurs from fluid volume shifts. Initially cardiac output decreases. At approximately 24 hours after burn injuries, cardiac output returns to normal if adequate fluid resuscitation has been given. Following this, cardiac output increases to meet the hypermetabolic needs of the body.

Management:
The resuscitation and stabilisation phase begins with the reassessment of the injured person’s airway, breathing and circulatory state. Appropriate interventions should be initiated to stabilise these. This may involve aggressive fluid resuscitation and, if inhalation injury is suspected, intubation. Once the injured person is stabilised, attention is turned to the care of the burn wound itself. Until then, it is advisable to cover the burn wound with a clean and dry sheet or dressing.

Early cooling reduces burn depth and pain, but care must be taken as uncontrolled cooling can result in hypothermia.

Intravenous fluids:
Children with TBSA >10% and adults with TBSA > 15% need formal fluid resuscitation and monitoring (blood pressure, pulse rate, temperature and urine output).Once the burning process has been stopped, the injured person should be volume resuscitated according to the Parkland formula . This formula calculates the amount of Ringer’s lactate required to be administered over the first 24hrs post-burn.

Parkland formula: 4mls x percentage total body surface area sustaining non-superficial burns x person’s weight in kgs.

Half of this total volume should be administered over the first 8hrs, with the remainder given over the following 16hrs. It is important to note that this time frame is calculated from the time at which the burn is sustained, and not the time at which fluid resuscitation is begun. Children also require the addition of maintenance fluid volume. Such injuries can disturb a person’s osmotic balance.  Inhalation injuries in conjunction with thermal burns initially require up to 40–50% more fluid.

The formula is a guide only and infusions must be tailored to the urine output and central venous pressure. Inadequate fluid resuscitation may cause renal failure and death but over-resuscitation also causes morbidity.

Wound care
Debridement cleaning and then dressings are important aspects of wound care. The wound should then be regularly re-evaluated until it is healed. In the management of first and second degree burns little quality evidence exists to determine which type of dressing should be used. Silver sulfadiazine (Flamazine) is not recommended as it potentially prolongs healing time  while biosynthetic dressings may speed healing.

Antibiotics:
Intravenous antibiotics may improve survival in those with large severe burns however due to the poor quality of the evidence routine use is not currently recommended.

Analgesics:
A number of different options are used for pain management. These include simple analgesics ( such as ibuprofen and acetaminophen ) and narcotics. A local anesthetic may help in managing pain of minor first-degree and second-degree burns.

Surgery:
Wounds requiring surgical closure with skin grafts or flaps should be dealt with as early as possible. Circumferential burns of digits, limbs or the chest may need urgent surgical release of the burnt skin (escharotomy) to prevent problems with distal circulation or ventilation.

Alternative treatments:
Hyperbaric oxygenation has not been shown to be a useful adjunct to traditional treatments. Honey has been used since ancient times to aid wound healing and may be beneficial in first and second degree burns, but may cause infection.

Home Remedy:..
One of them that is pretty popular but equally dangerous is the old, “butter on burns” procedure. Many people around the world apply butter (or margarine) to the skin to treat minor burns;
Complications:
Infection is a major complication of burns. Infection is linked to impaired resistance from disruption of the skin’s mechanical integrity and generalized immune suppression. The skin barrier is replaced by eschar. This moist, protein rich avascular environment encourages microbial growth. Migration of immune cells is hampered, and there is a release of intermediaries that impede the immune response. Eschar also restricts distribution of systemically administered antibiotics because of its avascularity.

Risk factors of burn wound infection include:

*Burn > 30% TBS
*Full-thickness burn
*Extremes in age (very young, very old)
*Preexisting disease e.g. diabetes
*Virulence and antibiotic resistance of colonizing organism
*Failed skin graft
*Improper initial burn wound care
*Prolonged open burn wound

Burn wounds are prone to tetanus. A tetanus booster shot is required if individual has not been immunized within the last 5 years.

Circumferential burns of extremities may compromise circulation. Elevation of limb may help to prevent dependent edema. An Escharotomy may be required.

Acute Tubular Necrosis of the kidneys can be caused by myoglobin and hemoglobin released from damaged muscles and red blood cells. This is common in electrical burns or crush injuries where adequate fluid resuscitation has not been achieved.

Prognosis:
The outcome of any injury or disease depends on three things: the nature of the injury, the nature of the injured or ill person and the treatment available. In terms of injury factors in burns the prognosis depends primarily on the burn surface area (% TBSA) and the age of the person. The presence of smoke inhalation injury, other significant injuries such as long bone fractures and serious co-morbidities (heart disease, diabetes, psychiatric illness, suicidal intent etc.) will also adversely influence prognosis. Advances in resuscitation, surgical management, control of infection, control of the hyper-metabolic response and rehabilitation have resulted in dramatic improvements in burn mortality and morbidity in the last 60 years.

You may Click to see :List of Burn Centers in  US

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.umm.edu/imagepages/1078.htm
http://en.wikipedia.org/wiki/Burn
http://www.bbc.co.uk/health/physical_health/conditions/burns2.shtml
http://www.doctorsatyourhome.com/blog/?p=77

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Begonia Picta

Botanical Name  :Begonia picta
Family :
Begoniaceae
Genus: Begonia
Synonyms :         Begonia echinata – Royle., Begonia erosa – Wallich.
Common Name : In the local Nepali language it is known as makkar-kajay.


Habitat
:  Range E. Asia – Himalayas .Eastern Himalayas in shaded ledges, along roadsides and among humus filled rock crevices. Shady banks and rock ledges in wetter areas, to 2800 metres. Plants are sometimes found at much higher elevations.


Description:

Perennial growing to 0.2m.
A tuberous rooted species growing from rock crevices and mud ledges. dormant in winter. New growth starts from late spring and produces beautifully colour leaves. Flowers throughout summer with clusters of showy deep pink flowers. A form with plain green leaves also exists.
CLICK & SEE THE PICTURES
From mid summer till early autumn Begonia picta is found flowering in the Darjeeling Himalayas. A botanical variant of the species has beautifully marked leaves. In winter the leaves and stems die down and the small tubers remain dormant, coming up again in late spring.

It is hardy to zone 0. It is in flower from August to September, and the seeds ripen from September to October. The flowers are monoecious (individual flowers are either male or female, but both sexes can be found on the same plant)
The plant prefers light (sandy), medium (loamy) and heavy (clay) soils and requires well-drained soil. The plant prefers acid, neutral and basic (alkaline) soils. It can grow in semi-shade (light woodland). It requires moist soil.

Cultivation:
Requires a well-drained soil. Plants do not require high light intensities. Prefers a pH between 6 and 7. A tuberous species, it is said to require greenhouse protection in Britain but plants are found at quite high elevations in the Himalayas and these provenances could be hardy in this country.

Propagation
:
Seed – surface sow in a greenhouse and keep the compost moist in a light position. The seed can be very slow to germinate, sometimes taking a year or more. 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 Basal cuttings from tubers in spring.

Edible Uses

Edible Parts: Leaves.

Leaves – raw or cooked. An acid flavour. The sour tasting leaf stalks and stems are pickled.
The stems and peduncles are succulent and sour and villagers prepare a tongue tingling sour chutney out of these parts of the plant.

Medicinal Actions &  Uses:
Anodyne; Ophthalmic; Poultice; Stomachic.

The juice of the plant is drunk to relieve headaches. The crushed leaves are used as a poultice on sore nipples. The root juice is used as an eyewash to treat conjunctivitis. It is also consumed in the treatment of peptic ulcers.


Other Uses

Mordant.

The juice of the plant is used as a mordant to fix the colours of vegetable dyes.

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.pfaf.org/database/plants.php?Begonia+picta
http://www.ganeshvilla.com/plants/begonia_picta.htm
http://www.ganeshvilla.com/portr/begonia_picta.htm

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