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Good and affordable dental clinic in Ashok Vihar
There is a huge difference between a dental clinic and successful dental clinic. Walking through a car or having a long walk on the road, we can see numerous dental clinics surrounding us. Having a tag and degree with the Doctor’s name will not gain the trust of the patients. To be successful, a dental clinic must be equipped with modern amenities and requisite facilities at low and affordable cost. One such clinic of all the clinics in Delhi, that stood out is Dr. Sachdeva Dental Institute, led by Dr. Rajat Sachdeva, perhaps one of the best and affordable dental clinic in terms of quality of treatment given and services provided, equipped with the latest technology at affordable prices. Moreover one of those few dentists in Delhi who follow a holistic approach to dentistry. With people all over the world vouching for their effective treatments at low and affordable cost with best and long term results.

The team at Dr. Sachdeva Dental looks beyond dentistry and delivers customer satisfaction, believing in prioritizing comfort, soothing and relaxing experience to patients. Carry out each and every procedures with utmost diligence. They also provide comprehensive, pain free treatment for all the dental procedures. A multi-specialty dental clinic with the latest equipment and state of the art laboratory that ensure that they deliver you the best. A lot of patients are treated by this clinic and are very happy with the treatments and desired results. Satisfied patients from more than 15 countries.

Experience dental services like never before. Get that flawless smile by visiting Dr. Sachdeva Dental Institute.

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Case study Enuresis in children
ABSTRACT: Nocturnal enuresis (NE) is involuntary urination that occurs at night during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology. There are a number of treatment options available for NE; such as drug therapy, bladder training, positive reinforcement, and the enuresis night alarm. It requires patience, persistence and motivation. Several behavioural approaches can be used for treatment such as enuresis night alarm therapy and various skills oriented components. A thorough homoeopathic case taking and treating with an individualised homoeopathic remedy of single dose gives an assured result. Case with marked peculiar symptom can be made basis of prescription and not all cases requires repertorization.
Keywords: Nocturnal enuresis, bedwetting, enuresis, homoeopathy, single dose, peculiar symptom.
Nocturnal enuresis (NE) is defined as “involuntary voiding of urine that occurs while sleeping that can happen at an inappropriate and socially unacceptable time and place” and due to which its negative impact occurs on the quality of life of the affected children and their families. It is most common in boys, with a ratio of three boys for every girl until the age of 15. Enuresis should be differentiated from continuous or intermittent incontinence or dribbling. The bed is usually soaking wet in enuresis, compared to incontinence in which there is loss of urine without normal emptying of the bladder.
More than 85% children attain complete diurnal and nocturnal control of the bladder by five years of age. The remaining 15% gain continence at approximately 15% per year, such that by adolescence only 0.5-1 % children have enuresis. Up to the eleventh year, enuresis is twice as common in boys as it is in girls; thereafter, the incidence is similar or slightly higher in girls.
Enuresis is called primary when the child has never been dry and secondary when bed wetting starts after a minimum period of six months of dryness at night.
Enuresis may be comorbid with mood and emotional disorders and also has a high level of comorbidity with attention deficit hyperactivity disorder (ADHD). Part of emotional disorder such as anxiety, expression and insomnia are experienced by persons who have elimination disorders related to distress and social stigma
Enuresis classified on the basis of the time of occurrence into the following three subtypes:
• Nocturnal Enuresis: Passing urine during sleep.
• Diurnal Enuresis: Leakage of urine during waking hours.
• Monosymptomatic or uncomplicated NE: Normal voiding at night with absence of symptoms.
• Polysymptomatic or complicated NE: Bedwetting at day time with symptoms urgency, frequency, constipation and encopresis.
• Nocturnal and diurnal Enuresis, also known as nonmono-symptomatic enuresis.
- NE is hereditary, children whose parents were not enuretic have only a 15% incidence of bedwetting and when one or both parent were enuretics, the rates increases to 44% and 77% respectively
- From the difficulty in waking up when the bladder is filled.
- excessive nocturnal urine production and nocturnal bladder hyperactivity
- Can be drinking late in the evening or not passing urine before going to sleep, resulting in excessive urine volume.
- Another cause may be a low amount of antidiuretic hormone during the night which controls the production of urine.
Goals of treatment
The following are goals of management for NE
• To stay without bedwetting on particular occasions such as sleepover at night or day.
• To decrease the frequency of wet nights.
• To decrease the impact of enuresis on the child and family.
• To avoid recurrence of bedwetting.
For achieving the above goals lifestyle and behavioural changes play an important role.

Primary management of enuresis is behavioural modification and positive reinforcement and it should be start with educating the child as well as parents about the condition, which can be achieved through :
-Behavioural Management.
-Night urine alarm therapy.
-Pajama (Under wear) Device
-Mechanism of action of Night urine Alarm Device
-Waking schedule

A female patient of age 10 years visited our A. M. Shaikh Homoeopathic Hospital on 22/07/2019 with her father who described her case in detail with the presenting complaint of Bed wetting since 5 years.

History of presenting complaint
Patient came with the complaint of bed wetting at night and daytime as well; there is no single dry night since 5 years.At times she passes urine 2-3 times at night and once during her day/evening sleep.
No H/O Night terrors or Nightmare.
Treatment history:
Has consulted an allopathic paediatrician for the above mentioned complaint and was on treatment for 3years with no desirable improvement, so wilfully seeking homoeopathic treatment.
Past history: No H/O any major illness or any remarkable events occurred since birth.
Family history: Nothing significant. No family history of enuresis.
Neck holding - 4th month
Monosyllable speech – 7th month
Crawling – 9th month.
Sitting without support by 10th month.
Walking without support – 14th month.
Normal speech with meaningful words – after18 months.
Personal History:
Diet : Vegetarian,
Appetite :Not adequate, hardly eats a roti at times.
Thirst : 1 – 1.5 ltrs / day,
Micturition : D/N : 3-4/2-3,
Stools : Once/day, Regular, Soft.
Desires : Spicy food.
Life Space Investigation :
 Birth history : Full term normal hospital delivery. Mother had absolutely healthy pregnancy throughout the term. Mother was not a known case of Hypertension, Diabetes Mellitus, Hypothyroidism. No H/O any insult (injury) at birth.
 Post delivery – till date. : Patient is born and brought up in Kadoli, Belagavi. No remarkable events since birth.
 She is good in studies, mingles with people easily. She gives debate and speaks freely without fear in-front of people and she has won in almost all the debate she has participated yet she is timid. She cannot takes / tolerates the pain when other people are quarrelling (reaction sympathetic). She is that sensitive she cannot even tolerate the fight in movies and serials. If she sees any beggar on road she tends to lend her tiffin.
General Physical Examination :
Patient is moderately built and moderately nourished, No pallor, cyanosis, icterus, clubbing, oedema, lymphadenopathy, Temperature : 98.6º F. (Afebrile), Thermals : Hot, Height :129cms, Weight :26kgs, Birth Weight : 2.75kgs, Pulse rate :84 bpm, Respiratory cycle : 18cpm.
Clinical diagnosis :Primary enerusis.
Totality of symptoms :
 Bedwetting at night and daytime.
 Desires spicy food.
 She cannot tolerate when other people are quarrelling (reaction - sympathetic), She is that sensitive she cannot even tolerate the fight in movies and serials. If she sees any beggar on road she tends to lend her tiffin
 Hot patient.
Analysis of symptoms :
Common symptoms Uncommon symptoms
Bed wetting. She cannot tolerate when other people are quarrelling.
Timid but speaks in public.
Desires spicy food

Prescription: Causticum200 HS 1dose
Basis of prescription : This case has been prescribed without repertorization as we found the substantial / peculiar symptom ( sensitive to emotional disturbances) for prescription while case taking.
Follow up’s : (written as it is expressed by father)
 29/07/2019
Father said patient has passed urine only twice during her sleep since last week.
Complaints are better by 50%.
Prescribed Placebo BD for 15 days.
 19/08/2019
Patient has passed urine during day sleep only once since past 10days.
No bedwetting at night since 10 days.
Appetite has improved, father said she herself asks and have food.
Patient is better by 75%.
Prescribed Placebo BD for 15 days.
 03/09/2019
Bedwetting only once at day sleep and no bedwetting at night since 1 month.
Feeling generally better.
No fresh complaints.
Prescribed Placebo BD for 15 day.
Conclusion : Enuresis can be successfully treated with detailed homoeopathic case taking with individualised homoeopathic medicine along with encouragement, a positive attitude and motivation are important components of treatment to become dry. Punishment and criticism has no role to play in care. Children with enuresis get always benefit from a caring attitude of parents. A positive approach by the physician and care taker is also important role to play for putting confidence and to increase compliance.
References :
1. Ghai. O. P, BaggaArvind, Pual. V.K; Ghai essential paediatrics; 8th edition revised and enlarged; CBS Publications and distributors Pvt. Ltd.; NewDelhi; 2013, P-504.
2. Kliegman, M. Robert, Stanton, F. Bonita. Geme, St. Schor; Nelson Textbook of Paediatrics; 20th edition; ELSEVIER; Philadelphia; 2016;
3. Sleep and hypnosis : a Journal of Clinical Neurosciences and Physiopathology.
From :
Dr Shashank H S
Dept of Paediatrics
PG Part 1
A M Shaikh Homoeopathic Medical College , PG Research Centre & Hospital, Belagavi.

Under the guidance of :
Dr Nahida M Mulla. M.D (HOM); MACH
Prof. and HOD Paediatrics
A M Shaikh Homoeopathic Medical College , PG Research Centre & Hospital, Belagavi.

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Best dental clinic in Ashok Vihar
With a bunch of dental clinics around it becomes very difficult to choose the best dental clinic in Delhi. Best is nothing if it does not satisfy your requirements and the right treatment. So what makes any clinic best is well experienced doctors, its treatment quality, latest equipments and best results at low and affordable prices. So talking about good dentist and best dental clinic Dr. Sachdeva’s Dental Institute is one among them as they provide highest of standards of services by professionals with extensive proficacy and knowledge of dentistry, by Dr. Rajat Sachdeva, leading the team of well trained and qualified professionals has been successfully running one of the best dental clinic in Ashok Vihar, New Delhi for the past 15 years. Situated in good and prime location in Ashok Vihar. A one stop solution for all dental related problems with top service at low and affordable cost. One of the best dental implants clinic in Delhi, specialized in 16 implant systems, including Single Tooth Implant, ALL-ON-4, ALL-ON-6, ALL-ON-8, Implant Bridge, Keyhole Implants, Full Arch Implants, Basal Implants, and more. Lifetime Warranty On Implant. The only clinic in Delhi to offer crowns in 24 to 48 hrs.

We at Dr. Sachdeva’s Dental Institute patient care is a top priority, offering a full range of treatments/procedures for all age groups to restore your smile, looks and personality with guaranted long term best results. As a centre of clinical excellence, our dentistry expertise is unmatched and unrivalled in our region. Satisfied patients from more than 15 countries. So, just walk in and let go of the fear and anxiety associated with a visit to a dentist with our friendly staffs and soothing atmosphere.

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Back pain treatment in Delhi
In simple words, low back pain can be defined as pain experienced in the bottom region of spine (between lower margins of ribs and the gluteal folds). It may remain localised to back or radiate to the legs.

Sciatica is a term used for pain radiating down from the lower spine to the legs. Most common cause of sciatica is irritation or compression of the nerves as they exit the spine on their way to the legs. It may be accompanied by numbness, tingling and weakness in the distribution of the affected nerve.

Globally low back pain (LBP) is one of the leading causes of disability. LBP is an important cause of limitation of activities, absence from work with resultant economic implications. In industrialised countries lifetime prevalence of non-specific low back pain is estimated at 60–70%.Despite the high incidence and intensive research into this area, pain generators are not easy to identify and the diagnosis Nonspecific Low Back Pain is used commonly. This is different from situations where a specific cause such as fracture, infection, neoplasm etc. responsible for pain generation can be identified.

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Alveolar Distraction Osteogenesis Analysis by Radiographic Mean for Vertical Reconstruction Of Alveolar Ridge: A Novel Research Approach.
Author : Dr. Naqoosh Haidry, Dr. Ritesh Raj, Dr.Brijesh Byrappa, Dr. Amit Kumar, Dr. Manish Kumar, Dr. Anshu Prakash

Aim and objective: The aim and objective of the current study was to evaluate the effectiveness of alveolar distraction osteogenesis technique radiographically for vertical reconstruction of atrophy alveolar ridges in partially edentulous patients.

Materials and Methods: A total of 120 vertical distraction osteogenesis procedures were performed in110 patients. Two panoramic radiographies were performed in all patients, one the day before the beginning of distraction, and one after consolidation period, 18 weeks postoperatively. The radiographic analysis consisted of obtaining the amount of the vertical bone gain in each radiography. For this, we
obtained initially the magnification factor of each panoramic radiography by dividing the real size of the activation rod among the image size of the activation rod. After this, to obtain the VGB, we measured initially the length of the distractonpre activation (LD1), which consisted of the distance between the superior portion of the basal plate and the superior portion of the transport plate, multiplying by the
magnification factor. Then, we measured the length of the distraction postactivation (LD2), using the same method described before, in radiographies performed 12 weeks postoperatively. The vertical bone gain was obtained using the following formula: vertical bone gain = LD2 — LD1. The results were applied to descriptive statistical analysis.Complications were also investigated during all of the treatments.

Results: The mean alveolar distraction achieved in 120 cases was 7.21 (range, 0 to 10.83 mm). According to the region treated, 50.8% were in the posterior mandible (mean vertical bone gain , 4.60 mm, DP: 2.04), 37.68% were in the anterior maxilla (mean vertical bone gain,7.46 mm, DP: 2.28), 7.33% were in the anterior mandible (mean vertical bone gain, 6.73 mm, DP: 2.04), and 4.33% were in the posterior maxilla (mean vertical bone gain, 6.32 mm, DP:2.65).

Conclusions: The Alveolar Distraction Osteogenesis technique was demonstrated to be an effective tool to treat vertical defects of the alveolar ridge with a success rate of 92.64%. Our radiographic analysis seems to be an important tool in verifying the technique as well as planning implant placement after Alveolar Distraction Osteogenesis.

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A Comparative Study of the Effect of Primary and Secondary Closure Technique Following Removal of Impacted Mandibular Third Molars
Author : Naqoosh Haidry, Ritesh Raj, Sandeep Kashyap, Brijesh Byrappa, Amit Kumar, Ankur Singh

Introduction: Surgical removal of the impacted mandibular
third molar is one of the most frequently performed surgical
procedures in oral and maxillofacial surgery. The purpose of
this study was to compare the primary and secondary wound
closure after surgical removal of impacted mandibular third
molars by evaluating the extent of facial swelling, the severity
of pain and degree of trismus.

Material and Methods: A prospective, randomized,
clinical trial was conducted in 80 patients. The patients were
randomly divided into two groups of 40 each. In Group 1:
patients underwent primary closure of the wound and in
Group 2: patients underwent secondary closure of the wound.
Postoperative pain, swelling, and trismus were evaluated on
the 2nd and 7th day postoperatively.

Results: Statistically significant difference was observed for
facial swelling and trismus on 2nd postoperative days between
both groups. Postoperative pain was less in the secondary
closure group.

Conclusion: From the outcome of the above study we can
conclude that the secondary wound closure technique has a
significant advantage over primary wound closure concerning
swelling and trismus.

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Shaken Baby Syndrome
Shaken baby syndrome (Shaken impact syndrome) is a serious form of abuse inflicted upon a child. It usually occurs when a parent or other caregiver has shaken a baby out of anger or frustration, often the baby will not cry.

Babies have very weak neck muscles that cannot fully support their proportionately large heads. Severe shaking causes the baby's head to move violently back and forth, resulting in serious and somethings fatal brain injury. These forces are exaggerated if the shaking is interrupted by the baby's head hitting a surface.

Is a serious brain injury caused by forcefully and violently shaking a baby? Other names for this condition include abusive head trauma, shaken impact syndrome, and whiplash shaken syndrome. it can result from as little as five seconds of shaking.

Babies have soft brains and weak neck muscles. They also have delicate blood vessels. Shaking a baby or young child can cause their brain to repeatedly hit the inside of the skull. this impact can trigger bruising in the brain, bleeding in the brain, and brain swelling. Other injuries may include broken bones as well as damage to the baby's eyes, spine, and neck.

The shaken baby syndrome is common in children under age 2, but it can affect children up to ae 5. Most cases of shaken baby syndrome occur among infants that are 6 to 8 weeks old, which is when babies tend to cry the most. Playful interaction with an infant, such as bouncing the baby on the lap or tossing the baby up in the air, won't cause the injuries associated with the shaken baby syndrome. Instead, these injuries often happen when someone shakes the baby out of frustration or anger.

Symptoms of Shaken baby syndrome:

Symptoms include:

. Difficulty staying awake

. Body tremors

. Trouble breathing

. Poor eating

. Vomiting

. Discolored skin

. Seizures

. Coma

. Paralysis

Deceleration of the head when it impacts a surface can cause the following:

Subdural hematoma, which is a collection of fo blood between the surface of the brain and the dura.

This occurs when the veins that bridge from the brain to the dura are stretched beyond their elasticity, causing tears and bleeding.

Subarachnoid hemorrhage, which is bleeding between the arachnoid and the brain.

Direct trauma to the substance itself, caused when the brain strikes the inner surface of the skull.

Shearing off or breakage of nerve cell branches in the cortex and deeper structures of the brain caused by violent motion to the brain.

Further irreversible damage to the brain substance from the lack of oxygen if the child stops breathing during shaking.

Further damage to the brain cells when nerve release chemicals that add to oxygen deprivation to the brain.

Retinal hemorrhages ranging from a few scattered hemorrhages to extensive hemorrhages involving multiple layers of the retina.

Skull fractures resulting from impact when the baby is thrown against a hard or soft surface.

Fractures to other bones, including the ribs, collarbone, and limbs, bruising to the face, head and entire body.


. Encephalopathy, brain swelling

. Subdural hemorrhage, or bleeding in the brain

. Retinal hemorrhage or bleeding in a part of the eye called the retina.

The doctor will order a variety of tests to check for signs of brain damage and to help confirm the diagnosis. These tests may include:

. MRI scan, which uses powerful magnets and radio waves to produce detailed images of the brain

. CT scan, which creates clear, cross-sectional images of the brain

. Skeletal X-ray, which reveals the spine, rib, and skull fractures

. Ophthalmic exam, which checks for eye injuries and bleeding in the eyes

Irreversible brain damage from shaken baby syndrome can occur in a matter of seconds. Many babies experience complications, including:

. Hearing loss

. Seizure disorders

. Development delays

. Intellectual disabilities

. Cerebral palsy, a disorder that affects muscle coordination and speech

Shaken Baby Syndrome is preventable. You can avoid harming your baby by not shaking them under any circumstances. It's easy to become frustrated when you can't get your baby to stop crying. However, crying is a normal behavior in infants, and shaking is never the right response.

It's important to find ways to relieve your stress when your child cries for extended periods. Calling a family member or a friend for support can help when you feel yourself losing control. Some hospital-based programs can teach you how to respond when infants cry and prevent the injuries associated with the shaken baby syndrome. Make sure your family members and caregivers are also aware of the dangers of shaken baby syndrome.

Shaken Baby Syndrome is completely preventable. Taking care of a baby can present challenges, especially for first- time parents. However, it is important to remember that it is never acceptable to shake, throw or hit a baby.

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Stretch marks
The medical for stretch marks is "Oestriae atrophic" which tabor's medical dictionary describes as fie pinkish- white or gry lines, usually 14cm in length, seen in part of the body where the skin has been stretched. Commonly seen on thighs, abdomen, and breasts of women who are or have been pregnant, in persons whose skin has been stretch by obesity, tumor, or dropsy, or in persons who have taken for a prolonged period.

This is different from cellulite, which is a dimpling of the skin caused by a thin upper layer of the skin with large, irregular fat cells below. Stretch marks are, however, somewhat related to cellulite in that women are much more susceptible than men due to skin anatomy. Women have more subcutaneous fat, which has less of a cohesive cellular structure and also tend to have a thinner top layer of skin which makes the superficial skin more to damage of all kinds.

The top layer of skin and the underlying fatty layer are constructed mostly of fats. Besides eating good fats to preserve skin integrity, use plenty of Vitamin C. Vitamin C is the primary nutrient in connective tissue repair. Skin is the largest and thinnest connective tissue organ of the body and uses a high percentage of the available vitamin c for upkeep and repair. Vitamin C is very safe in doses high enough to cause loose stool, at the point you're wasting nutrients, so cut back to a dose that normalizes the stool. This is called taking vitamin C to bowel tolerance fats would be ideally from fresh-baked, broiled or steamed fish, or plant sources such as olive, flax, and safflower. Avoid margarine, fatty meats including lunch meats and canola oil. Avoid mass-produced baked goods, which tend to use poor quality fats.

The best approach to stretch marks is, of course, prevention. Keep in mind that skin quality is at least 50 percent genetics, and some women are more prone to stretch marks just because of hard-wired information inherited from parents and grandparents. If your family history points to a greater possibility for stretch marks, you should apply the prevention tactics described below as faithfully as possible.

As with all prevention approaches to optimal health, good food is critical. Minimize red meat and other saturated fats, avoid caffeine and excessive alcohol, get lots of greens and fresh fruits, plenty of pure water, and of course, regular moderate exercise. Balancing work with play is essential. Don't forget to sleep. America's most ignored vital nutrient. Please don't skimp on sleep. The best approach to stretch marks is, of course, prevention. Keep in mind that skin quality is at least 50 % genetics and some women are more prone to stretch marks just because of hard-wired information inherited from parent and grandparents. If your family history points to a greater possibility for stretch marks, you should apply the prevention tactics described below as faithfully as possible.

As with all prevention approaches to optimal health, good food is critical. Minimize red meat and other saturated fats, avoid caffeine and excessive alcohol, get lots of greens and fresh fruits, plenty of pure water, and of course, regular moderate exercise. Balancing work with play is essential. Don't forget sleep, America's most ignored vital nutrient. Don't skimp sleep.

Skin Brushing :

Daily brushing of the entire skin surface with a stiffy, dry, skin brush is a Scandinavian beauty secret. Skin brushing takes off the top layer of dead cells. First thing in the morning, firmly stroke the brush over the skin towards the heart. Start with the feet, moving up the legs, be extra firm around the thighs and buttocks. Gentler on the belly, move in a clockwise direction as you look down at your navel, this is the direction which waste travels out of your body in the colon. Use the long handle to get the whole back. Gently up under the breasts and down the neck and throat. Go up the arms starting from the hands. with time, the skin becomes healthier and much less susceptible to irreversible stretching.

Contrast Hydrotherapy:

The alternating application of hot and cold water to the skin is a fundamental health tool for naturopathic doctors and, hopefully, their patients. Hot water encourages blood flow to the skin, cold contracts the tiny vessels, pushing excess fluid or debris into the natural garbage collection system of the body, the lymphatic channels. The basic approach to contrast hydrotherapy is bathing in warm or hot water, then chasing with cold. Ideally, the temperature differential would be at least 60 degrees F. The treatment must end with cold water, and kames sure to get under the armpit and the groin area. Also, turn around to reach to kidneys which are protected by the lower ribs in back, to encourage waste elimination.

Not losing or gaining weight quickly:

This is usually the reason stretch marks occur. You can improve the elasticity of the skin with a good diet, vitamin C, vitamin E and the skincare measures described above, but preventing skin stretching is best. Pregnant women should be prepared to gain 25 to 40 pounds slowly and steadily and take a full 9 months to regain their pre-pregnancy weight. Crash diets are notoriously bad for the skin and they don't work for permanent weight loss either.

Vitamin E topically and by mouth:

Personally, attribute getting through pregnancy with not a single mark on the belly to high-quality Vitamin E. I slathered it on daily the third trimester, and sporadically before that, from neck to knees, ingested 400IUs of vitamin E daily throughout the pregnancy, always breaking open the gel cap with teeth and letting the oil start to absorb right in my mouth, tossing the empty gel cap. I learned this trick from a nutrition instructor if you can possibly chew your supplements like food, the thousand or nerve receptors in the mouth single the brain what's coming down the pike, and start to prepare the digestive tract with the proper enzymes for optimal digestion and absorption.

Fact on stretch marks:

- Stretch marks are long, narrow streaks or stripes that occur when the skin is stretched too quickly.

- Pregnancy, puberty, and rapid weight gain call all cause stretch marks.

- There is little medical evidence available confirming the effectiveness of current treatments for stretch marks.

- Stretch marks often fade over time without treatment and do not pose any serious long- term health risks.

What are stretch marks??

Stretch marks are scars or disfiguring lesions. They are also called striae, striae distensae, striae atrophicans, and striae gravidarum.

The most common areas affected include:

- Abdomen

- Breasts

- Hips

- Flank

- Buttocks

- Thighs

Stretch marks are not physically dangerous but can cause problems with self-image and anxiety, for some people, stretch marks are a significant cosmetic concern that can affect day-to-day living.

Signs and symptoms:

Before stretch marks begin to emerge, the skin can appear thin and pink, it may also feel irritated or itchy.

The marks initially develop as wrinkly, raised streaks that can be red, purple, pink, reddish-brown or dark brown, depending on skin color. The streaks eventually fade and flatten and tend to change to a silvery color over time.

Causes and risk factors:

Extreme skin growth or shrinkage can cause stretch marks, common causes of skin stretching include:

- Pregnancy: Between 50 and 90 % of women who are pregnant experience stretch marks during or after birth.

- Puberty: Rapid growth is typical in young people going through puberty. This can lead to stretch marks.

- Rapid weight gain: Putting on a lot of weight in a short of time can cause stretch marks.

- Medical conditions: Certain conditions can cause stretch marks, such as Marfan the skin tissue, and Cushing's syndrome can lead the body to produce too much of a hormone that leads to rapid weight gain and skin fragility.

- Corticosteroid use: Prolonged use of corticosteroid creams and lotions can decrease levels of collagen in the skin. Collagen strengthens and supports the skin, and a reduced amount can increase the risk of stretch marks.

The skin consists of three key layers. Stretch marks form in the dermis, or middle layer, when the connective tissue is stretched beyond the limits of its elasticity. This is normally due to rapid expansion or contraction of the skin.

As the body grows, the connecting fibers in the dermis slowly stretch to accommodate alow growth. However, rapid growth leads to sudden stretching. This causes the dermis to tear, allowing deeper layers of skin to show through.

This can form stretch marks and contributes to the way they look.

Stretch marks eventually fade to a silvery, white, or glossy appearance, due to the pale fat beneath the skin becoming visible instead of the usual blood vessels.

They are more likely to develop and become more severe where there are high levels of circulating cortisone, or when cortisone is applied to the skin. Cortisol, the stress hormone produced by the adrenal glands, is converted into cortisone. This weakness elastic fibers in the skin.

Risk factors:

A number of risk factors have been associated with the development of stretch marks, but the evidence varies. More research is needed to confirm the causes of stretch marks.

The risk factors for developing stretch marks could be linked to:

- Family history

- Chronic diseases

- Body mass index (BMI) before pregnant

- Birthweight of the child in women who are pregnant

These finding can be explained by the greater degrees of skin stretching in obese women with larger babies and by age-related changes in skin collagen and connective tissue that affect the likelihood of tearing.


Stretch marks are easily diagnosis based on a skin examination and a review of a person's medical history.

The doctor will usually ask questions based on signs and symptoms, as well as any medications currently being used or existing medical conditions.

Stretch marks are not harmful and do not cause medical problems. In rare cases, they may indicate an underlying medical issue that requires treatment or monitoring.


Stretch marks cannot always be prevented. However, the following steps may help to reduce the risk:

- Maintain a healthy weight

- Avoid yo-yo dieting

- Eat a balanced diet rich in vitamin and minerals. Consuming a suitable amount of vitamin A and C can help support the skin, as well as the minerals zinc and silicon.

- Aim for slow and gradual weight gain during pregnancy.

- Drink six to eight glasses of water every day.

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Vitiligo is a disease that causes the loss of skin in blotches. The extent and rate of color loss from vitiligo are unpredictable. It can affect the skin on any part of your body. It may also affect the hair and the inside of the mouth.

Vitiligo is a skin disorder in which the cells that make melanin pigments are destroyed. The destruction results in the appearance of white patches o the skin. Vitiligo can occur at any age, but usually before the age of 20 in about 50 % of patients.

Normally, the color of hair and skin is determined by melanin. Vitiligo occurs when the cells that produce melanin die or stop functioning. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. The condition is not life-threatening or contagious. It can be stressful or make you feel bad about yourself.

There are five main types of vitiligo, which are based upon the location of the white patches and the pattern of involvement, focal, generalized, acrofacial, segmental and universal.

Focal vitiligo: minimal involvement with only one or a very few white patches scattered on the skin.

Generalized Vitiligo: The most common type with symmetrical patches on any location on the skin including the trunk and or extremities.

Acrofacial Vitiligo: White patches limited to the fingers and around the mouth and eyes.

Segmental Vitiligo: White patches on one side of the body and in a linear or line like distribution.

Universal Vitiligo: Widespread patches involving the entire body.

The cause of vitiligo is not well understood. It is believed to be an autoimmune, disorder which means that certain blood cells in your body, lymphocytes, turn against and attack the melanocytes. Another theory is that vitiligo is caused by an interaction between the body nerve cells and melanocytes.

Vitiligo may be associated with other immune disorders. They include Addison disease, alopecia areata, diabetes mellitus, thyroid disease, melanoma, chronic mucocutaneous candidiasis, pernicious anemia, and uveitis.

Skin is made up of many layers, the skin is the largest organ of the body. It protects, maintains the temperature balance, releases out the toxins out of the body in the form of sweat and maintains the equilibrium. It reflects the internal and general health of the person. Unhealthy, dry, discolored and pigmented skin depicts indication for certain medical diseases.

Skin cell contains melanin, a dark pigments that give the color to the skin and protects it from the strong rays of the sun that are particularly harmful. If the melanin is destroyed at a certain part of the body or not produced then the skin looses, its color and turns leave white spots known as Leukoderma or Phulveri in laymen's language. Leukoderma means Leuco- white and derma, the skin is also known as vitiligo in medical terminology. It is also true that all white spots are not of leukoderma.

Children born with congenital absence of melanin have complete white skin of the whole body called Albinism that is a congenital and incurable condition.


The main sign of vitiligo is patchy loss of skin color. Usually, the discoloration first shows on sun-exposed areas, such as the hands, feet, arms, face, and lips.

Vitiligo signs include:

. Patchy loss of skin color

. Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard.

. Loss of color in the tissues that line the inside of your mouth and nose

. Loss of or change in color of the inner layer of the eyeball

Vitiligo can start at any age, but often appears before age 20

Depending on the type of vitiligo you have, the discolored patches may cover;

Many parts of your body. with the most common type, called generalized vitiligo, the discolored patches often progress similarly on corresponding body parts

Only one side or part of your body. This type, called segmental vitiligo, tends to occur at a younger age, progress for a year or two, then stop.

One of only a few areas of your body. This type is called localized vitiligo.

It's difficult to predict how your disease will progress. Sometimes the patches stop forming without treatment. In most cases, pigment loss spreads and eventually involves most of your skin. Rarely, the skin gets its color back.


Vitiligo is obscure, the various hypothesis is suggestive of its genesis. Among these the important ones are

. Immune Hypothesis:

Melanocyte destruction and dysfunction or both may result in Hypopigmentation of vitiligo.

. Neural Hypothesis:

Neurochemical inhibitors are released at nerve endings that destroy the melanocytes or inhibit their functioning.

. Melanocyte self- Destruction Hypothesis:

Proposes that an intermediate in melanin synthesis causes melanocyte destruction.

.Dietary deficiency of proteins and cupro minerals is a major factor for causing vitiligo. Serum skin and cerebrospinal fluid copper levels are low in these cases.

. A gastrointestinal disorder like chronic amoebiasis, chronic dyspepsia, and intestinal worms may be additional factors.

. Use of broad-spectrum antibiotics, especially chloramphenicol and streptomycin leads to the appearance of vitiligo.

. Trauma or local irritation caused by wearing the sari or trousers too tightly do produce vitiligo in individuals predisposed to it.

. Acute stress may be followed by a fast-spreading type of vitiligo proving the theory of Troponeurosis. The emotional crisis may be an additional factor.

. An Endocrinal disorder may be operative, Diabetes, Pernicious anemia, Thyrotoxicosis, Myxoedema, and Addison's disease may be associated with vitiligo.

. Composite Hypothesis- None of the theories alone is entirely satisfactory. The actual mechanism of inhibition or destruction of melanocytes is much more complex than any of these mechanisms suggested.

Precipitating Factors:

. Emotional crisis- Death in the family, loss of a job, sudden shock

. Gastrointestinal tract disorders like worms, Jaundice, amoebiasis.

. Prolonged use of drugs, antibiotics, oral ovulating agents

. Local causes like trauma burns exposure to chemicals etc.

. pathologically: A defect in enzyme Tyrosinase is held responsible for vitiligo. According to some dermatologists, it is a Trophoneurosis and melatonin, a substance secreted at nerve endings inhibits Tyrosinase, thus interfering in pigment formation.

Clinical Presentation of Vitiligo:

Localized type:

Focal- one or more macules in two single areas but not segmented.

Segmental- One or more macules in a dematomal pattern.

Mucosal- Involvement of mucous membranes alone.

Generalized Type:

Acrofacial- Involvement of face and distal extremities

Vulgaris- Scattered macules in symmetrical or asymmetrical distribution.

Universalis- Total or nearly whole body involvement


There are certain precautions, which can delay or stop the onset of the disease.

- Maintain good general disease

- It is a non- communicable disease

- Any patch should be thoroughly examined first

- Application of any unconfirmed tropical medication on the skin should be avoided

- Use of synthetic clothes should be restricted

- Avoid excess intake of sour things

- Avoid steroids

- It is a myth that leukoderma occurs by drinking milk over the fish. Thre is no relevance in avoiding anything to eat or drink which is white in color as assumed by some people similarly in cases of jaundice for yellow-colored things.


Offers a comprehensive treatment as it goes to the root of the problem by helping build up immunity and eventually restores the pigmented patches back to the normal skin color. I have observed in the clinic that there is some definite connection in the patents who are being treated for Hypothyroidism then getting Hypertjyroidism show patches of leukoderma as drugs induced leukoderma.


- Syphilitic- Destruction of melanocytes- the predominance

- Psoric - Though in Aphorism 195, Dr. Hahnemann states that in chronic local maladies that are not obviously venereal, the internal antipsoric treatment alone requisite suggests that it is Psoric in nature.

- Sycotic- As sycosis is the miasm which disturbs the pigment metabolism and produces hyperpigmentation and depigmentation in patches or diffuses in different parts.

How effective is Homeopathy?

Homeopathy is able to give wonderful and miraculous cures in many of vitiligo. This is due to the fact that homeopathy treatment enhances the natural production of pigments. According to Homeopathic philosophy vitiligo not a disease in itself but an expression of an inner disturbed state of the body. Thus, the cure should occur at a level where things have gone wrong. In order to archive this, the patient is analyzed on various aspects of mental and physical and familial attributes and also a complete study is done on the psychological environment that the patent has gone through in his life.

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Dementia comes from a Latin word "Demens" which means "Absence of mind" chronic impairment of thinking that affects a persons ability to function in a social or occupational setting. The impairment is severe enough to interfere with the patient's ability to perform routine activities.

According to WHO:

Dementia is a syndrome, usually of a chronic or progressive nature, in which there is deterioration in cognitive function beyond what might be expected from normal aging. It affects memory, thinking, orientation, comprehension, calculating, learning capacity, language, and judgment. Consciousness is not affected. The impairment in cognitive function is commonly accompanied and occasionally preceded, by deterioration in emotional control, social behavior, or motivation.

Dementia is not a specific disease. It's an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80% of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Dementia is often incorrectly referred to as senility or senile dementia which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. A progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. Areas particularly affected include memory, attention, judgment, language, and problem solving, madness or insanity. Alzheimer's disease international estimates that are currently 30 million people with dementia in the world with 4.6 million new cases annually. The number of people affected will over 100 million by 2050.

The age group most commonly affected by this illness is 60 and over still, there is some risk group that is not age-dependent, such as people that suffer from high blood pressure, smokers high cholesterol patients and so on. Dementia is a brain disorder, beings after the age of 60 that seriously affects a person's ability to carry out daily activities. It begins slowly, involving the parts o the brain that control thought, memory & language. People with AD may have trouble remembering recent events, name of people.

Over times symptoms get worse and the patient might have trouble in speaking, reading & writing. They may forget how to brush their teeth or comb their hair, become anxious or aggressive, and wander away from home.


Dementia is caused by damage to brain cells, this dan-mages interferes with the ability of brain cells to communicate with each other. When brain cells can not communicate normally, thinking, behavior and feeling can be affected. The brain has many distinct regions, each of which is responsible for different function (for example, memory, judgment, and movement). When cells in a particular region are damaged, that region cannot out its functions normally.

Causes divided into primary and secondary causes.

Primary Causes:

- Alzheimer's disease:

Is the most common form of dementia, and the disease most people associate with memory loss. Usually diagnosed after age 80 and is uncommon in people under the age of 65.

-Vascular dementia:

Occurs when small strokes or brain lesions impair blood flow to the brain. It is the cause of 20% of dementia cases, making it the second most common cause after Alzheimer's disease.

- Pick's Disease:

Symptoms are often hard to distinguish from Alzheimer's disease. Pick's disease damages nerve cells in the brains frontal and temporal lobes. Nerve cells affected by Pick's disease weaken and eventually die.

-Huntington's disease:

Is a genetically inherited neurological disease that can dementia. Huntington disease causes behavioral changes and chorea. The usual age of Huntington's disease onset is between forty and sixty years old.

- Parkinson's disease:

Is a progressive neurological disease that affects movement and muscle control. Symptoms of Parkinson's disease include tremors, balance problems, difficulty walking, and a rigid posture.

-Lewy- body dementia:

Related to Alzheimer's disease. The cause is the presence of abnormal substances called Lewy-body in parts of the brain such as cortex and brain stem. Lewy body dementia causes classical dementia symptoms, including memory loss. The disease can also cause hallucinations, depression, and paranoia.

Secondary causes:

Dementia like symptoms can develop as a result of an underlying condition can be treated, the symptoms will generally improve. The following are some of the common secondary causes that can lead to dementia.

-Alcohol Dementia and substance abuse:

Alcohol abuse can lead to symptoms of dementia. The long term toxic effects of alcohol on the brain are enough to cause it. Symptoms can often be improved by abstaining from alcohol.

-Infections diseases:

A number of infections that affect the central nervous system have been known to cause dementia symptoms, including HIV, meningitis, and encephalitis.


As people age, they tend to require more medication for their health. Many of the medications include dementia symptoms as aside effect. The list of medications is incredibly long and includes such common medication as anti-diarrhea medication, anti-epileptic medications, antihistamines, cold and flu medication, sleeping pills, tricyclic antidepressants.

Pseudo Dementia:

Depression can result in dementia symptoms, including memory loss and a lack of motivation. Elderly people dealing with health problems, the loss of spouse, or loneliness are particularly susceptible to depression. Treating depression often result in the reversal of dementia symptoms.

Metabolic disorders:

Metabolic disorders can also symptoms of dementia. These disorders include cortisol hormone imbalances, diabetes, electrolyte levels, kidney failure, liver diseases, and thyroid disorders.

Wernicke- Korsakoff syndrome:

It results from a deficiency in thiamine (Vitamin B1) and is often due to chronic, severe alcoholism. It can also result from general malnutrition, eating disorders, or the effects of chemotherapy. Dementia due to Wernicke- Korsakoff syndrome involves confusion, apathy, hallucination, communication problems, and severe memory impairment.

Brain Tumors:

Brain tumors put pressure on and damage the surrounding brain tissue. A brain tumor can cause a number of symptoms, including dementia. The tumor may originate in the brain or may have spread to the brain from other organs.

Signs and symptoms:

Dementia affects each person in a different way, depending upon the impact of the disease and the person before becoming ill. The signs and symptoms linked to dementia can be understood in three stages.


The early stage of dementia is often overlooked because the onset is gradual. Common symptoms include:

- Forgetfulness

- Losing track of the time

- Becoming lost in familiar places.

Middle stage:

As dementia progresses to the middle stage, the signs and symptoms become and more restricting. These include:

- Becoming forgetful of recent events and people's names

- Becoming lost at home

- Having increasing difficulty with communication

- Needing help with personal care

- Experiencing behavior changes, including wandering and repeated questioning.


The late stage of dementia is one of near-total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. Symptoms include:

- Becoming unaware of the time and place

- Having difficulty recognizing relatives and friends

- Having an increasing need for assisted self-care

- Having difficulty walking

- Experiencing behavior changes that may escalate and including aggression.

Handling Money:

Trouble remembering simple words, often dementia sufferers will substitute inappropriate words without realizing.

Common forms of dementia:

There are many different forms of dementia. Alzheimer disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies, and a group of diseases that contribute to frontotemporal dementia. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.

Rates of dementia:

Worldwide, around 50 million people have dementia, with nearly 60% living in low and middle-income countries. Every year, there are nearly 10 million new cases. The estimated proportion of the general population aged 60 and over with dementia at a given time is between 5-8%. The total number of people with dementia is projected to reach 82 million in 2030 and 152 in 2050. Much of this increase is attributable to the rising numbers of people with dementia living in low and middle-income countries.


There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. Doctors can determine that a person has dementia with a level of certainty. But it's harder to determine the exact type of dementia because of the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnosis dementia and not specify a type. If this occurs it may be necessary to see a specialist such as a neurologist or a psychologist.

Diagnosis requires a medical history, physical examination, including neurological examination and appropriate laboratory tests.

Taking a thorough medical history involves gathering information about the onset duration, and progression of symptoms, any possible risk factors for dementia, such as a family history of the disorder or other neurological diseases, history of stroke, and alcohol or other drug use.

The various laboratory investigations include:

- Thyroid hormone tests to check for an underactive thyroid.

- Vitamin B12 blood test to look for a vitamin deficiency.

- Complete blood count, or CBC, to look for infection.

- ALT or AST, blood tests that check liver function.

- Syphilis test to look for this disease.

- Chemistry screen to check the level of electrolytes in the blood and to check kidney function.

- Glucose test to check the level of sugar in the blood.

- MRI or CT to look for tumors.

Other lab tests that may be done include:

- HIV testing to look aids

- Erythrocyte sedimentation rate, a blood test that looks for signs of inflammation in the body.

- Toxicology screen, which examines blood, urine, or hair to look for drugs that could be causing problems.

- Antinuclear antibodies, a blood test used to diagnose autoimmune diseases

- Testing for heavy metals in the blood, such as a lead test.

Risk factors and prevention:

Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of aging. Further, dementia does not exclusively affect older people- young-onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling and blood sugar levels, Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.

Social and economic impact:

Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be 818 billion, equivalent to 1.1% of global gross domestic product. The total cost as a proportion of GDP varied from 0.2% in low and middle-income countries to 1.4% in high-income countries.

Impact on families and carers:

Dementia can be overwhelming for the families of affected people and for their carers. Physical, emotional and financial pressure can cause great stress to families and carers, and support is required from the health, social and legal systems.

WHO response:

WHO recognizes dementia as a public health priority. On May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017- 2025. The plan provides a comprehensive blueprint for action, for policy-makers, international, regional and national partners, and WHO as in the following areas, addressing dementia as a public health priority, increasing awareness of dementia and establishing dementia-friendly initiatives, reducing the risk dementia, diagnosis, treatment and care, information systems for dementia, support for dementia carers, and research and innovation. An international surveillance platform, the global Dementia Observatory, has been established for policymakers and researchers to facilitate monitoring and sharing of information on dementia policies, service delivery, epidemiology, and research.

WHO has developed Towards a dementia plan, a WHO guide, which provides guidance to the Member States in creating and operationalizing a dementia plan. The guide is closely linked to WHO's GDO and includes associated tools such as a checklist to guide the preparation, development, and implementation of a dementia plan. It can be used for stakeholder mapping and priority setting.

WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on interventions for reducing modifiable risk factors for dementia, such as physical inactivity and unhealthy diets, as well as controlling medical conditions linked to dementia, including hypertension and diabetes. Dementia is also one of the priority conditions in the WHO mental health gap action program, which is a resource for generalists, particularly in low- and middle-income countries, to help them provide first-line care for mental, neurological and substance use disorders.

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