Disease, Medication and Healthy Lifestyle

Posts Tagged ‘Pain’

Back pain, known by the technical term dorsalgia, is experienced by just about everyone at one time or another. While some people only suffer when moving house or doing heavy lifting, for others it can be a chronic problem. It can make day to day life feel unbearable. Fortunately, there are a number of treatments, including physical therapy, chiropractic care, homeopathy, and medicinal painkillers. While physical therapy attempts to end the pain for good, most medicinal options should only be used as temporary relief, not as a daily regimen. It must be noted that some back pain could be a symptom of some serious, potentially fatal conditions. Contact a doctor immediately if you also experience: – Weakness in the legs – Incontinence of the bowels and/or bladder – Trauma, such as falling or impact (anything that could have caused a bone to break) – Osteoporosis – Multiple myeloma – Known cancer – Fever – Weight loss When it comes to treatment, it is crucial to identify exactly what is wrong with your back. It could be a muscle, tendon, joint, or nerve problem. It can be located in one or more of the regions of the back and spine: cervical, thoracic, lumbar, or pelvic. These bits of information and the type of pain will help a doctor isolate the problem and rule out more serious causes (e.g. Cancer, Infection).

Sources of Back Pain Most back pain can be attributed to only a few sources, but there are dozens. Starting with the most common: – Stress – Problems with synovial joints in the spine (Also called facet or zygapophysial joints) – Trauma – Spinal disc herniation – Degenerative disc disease – Osteoarthritis – Spinal Stenosis – Cancer – Infection – Fractures – Inflammatory disease Treatment for these conditions ranges from rest, heating, and stretching to surgery, therapy, and antibiotics, among other drugs. It’s important you and a doctor discover which is causing your back pain. It can be scary thinking it might be a disease, but many of these are very treatable and you may never have to suffer through back pain again. Knowing When It’s Time How do you know when it’s time to move on to prescription painkillers and/or muscle relaxants? Your back will tell you.

When your doctor has ruled out the large number of serious yet treatable conditions, when you have tried stretching and heating and over-the-counter stuff, when you can’t go to work, exercise, or even get around the house, that’s when it’s time to use prescription drugs to regain your life. If the pain is severe enough, a doctor may choose to put you on opioid drugs. These are your codeines, morphines, etc. However, these drugs may impair your daily function and are highly addictive. They’re not a long-term solution. Another option to consider: muscle relaxants. Muscle relaxants act on skeletal muscle tissue to affect muscle tone and relieve spasms, hyperreflexia (twitching), and pain. Among these, Carisoprodol reigns king. Carisoprodol is highly effective at relieving back pain and often comes mixed with the over-the-coutner painkiller acetaminophen. You get to worry less about addiction with Carisoprodol, and worry more about how you will enjoy your mobility.

More than half of the population of the world will face neck pain at some time in their life. If neck pain lasts for long periods or it creates problem repeatedly, it is said to be chronic. Generally chronic neck pain is caused by abnormalities in soft tissues either because of injury or due to prolonged wear and tear. Different types of chronic neck pain are caused by different factors:

Muscle strain:
Overuse of the neck creates strain in the soft tissues. It creates acute pain in the neck and back. Poor posture and work habits sustain the pain for long periods. Repeated overuse of muscles creates pain particularly in the back side of the neck.

Cervical Foraminal Stenosis:
Pain which develops very slowly over the years and occurs after particular neck positions might be due to Cervical Foraminal Stenosis. Wear and aging of the vertebral joints in the neck or at the disc margins creates this kind of pain. It is sometimes difficult to distinguish this type of pain from muscle pain by depending on Xray and CT scans. In such cases, an injection called a medial branch block (MBB) is performed. The injection confirms that the cause of pain is facet joint.

Cervical herniated disc:
Cervical herniated disc is the main cause of neck pain radiating down the arm in some cases to the hands and fingers. Herniated disc or bone spur compresses the spinal cord to cause the pain. Symptoms of this type of pain can develop both suddenly and slowly. If the pain is not responding to conservative treatments (medication, physical therapy or manipulations), surgery may be needed.

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Disk injury:
Discs control the motion of the neck. When discs are stressed beyond their limits pain is experienced which extends to the annulus (outer wall of the disc). An example of this is whiplash injury. Muscles and ligaments are inflamed or stressed by an accident. Neck pain sometimes flares or gets worse. Pain is increased by certain postures. In most cases it is healed but for some people it creates pain in normal activities. About one quarter of patients develop neck pain due to disc injury.

Using acupuncture to relieve symptoms of neck pain:

Acupuncture is part of the 2500 year old science of natural healing called traditional Chinese medicine. It also includes Asian bodywork therapy as well as Chinese Herbal therapy. The practice of acupuncture has turned out to be an accepted treatment for neck pain worldwide. Acupuncture needles are inserted into empirically exact points, called an acupuncture point, which are located along organ meridians, to stimulate the smooth flow of Qi energy. Qi energy is believed to be part of every living thing that exists, as a kind of life force or spiritual energy.

Acupuncture aims to affect the central nervous system, including the spinal cord, mid-brain and hypothalamus-pituitary intricate. Studies have also shown that acupuncture promotes vasodilation and increases blood flow. Concentrations of triglycerides, cholesterol and phospholipids in the blood can decrease following acupuncture treatments . Acupuncture’ is also reported to positively affect the immune system. It is thought that this is due to endprphins acting as mediators between the central nervous system and the immune system.

Reducing the chronic pain:

In twice blind scientific trails, acupuncture was proven successful in treating chronic pain, 55% to 85% of patients reported positive benefits. This compares positively with the effectiveness of potent drugs, like morphine, which helped in 70% of cases.

Acupuncture is currently being used worldwide as part of court-ordered drug withdrawal and detoxification programs. In a remarkable study, 42% of alcoholics remained alcohol free for three months following acupuncture treatment, and an additional 28% drank much less. These are extraordinary numbers when compared with any other type of drug therapy.

Acupuncture treatments resolve concern:

Although many people notice a reduction in symptoms of the neck pain following the first treatment, acupuncture may take 3 to 5 sessions before results are evident. This is predominately dependent on the difficulty of the problem being addressed. Generally the greater the chronic condition, the more treatments that are necessary to elicit long term relief. For chronic conditions of neck pain there are many acupuncture experts. The use of appropriate herbal formulas, changes in diet, lifestyle and exercise may be necessary to correct long standing problems of the neck pain.

Lower back pain or lumbago affects more than 80% of the people at some stage of life and can be very bothering. No specific reason can be assigned for this disease and the pain can be chronic, moderate and acute. This musculoskeletal disorder impedes free movement of an individual and the serious cases often demand total bed rest. The symptoms sometimes persist for a week and subside and may relapse after a gap of few weeks or months.

Symptoms

The following symptoms are the indications of Lower back pain -

1. Pain in back while bending, moving and walking.
2. The pain is felt in the buttocks and pains that can last for 48 to 72 hours.
3. Often the pain may extend below the knee to the foot and ankle.
4. Pain felt while sneezing and coughing.
5. Stiffness in the back and the hip muscles.

Causes

Though back pains don’t have any specific cause but some underlying reasons can be:

1. Any injury to the back muscles, spine and back bone that can result in this problem.
2. Abnormal functioning of the abdominal organs.
3. Pressure on the nerve roots or Sciatica is another factor.

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4. Degeneration of the spinal discs.
5. Spondylosis, Fibromylagia and Osteomyelitis are other causes of lower backache.
6. Even smoking can cause lower backache.

Treatment

In case of moderate and sub acute back pains some self care treatments and medications are enough to cure the disorder but in chronic cases regular exercises with due precautions must be carried to keep the pain in check.

1. Sleeping with pillows in between the knees or sleeping lying on the back with knees resting on the pillow gives some comfort and so are often recommended by doctors.

2. Exercises are beneficial for chronic back pain as it improves the blood circulation in the muscles.

3. Some backache may require long bed rest depending upon the severity of the pain.

4. Painkillers like ibuprofen and acetaminophen are prescribed to relieve the back pain.

5. Application of heat and ice packs are also found to be beneficial in some cases.

6. Application of a pack of black mustard seeds produces intense heat that lowers the back pain.

Low back pain symptoms are sometimes just bothersome, such as dull aches or tenderness, but can be severe in some cases. That’s why you need to be able to target the pain, learn about the symptoms that you’re experiencing, and know when you need to see a doctor and when you can just wait it out to see if it goes away. In some cases, symptoms can even seem like they’re related to low back pain but be the root of a different problem, such as when you have kidney problems or shingles, which is common in older adults.

Make sure that you are aware of where the acute pain is, what symptoms accompany it, and how severe it is. You never want to assume that it’s just a sore muscle when the pain is too much to bear, because this could lead to prolonged injury, permanent damage, or even severe illness because you didn’t recognize that it wasn’t actually back pain at all. Keep these things in mind when checking out your symptoms and you’ll be better prepared.

Millions of people all over the world regardless of their status in life have symptoms of back pain. These individuals affected by lower back pain are at the age of 40 and above, pregnant women and the obese.

According to doctors, there are many causes of lower back pain and for your information; here are some that causes pain in the back by many.

1. Herniated discs – the spinal discs expand thinner and degenerates and the center nerves bulges causing the discs to push against the nerve root. People who are older than 20 may suffer from this kind of disorder causing back pain.

2. Lumbar Radiculopathy – This is a type of nerve irritation that causes back pain in individuals. The discs degenerates and the middle portion of the back bones rupture. Pain can be felt in the back down through the legs.

3. Osteoporosis – Occurs usually in women. Osteoporosis causes bone density loss and it becomes thinner resulting to lower back pain and fracture of the bones because of brittleness.

4. Fibromyalgia – The causes of fibromyalgia is fatigue, sleeping disorders and tenderness of the tissues. Back pain is felt as the soft tissues are weakened.

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5. Spinal stenosis – This is another cause of back pain in older individuals. The joint cartilage enlarges; there are a thickened ligaments and bony spurs. Pain in the back worsens once individuals attempt to carry heavy objects.

6. Arthritis – Arthritis is an n inflammation of the joints. Arthritis can be in the hands, legs knees, neck or in several parts of the body that has joints. People who suffer from arthritis in the lower part of the body can feel back pain, difficulty from walking and swelling in the joint areas of the lower part of the body.

These are just some that causes an aching back in certain individuals. Now, as doctors may say; there are also treatments to stop these causes of back pain. Here are some immediate cures:

1. You can apply heat and cold pressure on the affected area using an ice pack or a heat pad. Heat and cold may reduce the swelling and pain.

2. Medicines that can be purchased over the counter can also help remove back pain. These medicines are: analgesics, pain relievers, anti-inflammatory drugs and muscle relaxants. Treatment can be temporary but it is quite effective.

3. Application of topical creams like capsaicin, ginger roots and other mentholated creams can help relieve the pain in the back.

4. Simple exercises are also effective as long as the correct procedures are done. Brisk walking, body twists and other back exercises will do.

5. Massage – Massage is a relaxing method to take away backache. The method utilizes the hands to gently massage the back. Rubbing creams can also be added to enhance the effectiveness of massage.

6. The last resort when every method has been done and yet it is a failure is surgery. Surgery is the immediate cure if there are tumors, fractures or bone misalignment that causes back pain.

The causes and treatments of pain in the back are applicable if proper consultation from the doctor is done.

Joint pain can indicate a comparatively benign condition, such as mild sprain. Joint pain can be the result of a moderate condition, disorder or disease, such as bursitis, ankylosing spondylitis, a moderate ligament sprain, or a dislocation. Joint pain can also accompany serious conditions that can even be life-threatening.

Joint Pain Causes

Joint pain can be caused by injury or sickness touching any of the ligaments, bursae, or tendons nearby the joint. Injury or illness can also influence the ligaments, cartilage, and bones within the joint, most important to a painful joint

Joint Pain Symptoms

Pain is the chief symptom of most musculoskeletal disorders. The pain may be mild or severe, local or common (diffuse).
Although pain may be acute and brief, as is the case with most injuries, pain may be constant with chronic illnesses, such as rheumatoid arthritis

Most Important Tips for Joint Pain: -

•    Apply Eucalyptus oil where there is pain. Steam the affected area or dip a towel in boiling water, twist the water out from the towel and apply it to the affected area.

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•    Have one tea spoon of cod liver oil every day-Stick to the one tsp measure. Avoid use of too much pain killers especially those containing narcotic and sleeping tablets.

•    You can have a look at your diet as there are some products that will exacerbate the pain. Sometimes dairy products, citrus, alcohol, some meat, beef, pork, lamb, and vegetable oils have inflammatory effects and if your condition is inflammatory then this is a joint pain remedy that you should consider. You can find a good arthritis diet out there for you.

•    Have lots of fruits containing Vitamin C like Guava, Oranges, and Gooseberries. Try avoiding milk and potatoes.

•    Usually Joint pain is felt more in the morning. Apply some ointment on the affected area before going to bed everyday.

•    Simple exercises in Yoga, Cycling, Swimming, Walking etc. can control the pain. Keep the exercises simple and do not overexert. Doing exercises standing in chest level water also improves the pain.

•    Proper posture should be maintained while sitting, walking and lying down.

•    If overweight, control weight by reducing food and doing exercises.

•    Prepare a mixture by mixing equal quantity of carrot juice and lemon juice. Consume one tablespoon of this mixture daily is one of the best remedy for joint pain. Carrot juice strengthens our ligaments to a great extent.

•    Drinking papaya seed tea has a positive effect in relieving join pain. Drink this tea at least 4-5 times every day for at least two weeks before you can see some results.

•    Drinking of plenty of water is effective in bringing down joint pain. Water is excellent for the purpose of flushing out the toxins from the body and providing joint pain relief.

•    When warm milk is inspired by adding one table spoonful of turmeric, it is an excellent remedy for joint pain relief.

•    Grind four peeled pieces of garlic, along with two grams of Sprague. Dip this mixture in 30 grams mustard oil and heat, on low flame, for 1-2 minutes. Massage the aching joints with this oil, after cooling it down, to get release from pain and swelling.

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Discitis is relatively uncommon but it usually affects children under the age of ten. It is a low grade infection, usually caused by staphylococcus or a virus. It affects the disc space between two vertebrae and develops very slowly. Medical experts say this should be viewed in the same category as vertebral oseomyelitis (infection within the vertebrae). It can lead to severe, debilitating, neurological damage.

Disease Process
The infection does not start primarily in the in disc space but migrates there from other sources in the body. Urinary tract infections, pneumonia, and soft tissue infections are believed to be the most common sources. Often, no site of infection is discovered. The lumbar(lower) back is affected most often, followed by the cervical spine(neck) and last is the thoracic spine (upper back). Some post-surgical patients have developed the disease weeks after their operation, and, in their case disease diagnosis is not delayed. They rarely develop neurological deficits.

The edges of the disc erode and the degree depends upon the amount of infection and destruction within the disc. These areas become calcified, once healing begins, and, eventually, there is an interbody fusion, when healing is completed

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Disease in Adults
This infection has a slow, insidious onset which can result in diagnosis being delayed for months. Pain in the back and neck are the most common complaints and movement makes it worse. Because the symptoms are similar to those of back strain, there is usually a delay in seeking medical attention. A doctor is often not seen until the sufferer develops an elevated temperature and chills, with weight loss. This delay can lead to a severe condition and the mortality rate (death rate) ranges between 2% to 12%. It more commonly affects males, with a ratio of 2:1 that has gone as high as 5:1.

Disease in Children
The onset is often more sudden, acute, and the back pain is accompanied by a refusal to walk, sit up, and there is extreme irritability. There may be localized tenderness over the spine and decreased range of motion.

Common Symptoms in Adults And Children
• Elevated temperature
• Chills
• Sweating
• Feeling of fatigue
• Loss of appetite
• Localized tenderness of spine
• Pain may travel to other parts of the body, including abdomen, hip, leg, groin.
• Movement aggravates pain.

Diagnosis
• Laboratory studies
• Sputum cultures may be done to isolate bacteria for diagnosis.
• Blood Culture
• X-rays of spine may show narrowing of disc space.
• Nuclear scan of spine
• CT Scan (Computerized Tomography)
• MRI (Magnetic Resonance Imaging)
• Echocardiogram can identify bacterial endocarditis which is responsible for some cases of discitis.
• Needle Biopsy of painful area to obtain tissue for culture

Treatment
• Antibiotics specific to kill organism once it’s identified
• IVs for hydration and supportive care
• Immobilization is necessary.
• Usually 2 weeks of bedrest
• Back brace when patient is able to ambulate
o This allows vertebrae to fuse in an aligned position.
• Bracing may be necessary for 3 to 6 months following treatment to avoid collapse of vertebrae and development of kyphosis ( curvature of spine – ‘round back’)

Discitis occurrence in the US ranges from 1 in 100,000 to 1 in 250,000 but in less developed countries, it is more common. In some parts of Africa, 11% of all patients seen for back pain were diagnosed with discitis.

The present article is relaed to the observation made by the author in his two and half decades of clinical practice on the cure of the divergent inflammatory diseases such as Asthma, Arthritis, Tuberculosis, etc. by administering a single molecule/ medicine. Extensive literature and patent search could not present any scientific explanation for the phenomenon observed and reported. Preliminary research at the author’s clinic and lab has enabled the postulation and confirmation of a novel theory and immune pathway involving Histamine haemostasis referred to as the Rao’s Vicious Cycle.  In this study the medicine used belongs to the category of allergies, a new mechanism is proposed for the action of mediators during the inflammation. It has been postulated that the histamine liberated from the mast cells is the key link among the divergent diseases. During inflammation, histamine is released at the inflammatory sites as predicted by Rao’s vicious cycle. The later refers to the proliferation of TH2 type of reaction and its dominance over TH1 reaction.  In this method of cure known as Appa Hista, antihistamine antibodies, combat the histamine at the inflammatory sites and also block TH2 type of reaction, thus indirectly helping the TH1 type of reaction. The dual effect of Appa hista antibodies has been visualized in 1) Killing the intracellular organisms through TH1 type of reaction and; 2) Neutralizing the histamine at inflammation site at the same time blocking the excess TH2 type of reaction. Since Appa Hista directly attacks histamine where ever it is present, it may cure all inflammatory diseases.

            The present investigation deals with the cure of some of the most stubborn problems such as paralytic stroke, arthritis, tuberculosis etc., by using histamine conjugated normal human immunoglobulin.  Histamine is a chemical mediator and also the prime mediator of inflammation.  It is a vasoactive amine, found long back and established as a chemical mediator of inflammation.  This compound is essential for vascular permeability and allows the vessels to leak the protein rich exudate and cells to the site of inflammation. The latter is divided into two groups: 1) Acute inflammation and 2) Chronic inflammation. While chronic inflammation may originate as chronic itself, an acute inflammation, may, over a period of time become chronic.  The inflammatory response is closely coupled with the process of healing or repair.  A foreign body (agent) always wants to destroy the host tissue for its settlement, while, the host always tries to get rid of the agent as it is foreign.  Thus, inflammation can be considered as a protective response of the host and serves to destroy, dilute or wall off the injurious agents, and, also as far as possible heal and reconstitute the tissues.

            Normally, inflammation is an immunological (protective) phenomenon and, pain is a protective signal to get rid of the stimuli (causes).  At times they become pathological and produce disease.1 Repair begins during the early phases of inflammation but reaches completion usually after the injurious influence has been neutralized. During repair the injured tissue is replaced by parenchymal (functional) cells or by filling of the defect with fibroblastic tissue (scarring) or most commonly by a combination of these two processes.  The defense mechanism is such that the system tries itself best to give protection by innate immunity. Alternately, if the agent is a stronger one, then only the acquired immunity is triggered either by humoral immunity (present in body fluids) or by cell mediated immunity or by both.  The humoral/cell mediated immunity is offered by several preformed or existing proteins like compliment and antibodies, or, by cells like macrophages, lymphocytes and neutrophils.  When an agent initiates an injury, the defense mechanism is triggered by release of mediators.  Rather than too few, there are a large number of mediators in the defense system.

            The cells that are developed in the bone narrow mature and liberate into the blood stream.  A few cells settle in the tissues and lympho reticular system to perform their immunological function.  The cells in the blood are red blood cells (RBC) white blood cells (WBC) and platelets.  Red cells supply oxygen to all the systems.  White blood cells defend body from foreign stimuli and platelets help in clotting.

            The WBC is further divided into Granulocytes, lymphocytes and monocytes.  It is well known that granulocytes are further divided into polymorpho nuclear leucocytes, Eosinophils and Basophiles. Lymphocytes are divided into T cells, B cells and NK cells.  Monocytes are referred to as monocytes in the blood and as macrophages and mast cells in the tissues.

Mediators are found in cells as well as in plasma. Mediators are classified into preformed mediators and newly synthesized mediators. Preformed mediators always exist even in the absence of the inflammatory stimuli.  These are histamine, serotonin, lysosomal enzymes which are generated by the cellular sources mast cells, platelets, neutrophils, macrophages etc. The newly synthesized mediators, on the other hand, are formed in the presence of an inflammatory stimulus.  These are prostaglandins, leucoterines, and platelet activating factors, cytokines, and nitric oxide etc., generated from cellular sources such as leucocytes, platelets endothelium and macrophages.

            Under the influence of an inflammatory stimulus certain proteins in the plasma like complement under go chain reactions releasing intermediary substances like C3a, C5a and C5b – 9.  C3a is an anaphylotoxin attracting histamine to the site, while C5a attracts neutrophils to the site.  C5b – 9b, on the other hand, are believed to create MACs (membrane activating complexes) and cause target cells lysis (destruction). A plasma protein known as Hegeman factor, on the other hand, activates, clotting/ kinin cascades resulting in blood clotting and pain.

            The response initiated by an antigenic stimulus in the cells and mediators in a host is known as immune response.  As is well documented IR can be divided in to two types such as the humoral (antibody mediated immunity (AMI)) and the cellular (cell mediated immunity (CMI)). AMI refers to interaction of antigens with antibodies present in the plasma and in the interstitial fluids (extracellular), resulting in neutralization.  CMI refers to the direct killing (lysis) of intracellular bacteria through various cytokines secreted by T lymphocytes.

            The current state of understanding regarding immunological reactions can be summarized as follows.  Briefly the I Anaphylactic, II Cytolytic and III Immune complex reactions eventually generate TH2 (T Helper cell sub set 2). The latter generate the IL4 IL5 and IL10 (interleukin cytokines) which take part in allergic reactions, basic healing and also provide opposition to the TH1 subset. TH1 subset forms in delayed type of hypersensitivity reaction (type IV) and includes the cytokines IL2, TNF and IFN contributing to intracellular killing.

 

Two decades of clinical practice in curing various inflammatory diseases and the possible common link between these is summarized in Table 1. The latter clearly points out the administering of the medicine for a primary disease such as Asthma which was found to have a beneficial affect on Arthritis, and so on.  Thus, a single medicine normally used in treatment of allergies had resulted in cure of several inflammatory diseases which are hitherto being treated separately.  Animal experimentation at All India Institute of Medical Sciences (AIIMS) confirmed the anti inflammatory properties of the medicine.2 This necessitated a re-look in to the fundamentals of cells, mediators and immunological response.  Literature and patent search revealed that in 1994 a US patent was granted to Yoshi et al from Japan.

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Subsequently relief by the treatment has been observed in the following inflammatory diseases;

Rheumatoid arthritis, SLE, Seronegative arthropathies, including reactive arthritis, ankylosing spondylitis, psoriatic arthritis, and various vasculitides.

Paralysis (Cerebro vascular accident due to vasculitis), Encephalitis, Tuberculomas, multiple sclerosis, Epilepsy, peripheral neuritis, migraine, Guillian-Barr’e syndrome.

Bronchial asthma, TB, Drug resistant tuberculosis, and pulmonary mycotic conditions.

Glomerulo nephritis, chronic renal failure, nephrotic syndrome.

Chronic UTI, Stress incontinence, chronic leucorrhoea, and infertility.

Hypertension, Rheumatic heart diseases, (also with CCF, Choria) Congestive cardiac failure, Atherosclerosis. Global hypokinesia.

Chronic venous (Sephanous) ulcers, psoriasis, Lepraneuritis, and Vitiligo (Early Stage).

Iridocyclitis, Uveitis, Retinal detachment, Glucoma, Vasomotorrhnitis, Epistaxis, Allergy, Miners disease.

Peptic ulcer, IBS, Ulcerative colitis.

Stress related syndromes. Dementias.

Cerebral Malaria, Filariasis, Fungal infections and DIC.

Cancer pains, chronic pains, few cancers arrested.

Thyroid, Diabetes.

 

 

COMMON LINK AMONG INFLAMMATORY DISEASES

Reorganization of cells

In the present methodology, the cells are reorganised into cells presenting antigens, cells required in processing antigens and intermediary cells, and, cells found at the site of inflammation. Of particular importance is the role played by intermediaries such as mast cells and basophiles. As will be seen later these are essential for release of histamine, and therefore, key agents for initiating and maintaining the inflammation.  It is thus imperative that any control on mast cells should control the inflammatory diseases.

Mast cells

Mast cells4,5are bone marrow derived tissue resident cells, relatively large in diameter (10-15 mm) and heterogeneous in shape.  Under optical microscope the mast cells reveal 50 to 200 densely packed granules in each cell, each granule in turn is bound to membrane. A typical granule of 0.1 to 0.4 mm contains relatively large amounts of histamine, heparin, TNF and other preformed inflammatory mediators.  The surface of the each of the cells is coated with high affinity receptors ecoR1, which attracts IgE molecules on the surface of mast cells. Following the attachment of the IgE molecules on the mast cell surfaces, the granules start degranulating.  Although mast cells are found in connective tissues through out the body, these are present in large numbers beneath the surface tissues such as skin, lung alveoli, gastrointestinal mucosa and nasal mucus membranes. Thus, mast cells are strategically positioned to interact with inhaled or ingested antigens.

Mechanism of Mediators:6

            Histamine at the inflammatory site has a long life (30-60 mts), and, is stable as compared to most mediators derived from phospholipids and nitric oxide.  As is well known histamine triggers all the mediators and vice versa. Therefore, in any physical injury such as trauma, cold or heat, the activation of already stored histamine from the mast cells is expected to play a dominant role.

 

Histamine receptors on lymphocytes:7,8,9 

            In the proposed protocol it has been postulated that histamine can trigger lymphocytes in releasing other mediators.  This is possible only if there is histamine receptors present on the lymphocytes.  This assumption has received a recent support from several researchers. Similarly, the action of T cells in the histamine homeostasis10 (self-regulating information feedback) is proposed to take place as illustrated in Fig. 1. An important point to note is that IL6, IL8 and TNF etc., present at the inflammatory site due to tissue injury are also capable of liberating histamine.

 

IgE B Cells:

            The IL4 cytokine is expected to play a dominant role in sensitizing CD4 cells and through it the effector cells i.e. B cells and CD8 cells.  Further, in a double pronged manner IL4 can directly sensitize an IgE B cell which in turn releases IgE and acts on mast cells to liberate histamine.  The latter in turn goes to the inflammatory site and causes healing through TH2 type of reaction.  In case the inflammation is larger, it may turn in to chronic due to liberation of cytokines IL4 IL6 TNF etc.11  These in turn, in a positive feed back cycle, trigger histamine release and aid in maintaining chronic inflammation.  This vicious cycle of generation of histamine at the site of injury and its subsequent triggering of IgE B cells ( Histamine pathway II) and CD4 cells ( Histamine pathway I) is termed as Rao’s Vicious cycle.  That is strong inflammation can turn into chronic inflammation by the continuous generation of excess histamine in repeated positive feed back cycles.  Micro organisms may be exploiting this phenomenon in producing chronic inflammation and autoimmune diseases.

 

Rao’s Vicious Cycle and it’s interaction with three immunological pathways

            As is well known, any immunological reaction operates through three different path ways as shown in Fig.2.  The path way 1 is known as IgE / mast cell / mediator path way can be sub divided to reflect physiological and pathological conditions as path 1a and path 1b respectively.  It can be noticed that in all the physiological conditions histamine is liberated and together with TH2 affect the cure.  The pathological conditions of inflammation on the other hand may turn in to chronic inflammation due to the excessive generation of histamine in a cyclic manner as explained earlier by Rao’s vicious cycle.

            Fig. 2 depicts the details of physiological and pathological path ways.  The difference between the 3 path ways is in the sources of histamine and also in the intermediaries.

Evidently, the histamine at the inflammatory site together with TH2 cures the inflammation.  Thus, histamine physiologically plays a role as type of switch for TH1 or TH2.          

IgE/mast cell/mediator path way12 (Fig. 3a) depicts the physiological path way which sets TH2 type of reaction after an allergic inflammation, there by affecting cure. Fig. 3b depicts pathological path way where in the presence of local cytokines IL4, IL6, INF etc., at the inflammatory site trigger the release of excess histamine over and above that required for maintaining histamine homeostasis.  This in turn triggers IgE B cells and in a cyclic manner contributes to release of more histamine making the inflammation chronic.  This in brief is the Rao’s vicious cycle proposed to be applicable for chronic inflammatory conditions.

            The IgG, IgM/Complement/neutrophil pathway as shown in Fig. 4, includes the pathological path 2b.  Typically IgG / IgM immune complex interacts with complement, which releases C3a and C5a and bring histamine and neutrophilis into the site. The presence of IL4, IL6, IL8 etc. at the inflammatory site trigger histamine and in turn the Rao’s Vicious Cycle.  The TH2 type of reaction, although, helps in healing process in physiological (2a) inflammation through the parenchymal cells, the excess of TH2 found in pathological inflammations can cause over healing, resulting in scaring and stiffening.

In the physiological path way 3a as shown in Fig. 5, theCD8 cells kill the intracellular organisms by TH1 type of reaction, and, the TH2 type of reaction set by histamine heals

through parenchymal cells. Pathological path 3b (T lymphocyte / lymphokine pathway) directly kills the intracellular organisms by TH1 reaction through the cytokines liberated by CD8 cells. However, the TH2 cytokines liberated from IgE B cells and the associated excess histamine through Rao’s Vicious cycle contribute to the chronic nature of inflammation.  Thus, in spite of the killing of intracellular organism (TH1 action) the inflammation continues (by TH2 action which opposes TH1).  The pain13, stress, and cancer cytokines are also the same as those that cause inflammation and, so can trigger Rao’s Vicious cycle.

 

Appa Hista:

            Appa Hista refers to the proposed method of curing inflammation using anti- histamine antibodies while exploiting the fundamental phenomena of Rao’s Vicious cycle.  It is by now clear that the histamine homeostasis in the body is disturbed during inflammation.  Antigen administered in the physiological condition of inflammation reacts with IgE B cells generating the IgE and in turn through TH2 type of reactions affecting the cure.  More serious is the pathological condition leading to chronic inflammation. Rao’s vicious cycle plays a major role in generating and maintaining histamine levels above those required for histamine homeostasis.  It is interesting to note that the generation of excess histamine is found in acute and chronic inflammation.  The cure therefore is to see that antibodies are generated to combat against histamine.  In Appa Hista method, histamine conjugated normal human immunoglobulin is intramuscularly injected. It works like a vaccine. This most likely reaches all the lymph nodes and stimulates B cells to produce IgG antihistamine antibodies (also referred to as Appa Hista).  The antibodies in turn reach the inflammatory site and neutralize the histamine i.e. it breaks the Rao’s vicious cycle, either directly or enhance the histamine binding ability of the plasma.  The histamine binding/ diluting ability is as high as 30 times in normal individuals as compared to that of suffering from allergic inflammation in normal individuals.14

            Appa Hista’s main advantage is that it neither interferes in primary histamine release nor causes any immuno suppression.  During the past two decades of clinical practice, the author had cured couple of hundreds of patients of both sexes with age groups ranging from 10 to 60 years. The relief from inflammatory diseases found in most cases range from good to excellent (patent application status). The intensity of the disease is found to be reduced on the administration of the medicine along with the gradual increase in the time periods at which the medicine has to be re-administered.  This may takes 3 weeks to 3 months depending up on the intensity of symptom.  An interesting feature is that the patients felt totally comfortable during in between drug administration periods along with a general feeling of well being, which was not the case with steroids or any other drugs.

 

Side effects:

            There are no side effects observed in the Appa Hista method of cure and applications.  It is however found that the method is not very effective in the case of smokers, and alcoholics. From an economic view point the treatment is inexpensive as compared to current day methods used.  Also, the drug, which is already bio-assayed and available in the market for last 30 years can be easily procured and administered.

            A link is observed among the inflammatory diseases and it is identified as Rao’s vicious cycle. Histamine is present in human body in levels corresponding to that required to maintain histamine homeostasis.  During inflammation, histamine is released at the- inflammatory sites as predicted by Rao’s vicious cycle. The later refers to the proliferation of TH2 type of reaction and its dominance over TH1 reaction.  In the Appa Hista method of cure, antihistamine antibodies combat the histamine at the inflammatory sites and also block TH2 type of reaction, thus indirectly helping the TH1 type of reaction. The dual effect of Appa hista antibodies can be visualized in:

1) killing the intracellular organisms through TH1 type of reaction, and,

2) neutralizing the histamine at inflammation site at the same time blocking the excess TH2 type of reaction.

Since Appa Hista directly attacks histamine where ever it is present, can cure all inflammatory diseases.

 

REFERENCES

 

1)      Espinoza, L. R. & Cuellar, M. L. Molecular Pathogenic Mechanisms of Spondyloarthropathies: (Medical Intelligence Unit). Publisher: (Springer,  Berlin, Germany), 125 pp (1995).

2)      Dr. Appa Rao Peddapalli. Use of Histamine Conjugated Normal Human Immunoglobulin for treatment of all types of pain and inflammation, Indian Patent Application: 3165/DEL/98, (1998).

3)      3) Dr. Appa Rao Peddapalli. Use of Histamine Conjugated Normal Human Immunoglobulin for treatment of all types of pain and inflammation, Indian Patent Application: 1301/DEL/2002, Dec 26th, (2002).

4)      3) Yoshii Haruo,  Fukata &  Yuriko. Immunomodulating and antiinflammatory agent. United States Patent 5,780,026  July 14, (1998).

5)      Valent, P.; et al. Variable expression of activation-linked surface antigens on human mast cells in health and disease.   Immunological Reviews, 179 74-81 (2001).

6)      Orth,  Reid N.; Wu, Min; Holowka, David, A.; Craighead, Harold, G. & Baird, Barbara A.  Mast Cell Activation on Patterned Lipid Bilayers of Subcellular Dimensions. Langmuir,   1599-1605 (2003).

7)      Falus, Andras; Laszlo, Valeria; Darvas, Zsuzsa & Bencsath, Martha. Histamine – an early messenger in the immune system and inflammation. Central-European Journal of Immunology, 52-54 (1996).

8)      Schneider, Elke; Rolli-Derkinderen, Malvyne; Arock, Michel & Dy, Michel.  Trends in histamine research: new functions during immune responses and hematopoiesis. Trends in Immunology,   255-263 (2002)

9)      Coge, Francis; et al. Genomic organization and characterization of splice variants of the human histamine H3 receptor. Biochemical Journal, 279-288 (2001).

10)  Mannaioni, P. F.; Fantozzi, R.; Giannella, E.; Masini, E. & Dep., Preclin. Pathophysiological significance of the distribution of histamine receptor sub-types:  a proposed dual role for histamine in inflammation and type I hypersensitivity reactions. Univ. Florence, Florence, Italy.    26-34 (1988).

11)  Lichtenstein, L. M. & Osler, A. G. Studies on the mechanisms of hypersensitivity phenomena. ix histamine release from human leukocytes by ragweed pollen antigen. Journal of Experimental Medicine. 507-30 (1964).

12)  De Rossi, Marco; Bernasconi, Pia; Baggi, Fulvio; De Waal Malefyt, Rene & Mantegazza, Renato.  Cytokines and chemokines are both expressed by human myoblasts: possible relevance for the immune pathogenesis of muscle inflammation. International Immunology, 1329-1335 (2000).

13)  Schwarz, M.; Sunder-Plassmann R.; Cerwenka A.; Pickl, W. F. & Holter, W.Regulation of cytokine production by human T-lymphocytes in allergic immune response. Wiener Klinische Wochenschrift, General Review, 672-6 (1993).

14)  Dickenson, A. & Besson, J.M. The Pharmacology of Pain. Handbook, Exp. Pharmacol., Publisher: (Springer,  Berlin, Germany.) 479pp (1997). 

15)  Kokai Tokkyo Koho. Nippon Zoki Pharmaceutical Co. Ltd. Japan, Allergy treatment. Japanese Patent, Application: JP 78-162375  19781223,6 pp (1980).

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Sciatica refers to a chronic pain that is felt at the base of the spine, the hip and buttocks, the leg and in the foot.  When someone is suffering from severe sciatica, even a task like walking becomes difficult as the pain can be such that weight cannot be put onto the leg. These painful symptoms get their name from the sciatic nerve, the longest and largest nerve in the body. This nerve is as thick as a finger in parts, and travels from the base of the spine into the legs.

Those that suffer from sciatic nerve pain often find that it attacks in bouts. They may be pain free for several months, then experience a few days where the pain in considerable. Often those that experience sciatica will also experience lower back pain and upper back pain in the times when their sciatica is worse. Migraines and neck pain are also felt in severe cases.

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There are differing potential causes of sciatica that have been identified by health practitioners. One identified cause of sciatica is a herniated disc. Between the vertebrae of the spine are discs which are made of soft, spongy tissue. Stress to the spine and back causes discs to bulge, placing pressure on the sciatic nerve. Damage to discs can be caused by things including bad ergonomics, sports injuries or other lower back injury.

During pregnancy, many women experience lower back pain and sciatic nerve pain. Pressure on the sciatic nerve is one of the most common causes of this pregnancy back pain. As the pregnancy progresses, shifts and changes in the body mean that the pressure on the body is increased which can in turn lead to back pain.

 Other causes of sciatica can include:

Spondylolisthesis – a condition where vertebra in the lower part of the spine slip forward and onto a vertebra below
Nerve compression caused by accidents or injuries
Spinal stenosis – a narrowing of the spinal canal causing pressure on the nerve
Poor posture or body use.

Treatments for sciatica can include lower back pain exercises and therapies to improve overall muscle function and integration to take pressure off the sciatic nerve. Surgery has also been used to address sciatic nerve pain caused by damaged discs.

 

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Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point of time during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks.If back pain is more than 3 months it is called as chronic back pain.Most back pain goes away on its own, though it may take a while. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.

 

To understand the sources of your particular back problem and / or how to prevent back pain, it helps to understand the anatomy of your spine.

The human spine consists primarily of a line of interlocking bones called vertebrae (derived from the Latin term vertere, meaning “to turn”).

 

 

One of a series of irregular bones that form the spine. A vertebra has 2 parts: the vertebral body and the arch; there are 33 vertebrae total: 7 CERVICAL,12 THORACIC, 5 LUMBAR, 5 FUSED to form the SACRUM and 4 COCCYGEAL; feature of a typical vertebra include: body, pedicles, transverse processes, laminae, articular processes, spinous process…

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The spinous process (projecting from the center of the vertebral arch) and the transverse processes (projecting from either side of the vertebral arch) serve as attachments for the muscles and ligaments.

The articular processes meet and interlock at the facet joints to link one vertebra with the next. Each vertebra arch has four (two superior and two inferior) articular processes.

 

Simple back pain can occur to any person aged from 25 to 65yrs who otherwise are healthy. There are some triggering factors for simple back pain.

 

Most of the time, your doctor will only need to discuss your symptoms and examine you for back pain. If the pain lasts longer than six weeks, or if your doctor suspects there is some underlying cause of the pain, then he or she may recommend more tests.

 

Non Surgical Treatment of Back Pain

‘Conservative treatment’ is a common term used for describing the different types of non-surgical treatments. As almost all people who have spine-related problems do not need surgery,

 

Medicinal Treatment

NSAIDs, Pain reliever, Muscle relaxants, spinal injections and antidepressants are used in back pain. NSAIDs work by reducing inflammation and providing pain relief. Inflamed ligaments and joints can cause pain directly or by irritating nerves as they leave the spine

 

Surgical Treatments for Back Pain

Only a small minority of patients suffering from low back pain ever require surgery. In the absence of severe or progressive weakness, or signs of cauda equina syndrome,

 

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Low back pain or pain in lumbar region affects nearly 80% of people once or many times in their lives. It is a pain caused due to musculoskeletal disorder and can cause acute, sub-acute or chronic pain. It is the area that supports most of the body weight of a human body, this structure makes all the movements of the body possible and provides flexibility to the body.

The lumbar area is made up of five vertebrae and between them are inter-vertebral discs which act as a cushion and also prevent the vertebrae to rub each other. These inter-vertebral discs also protect sciatica nerve which off shoots from the lumbar region. This whole structure is supported and held together by muscles and ligaments and muscles make the movement of the low back possible.

As it is evident that low back is the area which bears most of the weight of the body and is involved in most of the movements made by the body in day to day activities, this makes it prone to wear and tear and also to injuries. Any injury to the muscles or ligaments can cause pain in the back. With the growing age the lumbar area can have diminished or shrunk inter-vertebral discs which make the vertebra or facet joints rub each other causing pain and stiffness in the lower back area. With the age ligaments and muscles also loose the strength and elasticity which can make vertebra move more than they should, hindering the functioning and causing pain in the low back. Spinal stenosis, pinched sciatica nerve, osteoarthritis, rheumatoid arthritis, gout arthritis, herniated spinal disc are some other problems which lead to chronic low back pain and need special treatment and attention for alleviation.

The initial symptoms of low back pain is mild pain in the lumbar area which may radiate down on the front side or back of the leg or may remain confined to the lumbar area. This pain increases with the movement like walking or standing and sometimes it may get aggravated at night while in resting position or in prolonged sitting position. Inability to standup on the toes or inability to raise big toe upwards signifies irritation of certain nerves. Numbness or tender points or lack of blood supply to any leg during sitting position also suggest low back pain.

NSAID, herbs for controlling pain and inflammation, creams, massages, therapies and exercises are helpful in treating low back pain. In the case of chronic pain due to arthritis or herniated disc, massages and exercises are recommended along with pain killing medicines. Since side effect of NSAID are not yet known completely so herbal treatment for pain control is recommended. Rumatone Gold capsules and oil is very good ayurvedic remedy in lowering back pain. Light exercises, weight control and healthy life style are helpful in preventing episodes of low back pain. Yoga poses and exercises are also extremely helpful in curing and avoiding the pain in low back area by keeping the weight under control and functioning of the joints smooth and proper.