The trend towards later maternity is strongest among women with better educational qualifications, as they increasingly postpone child rearing to pursue their careers.
On the whole, babies are more likely to be planned and wanted by women in their thirties. There is evidence that older women express greater satisfaction and feel they are ready to have a child because they have been fulfilled in their lives before that time. The notion of sacrifice is more often talked about in younger mothers. Older mothers may want to spend more time with their children."

Most of the degenerative changes, pre menopausal problems and metabolic diseases, thyroid dysfunction, cancers of breast and genital organs and deteriorating vision start from mid thirties, let us say around 35 years only. For preventive and optimal healthcare, we have to start early from the mid thirties, while later comes curative and palliative stage. The most common problem faced by the females over age 35 is menopause. Lets learn what to expect and ways to stay strong and healthy in the years around menopause.

Menopause

Menopause is a natural process that occurs as a woman�s ovaries stop producing eggs and the production of female hormones (estrogen and progesterone) declines. Menopause can also occur if a woman�s ovaries are damaged by certain diseases or cancer treatments, or if they are surgically removed. Menopause usually happens gradually between the ages of 45 - 55. The average age that women reach menopause is 51 years although it can occur as early as age 40 to as late as the early 60s. Women now have a life expectancy of more than 80 years. Currently, women can expect to live some 30 or 40 years of their life in the postmenopausal state.

Menopause does not occur suddenly. A period called perimenopause usually begins a few years before the last menstrual cycle. There are two stages in the transition:

1) Early Stage. Pre menopause can begin in some women in their 30s, but most often it starts in women ages 40 - 44. It is marked by changes in menstrual flow and in the length of the cycle. There may be sudden surges in estrogen.

2) Late Stage. The late stages of pre menopause usually occur when a woman is in her late 40s or early 50s. In the late stages of the menopausal transition, women begin missing the periods until they finally stop. About 6 months before menopause, estrogen levels drop significantly. The fall in estrogen triggers the typical symptoms of vaginal dryness and hot flashes (which can last from half a year to more than 5 years after onset of menopause).

Menopause is considered to have occurred after a woman has gone a full 12 months without a period. Menopause marks the end of menstruation and a women�s fertility.
Menopause is not a disease. However, many conditions are associated with estrogen depletion, including heart disease, osteoporosis, and other complications. Fortunately, effective treatments are available for these conditions.

Many women experience some physical and emotional symptoms during menopause, caused by hormonal imbalance. Typically, a woman will begin to experience menopause symptoms around her mid-40's as her body's reproductive capability comes to the end. This prolonged stage of gradually falling and fluctuating hormone levels is called per menopause, which can last upwards of two years before a woman's final period. For most women, symptoms end at menopause; however, some women will experience symptoms into postmenopausal life. The first symptom is usually a change in the pattern of your monthly periods. The start of the menopause is known as the pre menopausal stage. During this time, you may have light or heavy periods.The frequency of your periods may also be affected. You may have a period every two-three weeks, or you may not have one for months at a time. Other prominent symptoms of the transition to menopause include:

1) Hot flashes and night sweats . Women often feel hot flashes as an intense build-up in body heat, followed by sweating and chills. Some women report accompanying anxiety as the sensation builds. In most cases, hot flashes last for 3 - 5 years, although they may linger in some women for years after menopause. Women who have surgical removal of both ovaries, and who do not receive hormone replacement therapy, may have more severe hot flashes than women who enter menopause naturally.

2) Heart pounding or racing can occur, with or without hot flashes.

3) Difficulty sleeping . Insomnia is common during perimenopause. It may be caused by the hot flashes, or it may be an independent symptom of hormonal changes.

4) Mood changes . Mood changes are most likely to be a combination of sleeplessness, hormonal swings, and psychological factors as a woman undergoes this intense passage in her life. Once a woman has reached a menopausal state, however, depression is no more common than before, and women with a history of premenstrual depression often have significant mood improvement.

5) Sexuality . Sexual responsiveness tends to decline in most women after menopause, although other aspects of sexual function, including interest, frequency, and vaginal dryness vary. It is useful to remember that most symptoms of menopause eventually go away.

6) Forgetfulness . This appears to be one of the few symptoms that are common across most cultural and ethnic groups.

7) Urinary symptoms. During the menopause, you are more likely to experience recurrent lower urinary tract infections, such as cystitis. You may also feel an urgent and frequent need to pass urine.

8) vaginal dryness and pain, itching or discomfort during sex.

9) Joint stiffness .

10) Skin, Hair and Other Tissue Changes. With the increase in the age, you will experience changes in your skin and hair. Loss of fatty tissue and collagen will make your skin drier and thinner and will affect the elasticity and lubrication of the skin near your vagina and urinary tract. Reduced estrogen production may contribute to hair loss or cause your hair to feel brittle and dry.

Women from different countries and states have different menopausal symptoms. Menopause is not a disease. However, many conditions are associated with estrogen depletion, including heart disease, osteoporosis, and other complications. Fortunately, effective treatments are available for these conditions. After the menopause it is common for the following complications to appear.

Cardiovascular disease - a drop in estrogen levels often goes hand-in-hand with an increased risk of cardiovascular disease. Women who experience early menopause are almost twice as likely as the general population to have a heart attack, stroke, or other cardiovascular disease later in life. In order to reduce the risk of developing cardiovascular disease a woman should quit smoking, try to keep her cholesterol, blood sugar, and blood pressure within normal, healthy levels, do plenty of regular exercise, sleep at least 7 hours each night, and eat a well-balanced healthy diet.

Osteoporosis - Bone density may be lost at a fast rate for the first few years after menopause because estrogen plays a role in building new bone. The risk of fractures to the hip, wrist, and spine are especially pronounced in postmenopausal women.

Urinary incontinence - the menopause causes the tissues of the vagina and urethra to lose their elasticity, which can result in frequent, sudden, strong urges to urinate, followed by urge incontinence (involuntary loss of urine). Stress incontinence may also become a problem - urinating involuntarily after coughing, sneezing, laughing, lifting something, or suddenly jerking the body.

Urinary Tract Infections - Because of vaginal drying, women are at increased risk for recurrent urinary tract infections after menopause.

Low libido - this is probably linked to disturbed sleep, depression symptoms, and night sweats.

Overweight/obesity - during the menopausal transition women are much more susceptible to weight gain because metabolism slows. Experts say women may need to consume about 200 to 400 fewer calories each day just to prevent weight gain - or burn of that number of calories each day with extra exercise. The chances of becoming obese rises significantly after the menopause.

Breast cancer - women are at a higher risk of breast cancer after the menopause. Regular exercise and check ups after menopause significantly reduces breast cancer risk.

Skin and Hair Changes - Estrogen loss can contribute to slackness and dryness in the skin and wrinkles. Many women experience thinning of their hair and some have temporary hair loss.

Lifestyle Changes Changing and improving lifestyle is the basic factor in preventing 50% of ageing and metabolic diseases. Making lifestyle changes may help ease the discomfort of menopause symptoms. Simple changes in lifestyle and diet can help control menopausal symptoms such as hot flashes. Avoid hot flash triggers like spicy foods, hot beverages, caffeine, and alcohol. Dress in layers so that clothes can be removed when a hot flash occurs. For vaginal dryness, moisturizers, and non-estrogen lubricants are available. Quit smoking, get enough sleep, and make a conscious effort to eat healthily and exercise more to keep symptoms of menopause under wrap and keep yourself fit and healthy. One of the keys to enjoying menopause is to try to keep up a happy and healthy lifestyle. The right diet, open communication with your partner, and stress relief are examples of ways to make life the most easy in menopause.

How long will the phases of menopause lasts in women is completely individual. Most women experience the majority of their symptoms over a 2-year period of time�, but that will just annoy those women who find themselves still up to the eyeballs in hot flushes after 5 years. The average age when menopause is on is around 52 years old, but many women start in their 40s and some not until their late 50s, so really you just have to see what happens for you.

The ultimate aim is to give healthy lives in later age, to compressor illness in to short period of time, to reduce morbidity and disability of ageing women passing more than one third of their life in the menopausal age.

Rupal Hospital for Women is a premiere leader in women's healthcare since 45 long years. The doctors are committed to providing women with the highest quality and most advanced healthcare throughout all stages of their lives, from adolescence through menopause. Rupal clinic for women is providing special care to women around 35 years, Premenopausal, Menopausal and post menopausal ageing women. Dr. Malti Shah senior Gynecologist and obstetrician, qualified for Menopause Practice gives her services to the clinic. Rupal Hospital Menopause Clinic offers care for women with concerns about the menopause, including women with early menopause or menopause caused by surgery or illness. Rupal Hospital understands and meets all the health needs of a woman and fosters the understanding of how advanced health care can improve the lives of women and their families.

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Jalaukaas in coronary block (Bypass to Bypass Surgery)

- Prof. Dr. Muralidhar P. Prabhudesai
M.F.A.M., A.V.P.
Ex- In-charge, Panchakarma Dept.,
Bhaisaheb Sawant Ayurvedic Medical College,
Sawantwadi, Dist. - Sindhudurga, Pin - 416510.

Case report of a pt. with IHD with TVD

Date - 9 March 1995
Name of the pt. � xyz
Age � 65yrs.
Sex � M
Chief Complaints � Dyspnoea on exertion (on walking a few steps, even after talking few words)
- Constipation, passes hard stools after 5-6 days interval
- Poor appetite
- Weakness
- Chest-pain
- Oedema over feet
- Hypertension
- Tingling in Lt. palm
- He used to get up in midnight due to chocking sensation in chest
- Feeling of some swelling (heaviness) in Lt. side of chest
- Consumes lots of Angised / Sorbitrate tabs. per day while walking or talking (20-22 tabs. in a day)
O/E � B. P. 220/110, Pulse � 102/min., Wt.- 59.5 Kgs., Jeevhaa � Saam, Koshtha- Krur, Agni- Manda, Nidra- Khandita, Bala- alpa, Ubhaya Paad-shotha- ++, Twak-sparsha - rookshata ++
Psychologically he was so depressed; he thought that he will never come out.
Past History � This pt. was serving in State Transport (Maharashtra) as Stand �in charge. Due to tight schedule of duties, he was not able to pass urine, whenever mootra-vega was there. As a result of which he developed urinary stones. He had heart-attack in 1980. His CST revealed ischemia. For investigation, he had undergone angiography in Feb. 1982, in Bombay Hospital & he was found to have 12 coronary artery-blocks (five in Rt. Coronary & seven in Lt. Coronary). Due to so many blocks, he was not allowed to undergo bypass-surgery. He was kept on conservative treatment (11 types of tabs. per day) and was admitted in the hospital for 4 mths. & was advised Tab. Angised and/or Tab. Sorbitrate SOS. He resumed his duties as he got little relief.
Due to chronic constipation he used to take Tab. Dulcolax 4 + Patankar Kadha (Laxative) � a cup + Kayam Churna (laxative) 1 tsf, very often. Even then he was not satisfied with his bowels (He got relieved temporarily).
After retirement (during 1992 - 1995) again the symptoms got aggravated for which he consulted many physicians but every time there was addition of medicines, without much relief.
He also was detected to have Diabetes mellitus.
Samprapti � Sedentary work (no shareerayas) � malavarodh & waramwar mootravarodh � apaan vaigunya � pratilom gatitah samaan vikruti � aama nirmiti � due to constant mental strain �Kha-vaigunya" in heart (which is moolasthana of Rasavaha & Manovaha srotas) � sthaan-sanshray of aama there � resulting in blocks � again malavarodh due to the medicines given for the ailment & the vicious circle went on. At the same time, Vyana Vayu-dushti (vyano hrudi sthitah�) & Udan-dushti (urah sthanam udanasya) - resulting in bal-hani - shram-shwas & vikruti in vak-pravrutti, prayatna, bal, warna and as mind was involved, due to various tensions (Hrudayam manasah sthanam), he lost his confidence & urja.
Diagnosis - He was diagnosed to have IHD with triple vessel disease + diabetes
With all the medications above, he was not satisfied with the treatment; as he had no much relief.
After retirement again the dose of Tab. Angised & Tab. Sorbitrate was increased since last four years.
After going through his huge file we thought to put him on Shaman (conservatory) treatment, along with the treatment he was advised, initially.
Initial treatment: Abhyantara Chikitsa-
1) Gandharva Haritaki 500 mg. twice a day before meals (apaane)
2) Arogyavardhini Vati 500 mg. twice a day after half of meal (samaan kale � as Munchan karya of Samana vayu was affected) thinking that Kutaki in the formula will do Bhedan of the hard stool. This drug is also Deepak & Pachak, which was expected in this patient.
3) Arjun & Punarnava-mool Quath, 4 tsf after meals (Vyaanodaane) with madhu (which is yogavahi), as anupan. Arjuna is well known for its specific role in Hrudroga. Punarnava is Shothghni & is useful in Hrudroga also (- Dhanwantari Nighantu). Hruday is awasthit sthan of vyana-vayu & this vayu is responsible for Ras-Rakta Samvahan. Vak-pravrutti, bal, urja (which were affected in this pt.) are under control of Udana-vayu, which has its awasthit sthan in Uroguha. So this medicine was given in vyaanodan kale)
4) Shankh Vati SOS ( as the pt. had aadhmaan due to malavarodha)
5) Snehan � As the Pt. was Vata-prakruti according to his age & he had Krura Koshtha & the rutu that time was with vat-prakop (kaalatah) -
1. Abhyantar � Ghrut Sevan (As usual, I had to spend about 15 minutes to convince the pt. about this concept)
2. Bahya - Mahamaash Taila
6) Siddha Jalapaan - Vidang-jeerak-siddha agnisanskaarit Jala (Vidang is Krimighna, which is needed in our area, where people used to drink water from well or river & Jeerak is deepak � Pachak & grahi, so dravashoshak, as the pt. had pedal oedema (udakavah srotovikruti)
7) 4 tsf of Castor Oil at every night, with lukewarm water.
8) Aashwasan Chikitsa - This is very important to support pt.'s positive attitude, especially when dealing with chronic pts. Vaidya should always create confidence in pt.'s mind that he will definitely come out. This helps to modify the state of mind from 'heen' to 'pravar' Satwa. (This is little easier for senior, bald headed Vaidyas).
He was advised to have light meals till his appetite was improved.
After a fortnight when he came for follow-up he was little happy to have bit easy evacuation of his bowels. His appetite was also improved a little more. He was able to reduce the no. of Angised & Sorbitrate by about 12-15 per day.
The same treatment was continued for another fortnight. His symptoms got aggravated in May 1995 after eating Jambu-fal (which is madhur-kashaya rasa pradhan & kashay-ras is known to cause dhamani-sankoch), so he had to increase the dose of Angised & Sorbitrate & as he had a little choking sensation due to �Durdin� in June 1995, (because of which he had to increase dose of Angised & Sorbitrate) he was advised to fumigate his bedroom with Vacha & Dhoop.
Then he was admitted in our hospital for Basti-treatment. He was given snehan, swedan & matra-basti of ground-nut oil 60 ml. (in those days Siddha tailas were not available in our area, as nobody was practicing Panchakarma, so we decided to use this oil, as it was freshly prepared in our farms), while going to bed every night for five consecutive nights. (This matra-basti yojana was advised to his on the basis of his 'vat-pradhan age' & malavarodhajanya (i. e. margavarodhajanya) samprapti.) Then after a gap of 2 days (to avoid sneh-saatmya) again matra-basti was repeated for another five nights. After these two courses of matra-basti there was remarkable improvement in his complaints & could get confidence that he will come out of it, soon. But till May 1995, he was not relieved of his chest-pain & he still had to wake up in midnight due to uneasiness in chest & tingling in Lt. palm.
By that time, one of my friend sent me an article from Reader�s Digest (Aug. 1995) titled �Welcome back little blood-sucker� by Alan Road. My friend knew that we were applying leeches for various ailments, in our practice. The article said that �Even though, the leech will suck for only 20-30 minutes bleeding may continue for several hours or so; clearing the most challenging blockage � � on page no. 82. "Their saliva contains a powerful enzyme capable of rapidly dissolving blood-clots", - on page no. 83. After going through these lines we remembered that our texts, Ashtanga-Hrudaya & Sushrut-Samhita mention the same �
1) Avagadhe Jalaukasaa����. - A. H., Sutra. 26/54
2) Grathitam Jalajanmabhi: ���..- A. H., Sutra. 26/53
3) Awagadhe Jalauka syaat�� - Sushrut., Shareer., 8/26
Meaning that, leeches are indicated in cases of blood-clots or thrombus.
And then an idea struck my mind � to apply leeches directly over the chest. We discussed our idea with many, but nobody had tried this type of application.
On 07/09/1995 - Pt. told that he was satisfied with his bowel-motions, even after consuming four tsf of Castor Oil, on alternate days. His B. P. was 150/80 mm of Hg.(in spite of stopping all his anti-hypertensive drugs; as he showed signs of hypotension on continuation of the drugs. May be because main cause of hypertension, i. e. tension about his own health, was reduced to a marked extent), Pulse-rate - 78/min. Wt. - 57 Kgs. (as he had no pedal oedema, any more)
We shared the above idea with the patient & after his written consent we decided to implement this novel idea.
On 25/09/1995 - Pt. was admitted in evening. We gave matra-basti of 50 ml. of groundnut-oil, at bed-time.
Next day, on 26/09/1995 we applied five leeches. The leeches left him after about 6 hours. But to our astonishment he had sound & undisturbed sleep that night.
Having encouraged by this result we applied leeches repeatedly after a gap of about a week or two and sometimes after a month even, & day by day the patient showed marked improvement.
Jalauka-application was repeated in Jan. 1996, Feb. 1996 & in April 1996. During all this period he was very happy with Shankh Vati. (It is very easy to know the 'Karmukatwa' of this Vati, as it created 'Vatanuloman' in this pt. so he got relieved with it.) He used to call it - 'a magic pill'.
Again his symptoms were aggravated in June 1996, when he went to meet his only son in Mumbai, so again dose of Angised/Sorbitrate was increased a little. This might be due to the atmospherically polluted conditions in Mumbai. This time we advised him to do Asanas like Pavanamuktasana, Shawasan, & Pranayamas.
By September 1996, his confidence & especially stamina was regained. Tingling sensation in his Lt. palm was stopped, he was able to enjoy undisturbed sleep at night and he was able to walk 5 kms. non-stop & he was able to climb about five stair-cases, initially after resting a while & then many a times without Angised or Sorbitrate. The intake of Angised & Sorbitrate was reduced to maximum two tabs. daily.
Encouraged by the results we decided to investigate the patient by repeating his angiography. After trying a lot we found a source. Fortunately, the head of cardiology department of KEM hospital agreed to carry it out through the donations collected every day, as a special case of research.
After the due schedule of appointment etc. the angiography was carried out, in June 1997, but to our astonishment the reports mentioned that all the previous blocks were increased in size. And naturally the HOD of the department was very annoyed, even though the patient was feeling relieved a lot than before.
After thinking a lot over this case, we came to realize that the previous angiography was done about 13 yrs. ago, when the pt. came to us for the first time. By that time, during those 13 years., many changes must have taken place, which were not on record. This was the main reason why we were unable to present the case, in a conference before Modern Medical Experts, even though there was marked clinical improvement.
This improvement was realized by a Senior Cardiologist in our area, whose advice was sought by the pt. repeatedly, before coming to us. While consulting the case before him, the Cardiologist remarked - "if this is proved, we will have to change all our concepts regarding modern anatomy & physiology��".
The pt., who was told that his life span is not more than 6 months, was awarded a bonus life of 7 more years, that too a pleasant life without any physical or mental stress & he was able to enjoy marriage ceremony of his only son. All this was possible for him because of the Ayurvedic way of thinking. He passed away in 2002, peacefully and without any physical or mental strain.
Many a times it so happens that after Ayurvedic treatment the lab. reports remain unchanged, but the pt. is relieved symptomatically. So, the new entrants in Ayurvedic Stream should take a note of this.
Our Observations in this case -
1) We applied jalaukas for about 12 times, after a gap of at least 8 days.
2) We avoid to take pricks with needle, to apply jalaukas, as we do not like to interfere with their inherited wisdom ( of course, allotted to them, by the God) to seek the site to prick & surprisingly, all the jalaukas applied, sought left lateral part of sternum to suck the blood. Not a single pricked over the central or right lateral part of sternum.
3) The jalaukas took too much time to leave pricked area; many of them took even 7-8 hours, initially. The admitted pt. could move here & there, with one hand over the moist gauze-piece, used to cover the applied jalaukas. (We do not force the jalaukas to leave the site, by applying Haridra or similar����.)
4) Almost all the jalaukas applied initially, vomited dark, very thick, sticky, tantumay & shleshmala blood, while squeezing. It was very difficult to to squeeze them to drain the vitiated blood sucked by them, as a result of which many of the jalaukas, applied initially, were dead after the very first application.
5) The initially squeezed jalaukas got globular & multiple sacs like appearance, as those were not drained properly.
6) Though the pt. was known diabetic healing of the tiny prick wounds took the same time, as in a normal person. (During my professional experience, for last 41 years only, I have come to the conclusion that usually, diabetes cannot be in the list of contraindication for Jalaukawacharan, except in pts. with very high BSL level (above 500 mg/dl.)
7) Not a single Jalauka pricked the same site again for sucking blood.
While concluding -
Whatever relief we could give in this case, the credit goes to the
- Our Gurujan, who gave us inspiration & the 'vision' while thinking about a disease, through Ayurvedic way
- The Samhita-granthas, which guided us from time to time
- "Bhishak-vashyataa" of the pt. who obeyed honestly, each & everything we advised, ( like consuming Eranda-taila daily, preparing quath every day, taking medicines regularly, performing daily asanas and pranayamas, observing the pathya very strictly) and
- The well-wishers like you all.
Actually, we had taken lot of risk to admit the pt. in our clinic, where no major emergency measures were available, there was no 'official' Dr. available in the area of 10 kms. radius, except us two, primary health care center was about 16 Kms. away. So, any emergency situation could have created lot of problems for us. With the blessings of The God Dhanwantari we did not had to face any problem.
To be frank, 'the bye-pass surgery' is a bye-pass to treatment, as the surgeons don't treat the cause. They just give a way to the obstructed flow of blood. They never give guarantee that surgery will prevent further blocks. If this is so, then why not try some other ways like one described here? Perhaps, this, low cost effective remedy, may prove to be an alternative for bypass surgery.
This was possible to accept this kind of case, because the pt. showed full faith with us & he had no other alternative because of his poor financial status.
If this story inspires anybody to try such cases, we will definitely help him/her with our limited capacity. I wished to get attachment to some institute with a large no. of OPD pts., to show positive results in various cases, but I failed to do it. (Dant-Chanak Nyaya).
So friends, I conclude here & wish you all the best in your general practice with Ayurvedic vision.
|| Sarve atra sukhinah santu ||


Contact :
Prof. Vd. M. P. Prabhudesai
Sawantwadi, Dist. - Sindhudurga.
Maharashtra, India. Pin - 416510
Mobile - +919422435323
e-mails - vdmurali13@gmail,com . . . . . . . . . . . . . . . . . . . . . . . . . dr_murali13@yahoo.co.in

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In a brief conversation, a man asked a woman he was pursuing the question: �What kind of man are you looking for?�
She sat quietly for a moment before looking him in the eye & asking, �Do you really want to know?� Reluctantly, he said,�Yes.�
She began to expound�
�As a woman in this day & age, I am in a position to ask a man what can you do for me that I can�t do for myself? I pay my own bills. I take care of my household without the help of any man�or woman for that matter. I am in the position to ask, �What can you bring to the table?��
The man looked at her. Clearly he thought that she was referring to money.
She quickly corrected his thought & stated, �I am not referring to money. I need something more. I need a man who is striving for excellence in every aspect of life.� He sat back in his chair, folded his arms, & asked her to explain.
She said, �I need someone who is striving for excellence mentally because I need conversation & mental stimulation. I don�t need a simple-minded man.
I need someone who is striving for excellence spiritually because I don�t need to be unequally yoked�believers mixed with unbelievers is a recipe for disaster.
I need a man who is striving for excellence financially because I don�t need a financial burden.
I need someone who is sensitive enough to understand what I go through as a woman, but strong enough to keep me grounded.
I need someone who has integrity in dealing with relationships. Lies and game-playing are not my idea of a strong man.
I need a man who is family-oriented. One who can be the leader and provider to the lives entrusted to him by God.
I need someone whom I can respect. In order to be submissive, I must respect him.
I cannot be submissive to a man who isn�t taking care of his business. I have no problem being submissive�he just has to be worthy.
And by the way, I am not looking for him�He will find me. He will recognize himself in me. Hey may not be able to explain the connection, but he will always be drawn to me. God made woman to be a help-mate for man. I can�t help a man if he can�t help himself.�
When she finished her spill, she looked at him.
He sat there with a puzzled look on his face. He said,�You are asking a lot.�
She replied, �I�m worth a lot�.

TRUE SELF AND NAMASMARAN: DR. SHRINIWAS KASHALIKAR

Student:
Sir! What is true self?
Teacher:
When we refer to self; it usually embodies and connotes a mixture of instincts, feelings, thoughts and vision, associated with the metabolic reactions, hormonal interactions and effects of neurotransmitters. All these interact continuously with the environment (The environment may be internal or external. Further; it may be; physical, chemical, biological, psychological, social, cultural or political. When it is characterized by people in the process of realizing true self; it is called spiritual environment). Thus; self with specific characteristics is recognized as a person; and said to be born and dead; distinguishing it from the body. The biographies do not describe merely the body; of an individual; but describe in details all above!
An object with three dimensions has a beginning, an end, a form and an identity. The space, which occupies; the inside and outside of that object; has a beginning and end. It has a form and an identity related to the object which it occupies from within and from outside.

Further; the time, which occupies a beginning, existence and end of an object; has also the identity of that object! For example; the time characterizes a house; as a 50 year old house! The period has an identity. The time that occupies the birth, life and death of an individual also has an identity. We call it the life of an individual.

Further; an individual human consciousness is associated the matter, the interactions, the energies, and the space and time; occupying all these! with
Self is associated with all above and it has a distinct identity.

True self is beyond all that has been referred to above! It is inside as well as outside. Our final destination is this true self. At one time or another; every one inevitably gets dissolved in the true self. Here the separate identity is dissolved in the cosmic consciousness and we lose separate and shackling existence. This is God; described with either no attributes or infinite attributes!
Student:
How to identify this true self?
Teacher:
The true self is the final and supreme controller. Since it has no form, no characteristics and no attributes, by which we can identify Him! However; He has descended in the consciousness of few; as NAMA and enthralled them with His attraction (ARTA, JIJNYASU, ARTHARTHEE, and JNANEE), remembrance (NAMASMARAN), orientation (ANUSANDHAN) and merger (MOKSHA)! Following them is the way of identifying and merging with true self!

AIDS / HIV & HEPATITIS C INFECTION: RECENT TREATMENT MODULE OF TREATING HIV AND HEPATITIS TOGETHER WITH SOFOSBUVIR

PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST
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Hepatitic C is a silent infection like HIv and is common with many patients of hHiv particualrly those are IV DRUG USER OR BLOOD CONTAMINATED.WITH HEPATITIS C HIV MUST BE TREATED FIRST AS START ANTI HIV TREATMENT OR ARV MEDICINES FIRST KEEP VIRAL LOAD OF HIV LOW AND CD4 COUNT MORE FOR BETTER RESULTFOR HCV CURE.
Hepatitis c produce cirrhosis of liver and liver cancer if not treated,we decide to treat it when we see that Liver function of patient deteriorates,Features of cirrhosis like Pedal Oedema,Black spots,Dilated abdominal Veins,Piles or oesophageal varices with Ascites or fluid in abdome with splenomegaly starts and cirrhosis confirmed by either Biopsy or Fibroscan or Usg or we see features of cancer then we resect this liver and transplant new one and with it we treat hepatitis c too.
so,if liver enzymes alters or fetures of cirrhosis starts of if HCV viral load IU/ML OR COPIES/ML(1IU/ML=7COPIES/ML) seen in good concentration and patient opt for therapy as if treatment taken completed than unlike HIV,HCV is curable after 12-24 wks now with sobosfuvir and previously 48 wks without sofosbuvir SVR (SUSTAINED VIRAL RESPONSE) OR VIRAL LOAD ZERO OF HCV IS POSSIBLE
we see that what type of HCV it is as Genotype 1 or 1A or 1B or type 2,Type 3 or type 4 .Genotype HCV 1A and type 4 are hard to treat they need peglyated Interferon with Ribvarin for 24-48 wks with Bocprevir and telaprevir either if alone or with HIV but with Sofosbuvir now it is found that interferon-free regimen of sofosbuvir plus ribavirin for 24 weeks led to sustained response in three-quarters of previously untreated people with genotype 1 hepatitis C and HIV co-infection in the PHOTON-1 study,and 12 wks therapy for type 2 but for type 3 also a course of 24 wks needed like type 1A not shorter 12 wks as for type 2 as we think type 2 and type 3 are easy responders.according to a report at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this week in Boston.

People with HIV/HCV co-infection experience more rapid liver disease progression and do not respond as well to interferon-based therapy as people with hepatitis C alone. Direct-acting antivirals like sofosfuvir or SOVALIDI or PREVIOUS KNOWN GS-7977 that target different steps of the HCV lifecycle offer the prospect of shorter treatment, fewer side-effects and higher cure rates for both HCV mono-infected and HIV/HCV co-infected patients.In less advanced case or type 2 or type 3 simprenavir can also be tried.Previous to this costly Sofosbuvir (ruprees 50000 dollars for one month )but pegylated Interferon is very toxic and cannot be easily tolerated by every pateient previously we were using INTERFERON ALPHA 2a OR ALPHA 2b which dose was twice a week but now pegylated once a week injection,Ribarin in dose 0f 1000-1200 mg as per body weight and Sofosbuvir 400 mg once a day only.