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The fruit can be used as a substitute for soap generic erectafil 20 mg otc impotence 17 year old male, and the leaves are some- times used as an insect repellent effective erectafil 20 mg vyvanse erectile dysfunction treatment. Although ashwaganda can be taken alone, it is more often combined with other herbs in tonics to enhance its rejuvenating effects. Indian ginseng Ashwaganda is sometimes called the Indian ginseng because its actions and uses are in many ways similar to those of Chinese ginseng, although its cost is much lower. Ashwaganda is supposed to impart that same horse-like strength to the people who use it. Ashwaganda is celebrated as an adaptogen that will do all of the following: • boost strength • increase stamina and relieve fatigue • enhance sexual energy and rejuvenate the body • strengthen the immune system • speed recovery from chronic illness • strengthen sickly children • soothe and calm without producing drowsiness • clarify the mind and improve memory • slow the aging process The powdered root of ashwaganda is normally used for whole body tonics that improve general health and well being. For most of these uses, ashwaganda is prepared as part of a rasayana, or rejuvenating formula that contains many different herbs. The use of ashwaganda in multi-herb formulas makes it difficult for modern laboratory scientists to assess its specific effects as an adaptogen. Disease-specific uses In addition to the whole body effects of ashwagan- da, the plant is used for many other specific conditions. Some researchers • chronic fatigue syndrome report that ashwaganda makes tumors more sensitive to • colds chemotherapy and radiation therapy without increasing side effects caused by these therapies. One drawback to arriv- • hemorrhoids ing at conclusive evidence in humans is that most people • hypertension take ashwaganda as part of a multi-herb tonic, making it • hypoglycemia difficult for researchers to attribute specific actions to any one particular component of the formula. Scientific • leprosy interest in ashwaganda is high, and laboratory studies • nausea continue to be performed. The usual cap- • tumors sule dosage is 300 mg of powdered root, taken once or twice a day. Ashwaganda tea can be made by boiling the roots external use, as it is thought to have antibacterial and an- for about 15 minutes. It is used to prevent infection in skin The fruit is often chewed to assist in convalescence from wounds and to treat skin diseases, including psoriasis, prolonged illness. The dose recommended depends on both the body Laboratory studies type of the person and the nature of his or her illness. University and medical researchers have been study- ing ashwaganda since at least the early 1960s. Chemical Precautions analysis shows that ashwaganda contains compounds Ashwaganda is not recommended for use by pregnant thought to have anti-tumor, anti-inflammatory, and anti- women. This effect has not been seen in The most rigorous laboratory tests have been done humans, but using the herb in moderation may be prudent. It will enhance the effect of any other cen- mans in the same way that it affects rodents. People operating consistent anti-inflammatory, anti-fungal, anti-stress, and heavy equipment or working in situations that require a sedative effects. In one well-known study, extracts of high level of alertness should keep this in mind when ashwaganda root were shown to significantly increase using ashwaganda. Side effects Experimenters have had mixed results in demon- strating anti-tumor and anti-cancer properties of ashwa- No undesirable side effects have been reported with ganda. GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 135 OTHER KEY TERMS “Withania somnifera aphrodisiaca. Decoction—A liquid extract of a herb, made by simmering or boiling the herb in water, then straining out the plant parts. Poultice—A soft moist mass of cloth, usually con- Asthma taining herbs, applied warm or hot to relieve pain or speed healing in a part of the body. Definition Psoriasis—A skin disease characterized by dry, Asthma is a chronic inflammatory disease of the air- scaling, whitish patches.

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Most of the labral contribution is posterior 36 6 Classifications of pathology of long head of the biceps tendon c d Fig cheap erectafil 20 mg with mastercard erectile dysfunction drugs rating. There are equal contributions to both the anterior and the posteri- or parts of the labrum cheap erectafil 20 mg with amex erectile dysfunction treatment psychological. Most of the labral contribution is anterior, with a small contribution to the posterior labrum 6. When this is encountered, it has to be classified as a complex SLAP type 2 and 3 or type 2 and 4 lesion. Of these, 62% had lesions that fit within the classifications system of Sny- der [122, 123]. Thirty-eight percent in this study had significant biceps tendon-superior labrum injury that did not fit into the classification system proposed by Snyder [122, 123]. The authors have observed three types of type II SLAP lesions by anatomic location: n Anterior SLAP lesion: anterosuperior type II SLAP lesion (Fig. Topographical classification of LHB lesions Lesion Zone Pathology Lesions of the origin of the LHB I SLAP lesions I±IV Andrews lesions Supratubercular lesions II Isolated tendinosis/tendinitis (Partial) tears of LHB (Partial) tears of LHB in Rotator cuff lesions Supratubercular instability (Walch I) Sulcus associated lesions III Subluxation/dislocation out of the bicipital groove (Walch II) without lesions of postero- superior rotator cuff but where applicable accompanied with a lesion of the subscapularis tendon (and capsule) Lesions below the bicipital groove IV Peripheral of proximal LHB (e. It must be stressed that the distinction is not always clear; the degenerated and inflamed tendon is more prone to trauma and, conversely, repeated trauma may result in changes in the tendon indistinguishable from those of inflammation. Nevertheless, this classifi- cation can help with the organization of the pathogenesis of these disor- ders and formulation of protocols for appropriate management. Subluxation n Type I: superior subluxation n Type II: unstable at proximal portion of groove n Type III: subluxation following melanin or nonunion of lesser tuber- osity 2. Dislocation n Type I: extraarticular, combined with partial tear of subscapularis n Type II: intraarticular, combined with full-thickness tear of subscapu- laris III. Superior labral tears (SLAP lesion) n Type I: significant fraying n Type II: complete detachment of biceps tendon and superior labrum from glenoid n Type III: ªbucket-handleº tear of superior labrum n Type IV: central superior labrum tear with extension into the biceps 42 6 Classifications of pathology of long head of the biceps tendon 6. Three different types of biceps tendon subluxation were recognized: n Superior subluxation (type I): The circular sling of the superior glenohumeral and coracohumeral liga- ments (i. The subscapularis tendon, which attaches to the lesser tubercle just below the superior glenohumeral ligament, is largely intact; otherwise a true dislocation is present. The lesion above the en- trance to the groove is sometimes marked by an accompanying partial lesion of the supraspinatus tendon on the articular side, directly at the lateral groove entrance, where it forms the roof for the biceps tendon. The pathologic substrate of the type I subluxation is discontinuity in the tendo-ligamentous rotator interval sling surrounding the long biceps tendon (i. With this type of lesion, the tendon slips over the medial rim of the bony groove and ªridesº on the border of the lesser tuberosity. The causal lesion is a detachment of the outermost fibres of the subscapularis tendon. Tearing of the superficial (outer) portions that line the floor of the groove and help anchor the long biceps tendon al- lows the tendon to displace to a medially subluxated position. The prin- cipal criterion for a type II biceps tendon subluxation is a partial rup- ture of the outer, superficial tendinous portions of the subscapularis muscle, allowing the biceps tendon to ride over the bone of the lesser tuberosity. The type II lesion may be confined to the superior half of the groove or may involve its entire length. The deeper portions of the subscapu- laris tendon still insert into the lesser tuberosity, separating the bi- ceps tendon from the joint space. Invariably there is a rupture of the common attachment of the superior glenohumeral ligament and cor- acohumeral ligament. The biceps tendon, then, is displaced over the anterior wall of the groove and slips or glides medially over the torn fibres of the subscapularis tendon. The clavipectoral fascia covers this 44 6 Classifications of pathology of long head of the biceps tendon lesion externally, and this might give the impression that the supsca- pularis tendon is intact over its full-thickness. It has been shown, however, that the outer attachment of the supscapularis tendon is al- ways torn.

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Organogenesis occurs during the em- include eczematous 20 mg erectafil with mastercard erectile dysfunction treatment australia, indurate–inflammatory purchase 20 mg erectafil free shipping erectile dysfunction drugs muse, and ur- bryonic period (the first 3 months of pregnancy), and ticarial eruptions. Irritant responses causing direct dam- therefore, susceptibility to teratogenesis is high; the em- age to the skin may be confused with allergic responses bryo is particularly vulnerable to teratogens on days 25 involving immune mechanisms. The fetal period consists of the last 6 months ence is that allergic reactions require an initial exposure of gestation and is a time of reduced susceptibility to to sensitize the individual; dermatitis is then elicited by teratogenic alterations. Functional im- pairment in tissues without marked structural damage Toxic Effects on Genetic Material and growth retardation is the most common effect of and Cell Replication chemical exposure during the fetal period. Mutagenesis, teratogenesis, and carcinogenesis are dif- Chemicals such as 1,2-dibromo-3-chloropropane ferent manifestations of damage to genetic material can disrupt spermatogenesis, leading to impaired repro- (genotoxicity). Men and women in several steps, and at each step there is opportunity for undergoing cancer chemotherapy with alkylating drugs repair. This includes resusci- Gases tation (if necessary) and maintenance of respiratory Carbon monoxide arises from the incomplete combus- and cardiovascular functions. An approach to eration by the internal combustion engine and by home the treatment of victims of poisoning is presented in heating units, particularly in poorly ventilated areas. Carbon monoxide emission by automobiles in closed garages and by unvented space heaters results in nu- merous deaths each year. Following inhalation, carbon EXPOSURE TO NONTHERAPEUTIC monoxide binds to hemoglobin, displacing oxygen and TOXICANTS forming carboxyhemoglobin. This applies not only to workers who ing hypoxia is the principal mechanism of carbon manufacture the chemicals and final products but also monoxide toxicity. Photolysis of nitrogen dioxide by ultraviolet ra- Air Pollution diation liberates oxygen atoms, which can then combine Industrial activity has polluted the outdoor air with a with molecular oxygen to form ozone. Both gases cause number of chemicals known to be hazardous to human irritation of the deep lung and can result in increased health. These include a variety of gases, such as carbon susceptibility to respiratory infection, pulmonary monoxide, ozone, and the oxides of sulfur and nitrogen. Unacceptable levels of air pollutants can occur indoors Oxides of sulfur (principally sulfur dioxide) are gen- as well. While some of these pollutants may be the same erated during the burning of fossil fuels, most notably as for the outdoor air, they also include biological coal, and are classified as reducing pollutants because of TABLE 7. Natural products such as pollen, anthrax spores, insulin shock) and animal dander can elicit toxic reactions on inhala- Evaluation tion or skin contact. The inhalation of asbestos, silica, or Identify the toxic agent and dose if possible Assess vital signs and level of consciousness coal dust can cause pneumoconiosis, which may develop Conduct laboratory tests into serious lung disease. The size of the particle, venti- Reduce absorption and enhance removal of poison latory rate, and depth of breathing will determine the Irrigate eyes and skin if involved extent of pulmonary deposition. Induce emesis with syrup of ipecac if victim is conscious and has not ingested acids, alkali, hydrocarbons, or petroleum distillates Food Additives and Contaminants Perform gastric lavage if victim is unconscious or in some in- stances when conscious Thousands of substances are added to foods to enhance Administer activated charcoal to bind poison their marketability (appearance, taste, texture, etc. Administer antidote, if one exists, that is specific for the Microbial or fungal contamination of food, either dur- poison Consider forced diuresis, urine acidification, or alkalinization ing processing or storage, can introduce potent toxins if specific antidotes are not available into food. Hemodialysis or charcoal hemoperfusion may be appropri- ate for rapid elimination if antidotes are not available Metals Characteristics of toxicity for a number of metals are presented in Table 7. Particulate matter lecular site of the toxic action of each metal is different, associated with most emissions promotes the conver- toxicity generally results from interaction of the metal sion of sulfur dioxide to the more toxic sulfuric acid and with specific functional groups on macromolecules in facilitates deposition in the deep lungs. These groups include sulfhydryl, carboxyl, cause bronchospasm and lung damage, including alve- amino, phosphoryl, and phenolic moieties.

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Definition Other studies have concentrated on the benefits of eating fruits and vegetables buy 20mg erectafil with amex erectile dysfunction treatment forums. Gladys Laryngitis is caused by inflammation of the larynx effective 20 mg erectafil erectile dysfunction treatment scams, Block, who was at one time an epidemiologist at the Na- often resulting in a temporary loss of voice. She con- Description cluded that as people ate more fruits and vegetables, the risk of cancer decreased. Those who ate the most vegeta- When air is breathed in, it passes through the nose bles and fruits had half the risk for cancer as those who and the nasopharynx or through the mouth and the ate the least. These are both connected to the larynx, a fiber, which vegetarian diets tend to be, reduce the risk tube made of cartilage. The vocal cords, responsible for for heart disease, cancer, and other conditions including setting up the vibrations necessary for speech, are locat- digestive disorders, appendicitis, and osteoporosis ed within the larynx. The trachea then splits into two branches, the left and Dean Ornish, has been shown to improve heart disease right bronchi (bronchial tubes). These bronchi branch and reverse the effects of atherosclerosis, or hardening into smaller air tubes that run within the lungs, leading to of the arteries. GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1181 However, the primary medical cause of laryngitis is a viral infection. The same viruses that cause the majori- ty of simple colds are responsible for laryngitis. In ex- tremely rare cases, more harmful bacteria or the bacteria that causes tuberculosis (TB) may cause laryngitis. In people with faulty immune systems (like AIDS patients), infections with fungi may be responsible for laryngitis. The person may have a sore, scratchy throat, as well as a fever, runny nose, aches, and fatigue. Difficulty swallowing some- times occurs, and the patient may have a ticklish cough or wheeze. Most characteristically, the patient suffers voice loss or the voice will sound strained, hoarse, and raspy. This is more common in infants because the diameter of their airways Either food, liquid, or air may be taken in through is so small. While air goes into the larynx and the respira- creased respiratory rate and exhibit loud, high-pitched tory system, food and liquid are directed into the tube sounds with breathing (called stridor). Because food or liquid in the bronchial tubes or lungs could cause a block- Diagnosis age or lead to an infection, the airway must be protected. Laryngitis could be the next phase over the larynx when someone is eating or drinking, pre- of the flu or the result of cheering too energetically dur- venting these substances from entering the airway. In addition to being an easily recog- In laryngitis, the tissues below the level of the epiglot- nizable condition, laryngitis is a self-limiting condition tis are swollen and inflamed. Hoarse sounds or loss of voice are characteristic of laryngi- However, a doctor should be consulted if the laryn- tis. Laryngitis is a very common problem, and often occurs gitis occurs for no apparent reason or if hoarseness lasts during an upper respiratory tract infection (cold). Symptoms of underactive thyroid include tiredness, constipation, Causes & symptoms aches, and dry skin. Laryngitis is primarily caused by overuse of the Diagnosis is usually made by learning the history of voice, a condition faced by people ranging from teachers a cold that is followed by hoarseness. Listening to the • strain on the larynx from talking or singing for long pe- chest, neck, and back with a stethoscope (an instrument riods used to hear heart and lungs sounds) may reveal some • shouting or cheering for an extended time harsh wheezing sounds when the person breathes. Using an instrument called a laryngoscope, a doctor can • colds or cough examine the airway for redness, swelling, small bumps • smoking of tissue called nodules, and irritated pits in the tissue called ulcerations.

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